Expert: Dr. Nekessa Remy - 11/11/2011

Question
i have quite a serious back problem

with stuff such as slight 9 degrees scolosis

3 prolapsed discs of the lumbar

at l3-l4, l4-l5. l5-s1

spina bifida occulta at l4 with a asymetrical facet


si joint right side dynfucntion

now i have very well minimized the once hell pain i was in all the

time from much posture correction and working on exacting muscle

endurance increasing excersizes of the back and glutes

and much foam rolling for the myofascial release of the said TrPs

but one problem remains

when i sit down on hard chair or seat many times only the

right side toes the bottom of them get numbs and it is

pins and needles

the options are

one of the prolasped discs touching but which one

would it be l3-l4, l4-l5, l5-s1?

as they all have an exact pain pattern to

different areas of the leg



or is it just that one piriformis muscle that is squeezing

the sciatica nevre thus this pseudo sciatca?

or something else?

and any idea what i could do to stop this from happening

i find it interesting that it is always the right side

and always to the underside of the toes goes numb

but i think sometimes if even a longer time the whole foot

going numb

but it always is the right side and it only happens when

sitted never have i had from standing

thanking you in advance

Answer
Hello,

To start each disc prolapse does have a specific referral pattern.
L3-4 - the L4 nerve is affected and will cause pain along the medial calf.
L4-5 - the L5 nerve is affected and will cause pain along the outer side of the thigh and the front of the calf into the big toe
L5-s1- the S1 nerve is affected and will cause pain along the back of the calf and the outside of the foot (pinky toe)

Disc herniations usually occur laterally and affect one side of the body.

Sitting causes compression of the discs, please pay attention to your thigh and leg pain/discomfort. This will help isolate a specific disc segment.  if your entire foot goes numb then chances are all of the discs are being compressed or the sciatic nerve is being compressed by the piriformis. To differentiate between the two you need a physical examination. without physical and neurological testing I can not determine the specific cause.

I suggest you get treatment, which includes stabilization training. Specifically, work on the transverse abdominus. This will help to strengthen your back. Also, speak to your physician about the Mckenzie protocol, it a active therapy geared towards treating disc derangement. These exercises can also be done at home.

Good luck!