Expert: J.R. Strecker, B.S., D.C. - 6/9/2008

Question
I had an MRI that indicated I had a 5L S1 herniated disc with disc material completely blown from disc.  I have had numbness and pain in my left hip, leg, foot, toes since my injury 5 years ago that hurt my back.  Lately, I tend to have these very painful muscle spasms or charlie horses in  the back thigh portion of my left leg and in my left ankle.  It hurts so bad at times, I feel it will actually break the bone inside my leg.  The left foot is never completely still.  There is constant jerking and my toes will pull and curve inward like I'm having a foot cramp but it doesn't hurt as bad as the charlie horses in my leg.  It just drives me crazy jerking all the time.  At times, my legs have random sharp pains in different areas that feel as if someone has stabbed me with an ice pick.  Most nights, my left ankle hurts so bad, like an abrasive hurt, as if I had actually scraped my ankle bone, and I have to turn in a position so as not to allow my ankle to touch anything.  Even a soft pillow feels painful to the touch on my ankle.  What is causing this and how can I fix it?

Answer
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Hello P.,

I'm sorry to hear about your discomfort.  Since your back injury was five years ago, and because your disc material was completely blown from the disc, it is doubtful that the McKenzie extension exercises or traction protocols will do much to alleviate your pain.  However, it's worth a shot.  The best thing you can do is talk to a knowledgeable chiropractor or physical therapist to give you some exercises to rehab your back along with a treatment protocol.

It sounds like obvious nerve pain, but the jerking of your leg makes me also wonder about restless leg syndrome.  Regardless of the primary diagnosis, it seems clear that your leg nerves are irritated.  There are some supplements that can help, but first and foremost, check with your doctor.  It is important that you have been evaluated and are being managed by a licensed doctor.  With that said, some things to know nutritionally is that the B-vitamins are usually very good for nerve problems.  Sometimes B-complex is enough; sometimes it's not.  B12 is an especially important B vitamin for nerve pain.  Fish oil is a good supplement to help with inflammation, along with ice therapy.  Magnesium is also a good supplement.  Sometimes you can find a good Calcium/magnesium supplement, which work well together for musculoskeletal pains.  The calcium/magnesium is also going to be one of the better supplements for your muscle spasms, possibly ridding you of the spasms altogether.  Vitamin E can also be beneficial for nerve pain.  Regarding the nerve pain, it is also advised to limit your caffeine intake.  I would recommend talking to a naturopathic doctor or certified nutritionist to determine an appropriate balance for your needs.  

Keep in mind that disc problems are mechanical problems.  Taking supplements will only help you tolerate the pain.  Sometimes when the injuries to the disc are severe enough, surgery is the only option.  I don't know the extent of your symptoms or the herniations, so I'm not qualified to make any recommendations like that.  The best thing you can do is get a few different opinions from different doctors, maybe even an orthopedist as well.  If the spasms turn into a weakness of the leg or muscle, it can become more of an emergency, so as mentioned, make sure you are addressing this under the care of a doctor.

I hope this helps a bit.  I've tried to be as specific as possible without actually evaluating you.  But as always, check with your doctor.

Best of luck!
Dr. J.R. Strecker, D.C.