Quote:
Originally Posted by Mxfrank
Since we'e all tinkerers, it's helpful to think about the mechanics of this problem. Your spine is composed of many bones, separated by flexible "disks". Each bone has a name and number depending on it's location: the cervical bones at the neck, the thoracic bones in the middle, the lumbar bones in the lower back, and the sacrum at the pelvis. So when your problem is correctly diagnosed, the specific joint will be identified, like L5/S1, being the joint at the top of your pelvis. The disks are like inner tubes: they have a tough skin and a spongy interior. The spinal cord runs through the center of the tube. Strain can cause the skin to weaken and then the disk bulges. It can touch the spinal cord or the nerves that radiate from the cord, and that causes pain or worse, loss of nerve function. If the tube tears, the spongy insides can extrude into the spinal column and cause more complicated problems.
If the damage isn't too bad, stretching exercises or chiropractic manipulation can push the bulging material away from the spinal cord, and you have relief, maybe permanent, maybe temporary. Sometimes the bulged area will shift by itself by natural process, or relaxation. And sometimes, the pressure on your nerves simply can't be relieved without surgery.
Surgery shouldn't be undertaken lightly. Although it's a pretty common surgery these days, a surgeon going around your spinal cord with a cutting tool can easily do permanent damage. So you only want to do this as a last resort. Some of the things that would move you to surgery: chronic pain that can't be relieved by any conservative therapy. Weakness, numbness, or tingling indicating nerve damage. Pain that doesn't change, regardless of your position. Surgery can be very successful, but can also be disastrous, so don't be naive. Surgery can be done by a neurosurgeon or an orthopedic surgeon, but you want to check out your provider as best you can.
You should speak to a neurologist before considering surgery, not a GP, PCP, or orthopedic doctor. The neurologist is equipped to evaluate the extent of nerve damage and will order the correct radiologic studies. The neurologist will refer you to a surgeon if it's warranted.
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All good stuff to consider. My PCP is pretty good, pretty sure she would insist that I see a neurologist first. I phoned her office and her assistant got back to me saying they had just started physical therapy at the clinic and was I interested in checking it out. I'm going to give it a go, I can always add in more yoga later. For now my improvement is ongoing. Really great to be able to use my right leg mostly normally again. But I'm not out of the woods yet. I still wake up with weird cramping pain that won't go away like I can usually get cramping pain to go away.
I had arthoscopic rotator cuff surgery in 8/'16 and it worked out very well. But I don't want to get surgery-happy, cutting near the spine is indeed another matter as you point out.
I had an encounter years ago - '77 - with a young man who had experienced nerve damage during surgery. I was in the UW hospital for 10 days after a severe break of my left fib and tib - had a fasciotomy to relieve swelling and a tibial nail inserted. Towards the end of my stay I got a new roommate, around 19 or 20 IIRC, I forget what the surgery was that incurred the damage, he referred to it as they accidentally 'nicked a nerve,' Something to do with his bladder, he no longer had the ability to send the signal to his bladder to let the pee go. He had to cath himself several times a day (!?). His stay at that time was for experimentation into what pharmaceuticals might allow him to regain control of that. What did I know but privately I wasn't opimistic on that score.
I have yet to cath myself once, I'm not sure it's been done to me during anesthesia even, maybe it's not as annoying as I think it would be, but dang, it's hard to imagine needing to do that from age 20 on - every time you need to pee. I forget what it was like back then, I know now that if I'm way full I have hard time holding it back but I'm not sure it works that way when you're younger.
At any rate, that episode comes to mind now and then and I think 'count your blessings.'