Question
i have quite a serious back problem

with stuff such as slight 9 degrees scolosis

3 prolapsed discs of the lumbar

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 interesting 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

now what do you think this is i think the options are

one of the prolasped discs touching but which one then

as awhile ago i did see somewhere that if one knows where the

refered pain is exactly in the leg then the exact said ie

l4-l5 disc could be identified

as apparently the all leave an exact path of pain

or is it just that one piriformis muscle that is squeezing

the sciatica nevre thus this could be 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

thanking you in advance

Answer
Thank you for your question.

While I can't provide you with specific treatment advice over the Internet, in general, prolapsed discs in the lumbar spine that compress spinal nerve roots and cause lower limb symptoms most likely need to be surgically dealt with. Signs of neurological compromise which generally require emergency surgery include loss of control of the bladder and bowels, severe lower limb weakness (inability to bend the foot toward the head or walk), and numbness in the groin and inner thighs.

True sciatica tends to produce leg pain in the back of the leg that extends below the knee. Sciatic nerve symptoms may be produced by lower spinal nerve root impingement or by entrapment of the sciatic nerve by the piriformis muscle.

I assume that you have already had a recent MRI scan of the lumbar spine to quantify the level and extent of disc prolapse. Prolapsed discs represent failure of the integrity of the fibers of the disc to maintain the disc in its normal anatomical boundaries; you likely have suffered from progressive degenerative disc disease, which usually is the prelude to degenerative joint disease. Depending upon the extent of the herniation compared to your physical examination findings (especially regarding any loss of muscle strength in the lower limbs and/or reflexes), there may not be much of the disc left to rehabilitate conservatively.

Please see the following article for more information on lumbar disc herniations and treatment options:

http://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc

If you have had low back and leg/foot symptoms for greater than six weeks accompanied by severe pain or loss of proper limb function, and you have pursued aggressive physical therapy, you should see a medical physician for a surgical consultation.

I hope that this helps to answer your question.