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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed Herniation With Severe Nerve Root Compression, Poor Ankle Reflexes, Pain. Can It Heal By Itself Without Surgery?

I was diagnosed 2 months ago with large l5s1 herniation with severe nerve root compression and significant DDD at that disc. Treated for 2 wks with acupuncture but a twist renewed the agony. Symptons were poor ankle reflexes unable to toe rise and painful sciatica .. Surgery was arranged for 4 days later however the feeling started to return and could do tow rise on morn of surgery so surgeon postponed ... This was 5 wks ago. I still have skin numbness at back of leg and last two toes and am very limited in what I can do. I take 100 mg anti inflamm a day stopped other meds 3 days ago. Can a large herniation heal by itself. I am usually a fit healthy perso. (yoga 2 a week cardio and weights 3 timesaver week) there has been improvements in mobility etc. anyway 36 female 126 lb 5'3 .. I should add that I didn't get the MRI for 2 wks and only had acupuncture and paracetamol for pain relief during that time the onslaught of sciatica was horrendous and fast but improved !!
Wed, 17 Apr 2013
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Ayurveda Specialist,  's  Response
1. L5,S1 herniation is either due to Trauma or bad posture (postural dysfunction), please specify your's?
2. because DDD (degenerative disc disease) is there, probably weak inter-vertebral disc due to poor posture can be the the cause (only proved otherwise), and L5,S1 is the commonest site for herniation.
3. Compression of sciatic nerve has lead to Sciatica, L5 nerve impingement has lead to numbness and causes weakness in extending the big toe (foot drop),whereas S1 nerve impingement results in loss of ankle reflex (patient cannot do toe rises).
4. Any bladder/bowel dysfunction?
5. have you consulted for Osteopathic/chiropractic manipulation?
6. Symptomatic disc herniation rarely heal on their own, but before opting for surgery, please consult a physiotherapist (PT)for the same, but before that make sure you get an MRI done of the spine to rule out any STENOSIS, which could result in edema and MASSAGE given by PT will further aggravate the symptoms.
7. If you are insured,check with the Insurance company about the same.
8. If pain and symptoms continue, consider microdisectomy or lumbar herniated disc surgery.
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Internal Medicine Specialist,  Dr. Andy Fine's  Response
greetings friend, sometimes large herniations can heal by themselves with yoga and stretching and time and anti-inflammatories like steroids orally. I think if you are not in severe pain and can tolerate I would recommend against surgery until he cannot tolerate the pain any longer. The outcomes on these kinds of surgeries are very variable, sometimes people are worse, sometimes people are better, but you already have scar tissue and hardware put in during the surgery and this often relates to chronic back problems for the rest of your life. Go the conservative route first without surgery if you can. Have a great day.
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Diagnosed Herniation With Severe Nerve Root Compression, Poor Ankle Reflexes, Pain. Can It Heal By Itself Without Surgery?

1. L5,S1 herniation is either due to Trauma or bad posture (postural dysfunction), please specify your s? 2. because DDD (degenerative disc disease) is there, probably weak inter-vertebral disc due to poor posture can be the the cause (only proved otherwise), and L5,S1 is the commonest site for herniation. 3. Compression of sciatic nerve has lead to Sciatica, L5 nerve impingement has lead to numbness and causes weakness in extending the big toe (foot drop),whereas S1 nerve impingement results in loss of ankle reflex (patient cannot do toe rises). 4. Any bladder/bowel dysfunction? 5. have you consulted for Osteopathic/chiropractic manipulation? 6. Symptomatic disc herniation rarely heal on their own, but before opting for surgery, please consult a physiotherapist (PT)for the same, but before that make sure you get an MRI done of the spine to rule out any STENOSIS, which could result in edema and MASSAGE given by PT will further aggravate the symptoms. 7. If you are insured,check with the Insurance company about the same. 8. If pain and symptoms continue, consider microdisectomy or lumbar herniated disc surgery.