AIBU To Be concerned about overtreament of Back issue - L5 Nerve.

[outofbreath]

A few weeks back I had some back pain. About that time I noticed the top/side of my foot felt quite numb.

Went to the docs, he suggested the L5 nerve might be being compressed. (He showed me the nerve diagram and it's clearly that nerve.) He said an NHS patient wouldn't get to see a consultant for that but since I have private healthcare through work he referred me.

Now I'm getting concerned. I'll probably get scanned and they'll probably find the disc is a bit saggy or whatever, but what then? I doubt it's worth an operation so I'll just have a formally diagnosed back issue which it might be better not to know about until it worsens.

Maybe a bit of numbness is normal for a 53yo and exercises or physio would be more appropriate and a consultant is being involved way too early?

I'm not even sure how numb it really is. It feels numb but I haven't tried jabbing a pin in. Maybe I'm imaging the numbness?

The back pain lasted less than a week. I've had similar occasional lower back pain periodically for years. I've always though that was fairly normal.

YABU: This requires a consultant's opinion.

YANBU: By all means see the consultant, but a bit of foot numbness is pretty standard for middle aged people and a physio or excecises are all you really need. Just live with it.

I'm not quite sure what youre worried about by being diagnosed and treated.

Think if you were the Princess of Wales, do you imagine if she had a problem with back pain and numbness, there would be any delay in being seen, diagnosed and given appropriate treatment?

If your foot isnt numb in normality, then there is no pathway that should be "get over it your 50 now".

Think if you were the Princess of Wales, do you imagine if she had a problem with back pain and numbness, there would be any delay in being seen, diagnosed and given appropriate treatment?

Interesting you should cite Princess Diana because high profile patients absolutely do get overtreated: Google "VIP Syndrome" or RPS.

I'd not heard of VIP syndrome before, thank you.

My view would be go see the consultant, see what they recommend, at that point make your assessment whether you think its an overtreatment recommendation.

It could just be a recommendation for stretches daily and a referral to a physio for information or it could be they suggest an MRI and back surgery; you dont know the diagnosis and potential treatment until you've had that conversation.

Or just go on YouTube and get the stretches, see if it improves in a week.

But I stand by if it wasnt numb in your 20s then numbness isnt normal just because your now in your 50s; yes it might be stretches you need, but you dont know those stretches yet.

Yeah, and I've been told in the past Neurolgists are more conservative than an Orthopedist who are (allegedly) a bit more gung ho. So hopefully he won't go crazy and start off with spine fusions.

Youtube for exercises is a genius idea, thanks.

You have a voice no one is going to make you have a treatment you don’t want .

I was also fishing for other people with similar stories. If the NHS wouldn't even refer me there must be a lot of people living with occasional back pain and numb bits, it would be handy to know how they got on!

You really should get it checked out, even if just to make sure its
not something more serious

I'm 18 months on from having a "wee bit of a numb foot". In reality, the whole side of my right ankle to knee is numb, the top of my foot and big toe, I can't move my big toe at all, have partial foot drop, permanent flaring nerve pain through my thigh and hip.

I've had issues with my back since I was 15yo, now just about 40 and they've finally referred me to neurosurgery.

You are lucky enough to have private health cover.

just go and see what they say.

you are not obligated to do anything after the initial appointment.

gave you considered that the reason that you couldn’t see an nhs specialist is not because it’s not clinically needed but because the nhs is on it’s knees and so there is so much rationing going on so unless you are literally dead in some cases they won’t look at you. Serrated area of health but In our locality for MH support you can be suicidal and self harming quite severely and still considered ‘not bad enough’ to need specialist support. Not because that is true but because they have no money for the beds and care you need so they just turn people away.

Thank your lucky stars you are in a place of privilege where you CAN see a consultant and can then make a decision as to what if anything further you will or won’t do.

So I had the same.

Also went private, had an MRI which showed nothing. Was then referred for OMG I am 47 and I can’t think of the fucking words!!! It’s where you have an electric current through your nerves to see where there is damage.

That showed L5 nerve damage. Consultant said injections with a view to nerve ablation. Had injections which did fuck all. He will wanted to try the nerve ablation, but there’s no point if the steroid injections don’t work.

I’ve not used the NHS in 30 years, I’ve always had private health care and yes, they can just try and flog you anything. But that whole process was done in 3 months on my insurance (would have been quicker but I had some things to do so had to change appointments about). NHS - it would have all taken 3 years.

I did physio but that was a bit useless.

I just left it in the end, happy that the MRI didn’t show anything sinister.

Long story short, I was in pain/numbness for 18 months and it eventually healed on its own.

Nerve conduction study! Finally came to me.

Well you don't have to. Get ot diagnosed and get optimal advice. Precise information will help any physio to help you as well as possible.

FWIW I have bulging L4 and L5 and have wedged L1 and T12. I have very little pain and my physio delivered pilates keeps my core as good as possible.

If you get a full diagnosis, you ha e a rwference point for any future issues/changes.

Be glad.

I’m really sorry to hear this

@outofbreath I can’t believe you don’t want a private opinion but it sounds like you don’t know how serious this can be. I had a spinal injury and I live in fear of this kind of thing happening - I was told to watch out for it for at least a year because it can be a sign of paralysis.

and the consultant will tell you if you need exercises or physio

nothing about this is normal, I’m 50 and lagging behind most of the people I know who are doing lots of sporting events well into their 60s.

I’ve got this OP. I had a back injury about 20 years ago which has left me with a numb strip of skin down the back of my left thigh and numbness in my left foot. I had mri and saw NHS neurologist who was very pragmatic and said as there was no pain, and no mobility issues to simply live with it. I could have been referred for an Operation but it truly wasn’t causing a problem other than being a bit weird.

Over the years I have had to work hard on core strength as I have developed a limp a few times - fixable through exercise/physio. I’ve occasionally trodden something like a stone or sliver of glass and not noticed until I’ve heard it tapping the floor or if it’s drawn blood. I’m in my late 50s now and have no regrets about taking this more conservative course of care

You can decide what treatment you want. I’ve had similar to you , but more serious issues spanning 20 years and am almost a decade younger than you.
I ‘ve had numbing/ tingling feeling that lasts up to 3/4 months. They have resolved themselves however and full recovery of nerves at around 6/8 months.
I was offered surgery but turned it down because I don’t want it at the moment. Spinal surgery of this type isn’t a case of always being the best option.

Do you have any foot-drop or weakness in that leg?
Do yoy have any numbness in the saddle area or reduction in sensation around going to the toilet?

Both of those indicate nerve damage, the second being an emergency A&E job.

It's good you don't have pain but I'd be wanting an expert opinion on whether an MRI is needed. You may need a nerve conduction study. Spinal injections are usually given for pain but the consultant will know if the numbness is an issue.

Physio is probably essential to prevent a full disc herniation. I've had a number of those, do every bit of pilates (run by a physio not a gym bunny) and physio you can to prevent further issues.

i have issues with my L5/S1 nerves and lose feeling in my foot on and off.

I've had all the diagnostics done, x-rays, MRI's, physical exams.

I can tell you the NHS will offer you physiotherapy, and absolutely nothing else as long as you're not showing signs of Cauda Equina. The only 'treatment' i get is meds for the pain.. both nerve pain and inflammation. They've never offered a single thing to help with the root cause.

I had similar but it was fixed with physio and I keep it away with Pilates based exercises/back exercises. Mine was numbness down left shin and foot drop. So physio definitely a good start but seeing a consultant isn't a bad idea, they should discuss any treatment options with you and not push you into anything.

You're asking for opinions on "overtreatment". Lots of people have pain for ages, and if the problem had been dealt with quickly, they'd not have lost the use of eg a shoulder.
I'd have all the tests and find out the different options. Plenty of people in their seventh decade are very active these days. 50s isn't old.

Thanks for some superb and positive contributions. I really appreciate them all.

I assure everyone I am well aware of how serious nerve damage can be due to a previous injury further up my spine. I won't be taking any chances if I feal weakness of any kind. (It will be familiar to me, I think!)

Luckily I'm still very active, run and do various water sports.

Of course, this numbness could be directly due to that historic damage - as I age the normal decline in my nerves will make the effects of that injury far more noticeable - this could be that.

Thanks again, all.

The reason the NHS no longer provides spinal fusion for the kind of back pain you describe is that there’s not enough evidence that it works, while there is evidence that physio and other interventions are more successful than surgery.
Is a physio referral a possibility? As you’re an active person it seems like it would do less harm to you than spinal surgery.

Is a physio referral a possibility?

I don't know, but that would certainly match my own biases, so let's hope so. Ideally I'd like a set of exercises I can do myself.