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June 7, 2005
Back Pain - MRI of Zack's Back
Six years ago I had back surgery, an L5-S1 microdiscectomy to be precise, performed by neurosurgeon, Dr. Bruce McCormack (who I highly recommend). Until four weeks ago I felt great but then something went wrong. I couldn't get off the ground. Muscle spasms down my left leg, numbness along the outside of the left and severe sciatica.
For those who don't know, sciatica is actually a symptom and not a diagnosis. The term literally means that a patient has pain down the leg from compression on the sciatic nerve. The diagnosis is what is causing the compression (such as a disc herniation). The sciatic nerve is the largest single nerve in the human body; it runs from each side of the lower spine through deep in the rear and back of the thigh, and all the way down to foot, connecting the spinal cord with the leg and foot muscles. Most often, sciatica pain is caused when the L5 or S1 nerve root in the lower spine is irritated by a herniated disc. When this happens, pain radiates into the rear and back of the thigh and calf, and occasionally may extend down to the foot.
S1 nerve impingement from a herniated disc may cause loss of the ankle reflex and/or weakness in ankle push off (e.g. patients cannot do toe rises). Numbness and pain can radiate down to the sole or outside of the foot.
There are several different causes of sciatica. You can tell which neve is being pinched by where the effects (tingling/pain) are felt. Mine are on the outer leg and go down to the foot, and my two left toes on my left foot are numb.
I've been working with an excellent hanna somatics practioner Kristin who has helped relieve most of the pain, but the radiologist I spoke to about my MRI suggests that I may need surgery again. I busy taking care of my back by doing my somatic exercises which are amazingly powerful. I'm optimistic that I can retrain my chronically contracted muscles and be able to work, run and the have freedom of movement that we all expect, but don't appreciate until its taken away. I'll let you know how I am progressing. Until then...get up out of your chair, step away from your screen, walk outside and enjoy your freedom.
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