Cant stand on tip toes and calf muscle atrophy

[Blackfire]

Cant stand on tip toes and calf muscle atrophy

I'm numb from my crotch down the back of my leg to my foot, but noticed in the past 2 weeks or so my right calf muscle was feeling very tight, never paid much attention but over the past few days I noticed I cant tippy toe on that foot and it scares the hell outta me!!

I had severe sciatica last feb (08) lasted for about 10 weeks. Was on Naproxen, Co-Codamol 30-500's and Tramadol for the pain, one day my back went and couldnt walk for about 8 hours, after that it got gradually better (as in pain was less) but developed the numbness now the wasting calf muscle!!

Can anyone help me on this, what I need to do, exercises etc to rebuild the muscle or lessen the numbness.

Does anyone know if the numbness has replaced my severe sciatic pain?
Jon

[Zak_Han]

how are you now? getting better?

[DM1906]

Hi Blackfire, I had the same exact symptoms as you.  It started as severe sciatica running down the back of my right leg all the way to my foot.  Turns out that I had a herniated L5 disc that was impinching my S1 nerve.  I went for about 5 months with that condition before opting for a discectomy.  I had a discectomy back in Dec 2008 and shortly thereafter I noticed right leg weakness and calf numbness and inability to stand on tippy toes.  I underwent 5 months of physical therapy and exercising on my own but didn't notice any improvement in my condition.  I am now 4 weeks post second surgery in less than a year.  I had nerve decompression surgery back in november.  The procedure was performed by a neuro surgeon but he did explain to me before the procedure that there were no guarantees I would see any improvements.  Now four weeks post surgery I am noticing a little improvement and starting to gain a little strength back in my leg and the calf is starting to get a little stronger as well, day-by-day.  The definition is finally starting to return to my calf.  However, some days are better than others.  Some days my leg feels strong while on other days it feels like it did before the second surgery.  I'm actually not sure what to conclude at this point and I'm not so sure the second surgery is going to be a permanent fix.  I recommend that you go see a neurosurgeon and explain your condition and ask for an MRI.  If you have a compressed nerve in your lower back, physical therapy or other non-invasive procedures won't work.  They will just irritate the nerve more and more.  On my MRI before the second surgery, the irritated nerve showed up clear as day as it was swollen and easiy recognizable.  I'm afraid if you do nothing your problems with your right leg and calf will only worsen and could end up becoming permanent.  There is a strong probability that based upon the symptoms you listed in your post you have nerve compression in the L5/S1 region as well.  But only a neurosurgeon will be able to diagnose and provide you with different options for treatment.  Oh, BTW, don't opt for the accupuncture either.  That non-invasive procedure was only an irritant and made my ears hurt after the doc put pins in my ear lobes. Made my lower back hurt as well after being shocked with 6000 volts of electricity on numerous occasions trying to make my condition better.  The only thing that treatmant made me want to do was whip the doctor's ***.  I was only scheduled for one of those appointment and that was my decision.  

If your symptoms are anything like mine, you have the problems with the right leg but no back pain.  I still don't have any back pain and thankfully I do see slight improvement with my leg.  We'll see what my condition is a few months from now.

Hope this helps. Let me know what you decide to do and how you're progressing.  Like you, I'm also concerned about long-term prognosis.

[IndianaDude]

I read your response to blackfire.  Interesting.
I have been to 2 specialists ... neuro-surgeons and one was the head of medicine in his field for a well known hospital.

I have ... through tests ... lost muscle mass in my calf muscles.
I am unable to lift up and stand on my toes on either leg.
Even by holding onto a chair to balance or push down on ... legs can't lift my body.  Very frustrating.  Especially since I was an athlete who used to do calf raises with weights.

I have NO back or leg pain ... other than I am often prone to leg cramps.  I have also experienced deep, deep pain in my knee and shins.  It's like my leg just has a "deep pain" and it feels as if my leg is a piece of wood.

Does any of this sound familiar to you?

Just trying to find some answers.

Sincerely,

Indiana Dude

[IndianaDude]

I read your response to blackfire.  Interesting.
I have been to 2 specialists ... neuro-surgeons and one was the head of medicine in his field for a well known hospital.

I have ... through tests ... lost muscle mass in my calf muscles.
I am unable to lift up and stand on my toes on either leg.
Even by holding onto a chair to balance or push down on ... legs can't lift my body.  Very frustrating.  Especially since I was an athlete who used to do calf raises with weights.

I have NO back or leg pain ... other than I am often prone to leg cramps.  I have also experienced deep, deep pain in my knee and shins.  It's like my leg just has a "deep pain" and it feels as if my leg is a piece of wood.

Does any of this sound familiar to you?

Just trying to find some answers.

Sincerely,

Indiana Dude

[ladymeg]

A year and a half ago I ruptured my L6!-S1 disc and am still experienceing problems.  I also had minor ruptures L3-L5, but those are much better.  However I have experienced atrophy in my calf and foot.  My little toe has a mind of its own, and my big toe has lost at least half of its strength, but everything seems to have stabilized now.  The Nuerosurgeon told me that no surgery could help me, only time.  He did'nt want to cut into me, as I was not in severe constant pain.  Try to do walking daily, it's the only thing that helps. I'm okay with one foot being 2 shoe sizes smaller than the other, because when it first happened walking was agony for 6 months, so I'm grateful to be able to walk now with my little foot.  I had physical therapy and still do the methods I was taught whenever pain sets in, it helps a lot.  I took 6 pain pills in total, but everyone kept giving them to me, I could open a pharmacy with what I was given, but I did'nt want to get dependant on that stuff, so I just toughed it out, not fun. I know it could be several years before I feel better, so don't give up.  Most back surgery is barbaric, and leads to more problems.  Your spine is in a perfect vacuum, don't let anyone open it up.  Good Luck!! Don't give up...

[DM1906]

All of your symptoms sound very familar.  Roughly two full months after my second surgery in two years, I'm starting to re-gain strength in my right leg and in my calf.  Definition in the calf is also starting to return.  Going to see a neurologist or a neurosurgeon is definitely the right approach for you.  I didn't do that back in 2008 and saw an Orthopedic surgeon instead.  Mistake on my part!  As you know, the nerves in the back are very sensitive and it is my opinion that the problems I'm now experiencing were caused by my surgery back in 2008.  A neurologist or a neurosurgeon will definitely take the nerves into consideration whenever outlining a treatment plan for you.  I'm optimistic that my improvement will continue and I will regain most of the strength in my leg.    Let me know how you progress and what you decide about a treatment plan.  

[mccoubs]

You may want to be tested for Charcot Marie Tooth which is a mile form of Muscular Dystrophy. I had the same symptoms, I was an athletic person and never had a problem until one day I fell and injured my back. After much exercising and chiropractic work, I still didn't see positive results, so I ended up visiting the MDA and was tested for Muscular Dystrophy. It is a neurological disorder that progresses slowly overtime. But the moment you start realizing the weakness in the calf muscles, that's when it becomes apparent and it almost feels like the symptoms came out of "nowhere". The major symptoms are weakness in the calves, not being able to stand on your toes, and eventually you will have more atrophy of the leg muscle. It is a condition that you can live a very fulfilling life, just might need orthodics, special shoes, and regular exercise to keep the muscles strong that you still have. www.mda.org

[AndGil]

. I had emergency spinal surgery in 2004 due to a severe herniated disc and was tild I could have been paralysed but I was lucky. The pain has gone but I lost the ability to stand on tip toe on my left foot and like you have a limp. I am very conciuous of this and feel people look at me. Its harder to walk uphill than down for obvious reasons. Somewtimes it gets me down but I shouldnt complain. My left calf is nearly 2 inches less in size and is now quite apparent. I was told that I would never have the ability to stand on tip toe again as the nerve damage was permanent, and they weere right as here I am 7 years later. Please keep in touch as no one understands what it feels like, only those like us.

Regards and best wishes

Andrea

[LP1981]

I have had pretty bad back pain which has increased to the back of my leg down to my left calf for about 2 months and have been going to physical therapy.  I was told that my back muscles and quads are too tight and are making my lower back pinch my nerves, just today after attempting to do the exercises my PT showed me I noticed that I am able to stand and lift myself up and down on my right toes however unable to even budge myself with my left leg.  It feels like I have no control of my foot/ankle.  I am however able to move my ankle in all directions as long as no weight is on it.  I appreciate all the info you all have shared and have hopefully saved me a lot of damage.  I am not going to just tough it out and hope it gets better, and going to the doctor and requesting an MRI asap.

[Angbn13]

Your comment here hits home very much.  I recently had emergency back surgery due to a herniated disc in my lower back.  The doctor screwed up and I ended up having 2 sugeries in a row because he missed the whole left side of my disc and had to go back in.  Since then I have had a snowball effect of all sorts of other problems due to the nerve damage in my back.  My calf muscles are completely gone.  Mainly in my left leg.  I can't stand on my toes at all and noticed my muscle just hangs in my leg.  I also now am having problems with my female area as the muscle that holds everything into place is also now failing.  I am having a prolaps uterus, prolaps bladder and colon now too.   My colon muscles do not work properly either.  My surgeon has basically kicked me to the curb as he is done with me and tells me to go see my regular doctors now until I need back surgery again.  I have severe nerve damage now and all they tell me is that it can take 6 months to 2 years for my nerves to regenerate if at all.  I am very scared and have a a bunch of more tests coming up here in October for a whole pelvic floor testing and then probably more surgeries.  

[sally182]

Hello.. I had back surgery in 2002.. emergency .. told I was lucky not to be paralysed.. I have a permanent limp.. cannot tip toe on my left leg and realize I have a disability.  I am sad to realize I will always have a limp.  Walking for excercise is difficult for me.  I relate to you.  What I dont know is did my surgeon cause this or was the fact the l4 , l5compressed nerve that fragmented into my spinal column create.  I can live with the numbness in the portion of my right genital area and portion of  the rectal area.. numbness in the back of my leg outer thigh.. but the limping is really a bummer.

[uwgbnick]

so are these side effects common, or are we just the unlucky few. I'm only 3 weeks outside of an emergency microdicectomy where my entire right leg was so numb and in so much pain I was at the emergency room and 2 days later I had surgery.  I however can't make a muscle with my right leg and I'm worried that the dr won't let me drive if I can't push down with my right calf. I'm walking with a limp. My balance is bad, my legs are weak. steps are terrible.  Again I'm only 3 weeks out from surgery though.  the funny thing is my hernated disc was pushing on my left side nerve originally and that's where all the pain and weakness was originally.  the bulge was so big it hooked itslef around and impacted my right side worse than my left side was impacted.  After reading these comments, I'm getting pretty nervous.  

[Circusgirl1]

Are you better now? I'm two weeks out of L5/S1 Disectomy. Pain was originally in buttocks and numbness same area. However since coming out of surgery I now have pain in my leg behind my knee and I can't actually stand on my tip toes or do a heel raise!! Have you improved?

[SteveSolid]

Dear Colleagues

In July 2007, I underwent surgery inclusive of two {2} TOTAL DISC REPLACEMENTS in L4/L5 and L5/S1/

The original bodily discs were replaced with titanium discs and after 12 years of pain, in which the final 3 years prior were chronic, my severe pain was no longer.  I mean I was totally pain free.  The only let down was the noticeable atrophy in my right calf muscle.  My left calf muscle radius measured 36cm and my righ a mere 25cm.  Now it is obvious the reasons why the muscle withered but now I am more interested in rebuilding the damaged calf.  I notie that when I consistently do caly raises, it needs to be done in the following manner to begin to get benefits.  I start by perfmring raises on my strong left leg to fatigue it.  By doing this, the right and weaker leg compensates by picking up the load.  I then go ahead and perform 300 calf raises in 3 x 100 sets with no extra weight other than my own body.  The toeher trick is to take a time ratio of 1 to 4 seconds for the complete movement of exercise.  That is, raise your leg and if it takes 1 second then you MUST lower your leg over 4 seconds to work the muscle on release.

trust me this works, even if the progress in minimal.  remember, the nerve needs time to recuperate and for me it has now been 5 years since my surgery and no pain.  My calf is getting slightly better and it is painfully slow however; I has wastage occuring over 12 years so I must be patient.  Doing nothing will ojnly add to the demise of your current condition.  We need to train the brain to become more adept to out bodily function.  Doing nothing requires no action from the brain, through the damaged nerve/s. to action movement.

Cheers.

[MelissaG30]

I am 30 years old and 5 weeks post-surgery for what was classified as "severe spinal stenosis" caused by a herniation in the L4-L5 disc.  I, like you, began with issues in my left leg first.  Basically, if I lifted anything heavier than 15 lbs, I would feel pins and needles in my left leg instantly until I put the weight down.  

I was not in pain, but I was concerned after it didn't go away. I went to see my family doctor and he sent me for a CT scan and was referred to physio.  A few weeks later, before I could even be scheduled for physio, I woke up with the worst pain I have ever felt in my life radiating from the right side of my back down my right leg.  I had to crawl on hands and knees just to get to the bathroom.  12 hours later my right leg was completely numb and I was experiencing fasticulations from my lower back right down to my foot on the right side.  It was like there was an alien under my skin.  

I went to the ER, where I was sent home with the expectation that I would be contacted for emergency surgery in a hospital 4 hours away, which was where the nearest neurosurgeon was located.  The ER doctor did what he could, but my family physician didn't seem very concerned.

I went to see my family physician 2 days later.  I had an MRI done which showed the seriousness of my condition.  Other than beginning physio (where I was told straight out by the physiotherapist that he was not going to be able to help me, although he would continue with me until the doctors figured out what they were going to do) Nothing was done for 5 weeks until the local neurosurgeon came back from vacation on august 28/12.  For 5 weeks, I experienced severe back pain, complete numbness/tingling in my right leg, and foot drop.  I was dragging my foot behind me like quasimodo so I wouoldn't trip over my own toes as I had no control over the muscles in my ankle and foot.  The local neurosurgeon asked me "why I waited so long".  I was immediately sent to the ER for tests to check the strength of the muscles that controlled my bladder, which turned out to be functioning well.  I was scheduled for surgery on Sept 10/12.

After the surgery 5 weeks ago, I have regained control of my ankle muscles and am no longer experiencing foot drop.  I have feeling in my big toe and the arch of my foot, but the rest of my foot is completely numb.  i am experiencing numbness in the back of my thigh, the back and right side of my right calf as well as the outside of my foot.  I can move all of my toes, and walk with a slight limp if I sit for too long or if I sit on a soft surface like a couch, which disappears after I walk on the leg for a few minutes.  I cannot stand on my tiptoes, but I can flex the muscles in my calf as long as my body weight is not on it.

Sometimes the calf muscle feels really tight, like there is a knot in it, and I occasionally experience a burning/tingling/electrical shock feeling in my right foot. I have been taking gabapentin which helps ease it some.  I am fearful that the feeling in my foot will never return.  I can jog without a limp  although I haven't tested it out on long distance yet, but I cannot run at the moment.

Also, I am a woman and I can't wear high heels without going over on my ankle, which is a total bummer.

I go for my post-op check up with the neurosurgeon in 4 days.  Hopefully he will clear me for physiotheraphy and I can begin rebuilding my strength in my back and legs.  Once again, I am hoping the feeling will someday return to my foot, though I realize it could take years.

Have you experienced any improvement since your last post?

[GiantElfen1]

Hope you're doing better.
I've had severe back & leg problems for about 18 years now.
6 years ago I went in for a lamenectomy to relieve severe spinal stenosis in the L3, L4, L5, & S1 area of my lower back.  As it turned out the stuff that forms in the spinal column that wraps itself around the spinal chord & strangles it causing the stenosis didn't wrap itself around my spinal chord but went through it instead!  The neuro surgeon told me afterward that she ended up spending 3 extra hours in there snipping & pulling & snipping & pulling little bits out from betwen the twining nerves that make up your spinal chord and it's nerve branches.
Well, as it turned out I have spinal chord damage.  After all the therapy I could still only stand for a minute or so & walk maybe 50' but then there better be somewhere for me to st down or my legs would literally go out from under me.
Then I got a spinal chord stimulator put inside of me.  And it was definitely better.
For about 2 years.  Now I'm worse than I was before the stimulator.  About 20' is a long walk!
But I also noticed my left leg was much worse & I began to notice it getting smaller.  My thigh muscle is atrophying & my calf muscles in both legs stay hard as a rock.  And if I try to massage them they want to charley horse on me.  So that's HOW I found this site!  Looking for help.
So I hope the posts keep on coming.
The only thing I can add is Aquatic Therapy.  I had about 7 weeks of Aquatic therapy twice a week & it really helped but then the Medicare money ran out so I had to quit.  In about a week I went back to how I was but it told me I need that warm almost hot water to work out in.
So my wife & I are betting the farm.  We're refinancing to build a poolhouse & put in a heated swimming pool to excersize in.  There's actually an underwater walker you can get for your pool!
Hope that helps!

[cmaqueda]

Cant stand on tip toes and calf muscle atrophy.
I had a herniated L5 disc that was impinching my S1 nerve.  I went for about 12 months with that condition before opting for a discectomy on February 2013 I was numb down the back of my leg to my foot, but noticed my right calf muscle was feeling very tight,  after my surgery and I cant tippy toe on that foot and it scares the hell outta me!! after 45 days my leg feel better but still I can't tippy toe.

Can anyone help me on this, what I need to do, exercises etc to rebuild the muscle or lessen the numbness and be able to tip toe


Carlos

[bazer1650]

Hi I can recognise what you are all saying and have been unable to stand on tip toes since an S1-L5 back fusion in 1992.  No problems before the fusion afterwards the deficit has got slowly worse.  I have had a spinal decompression (laparoscopic)  and another "open" fusion at L4-L5 (2013) with no extra problems.  The latter operation went very well and I am back to the gym an off pain meds for back pain.  However, still having the same problems from the first op.

My calf muscles have atrophied over the years and I have seen a bunch of physios, podiatrists and  consultants re this condition but no one to date has spelt out exactly what's has been happing and what if anything I can do to be able to manage this condition (due to lack of exercise I am a type 2 diabetic).  However, my last consultant have given me the results of a motor NCS and Needle EMG that was performed and it all now fits together.  Basically my right and left gastrocnemius  and Tibialis anterior have been denervated  due to the first operation and build up of scar tissue over the years.  After 23 years there is no way back on this and the only way of getting the muscle mass back is to use estim to artificially stimulate the muscles.  There are positives to this and some draw backs the major one being that the increased muscle mass is lost after stopping estim and that it does not help with walking and standing on your toes as you are reliant on estim to enable the muscles to work.

In the gym I do most exercises but for cardio rely on the cross trainer as running is very difficult.  I try calf raises but do this with 20Kg and 25Kg on my right and left calf (no body weight).  Walking and standing still cause me a lot of pain in my calf muscles principally because I overuse the ones that still work and get severe cramp etc.  Really annoying as I used to be an active mountaineer and rock climber.  

One of the issues with walking and running is that (a) my gait is basically heel to heel with no push up from the front of my foot and (b) I walk with very flat feet again as I don't push off with my toes.  I have found good trainers with heel pads help as do orthotics with arch supports.  However my ankles are suffering and I am trying out some combined ankle and arch supports  from air-cast to assist in minimizing any damage I do from walking and manage any foot pain.

In summary my advice is to get a NCS/EMG study done as soon as possible after the back operation if you get these symptoms.  The longer it is left the less you will get back in the future.  It may well recover after the operation as my first surgeon suggested it would but it may not.

If you are stuck with it the NCS/EMG study should enable you and your medic to monitor the situation and to suggest the best ways for you to manage the condition in the longer term especially if your condition leaves you a medium level of long-term disability.


Barry

[ann23262]

Hi there, I wonder how your situation is now regarding your foot and calf. I had a similar surgery about 2 months ago and am now almost in the same state as you describe. Did you find out any exercise or anything that has helped with the numb / tingling foot and stiff calf muscles? Regards - Annie

[papa3318]

My problem, i can lift my two hundred pounds with my left foot but i can't get my right heel off the floor, therefore i don't have any push off with the right foot
when walking, which causes a very bad limp, kinda like having a broke toe and having to walk on your heel. Any help greatly appreciated.

[Emily1966]

I would suggest finding a good PT.  I fell herniated L5-S1 had surgery in May 2011 was totally fine until Jan 2013 when I had a sciatic flare up after that I have been limping and unable to lift up on to my toes.  Have been seeing a PT for four months now and my calf muscle is a little bigger and I am able to walk using the front of my foot to some extent.  When back to neurosurgeon and he did another MRI.  Says there is some fullness in same area possible bone spur surrounded by sinovial cyst that is pressing on S!.  He wants to do a decompress/fusion.  I don't want to have another surgery more often than not I hear there is improvement if you are lucky for a short period to time but for the most part more problems arise.

[Dave_Law]

I suffered a ruptured L5/S1 disc when I experienced a 10 foot fall, landing on my left hip. I had tingling/numbness down my left leg, couldn't feel my little toe and the part of my foot to which it attached. I could not raise my heels / stand on my tip toes. I was in agonizing pain, but because I feel strongly that the body has the ability to heal itself (to an extent), I wanted to find relief that did not involve surgery. Initially I found some relief in going barefoot whenever possible. It's worth mentioning that I have high arches, as I am trying to help anyone who might have had my experience and people with fallen arches might have a different experience. Five Fingers shoes made by Vibram, although unattractive, made a huge difference in my back pain. I started going on walks again. In the winter, I wear Ugg boots, which are intended to be worn without socks and provide room for toes to spread out. A few years later, my wife also suffered a ruptured disc. The neurologist said my wife's MRI indicated the worst rupture he'd seen in his full 25 years as a neurologist. She did some research and went on an anti-inflammation diet. 6 months later, she went back to the neurologist for a follow-up. Although he clearly had no interest in entertaining the idea that an anti-inflammation diet could alleviate the effects of a ruptured disc, he said "whatever you are doing, it's working." The followup MRI showed that the bulge had receded dramatically. She felt much better and has been pain free (for the most part) ever since. Because of her success, I tried the anti-inflammation diet. Prior to seeing her results, I was apprehensive because the diet requires commitment to work and meant cutting out some foods I loved. But I finally decided I was (literally!) sick of feeling pain all the time.  The results were not overnight. I guess it took about 2 months to see a difference in my level of pain, and I realized in hindsight that it happened so gradually that by the time I noticed, I was feeling not just a little better, but much better . Eventually (in 2 years) got 90% of the feeling back and I now have full feeling and function. I can stand on my tip toes. I still have this weird phenomenon when I'm sitting (in any relaxed position): my left calf has little spasms in small areas all over at different times like there's a little storm going on in there. I can't feel it at all, so seeing it happen without feeling is strange.
Anyway, I hope this helps someone and will maybe keep them from going through surgery. I fought the urge to go under the knife as I was unable to sleep (attempting to sleep on the floor helped some), go to the bathroom properly (sometimes I couldn't distinguish the feeling correctly and would attempt but not really need to go), and I had to crawl most of the time, for six months! But I'm glad I did because although I expect to live with a level of pain for the rest of my life, it's small compared to what might have happened if I had surgery. As many have posted on the internet, any surgeon will tell you a discectomy is not guaranteed and might even make things worse.
The book my wife followed is called "Clean" by Alejandro Junger. She did not follow it's every word, just it's basic principles.
Ten years since my injury, I'd say I'm 95% back to normal. I have my days when I don't eat right and it affects my level of pain, but I can always get back on track by avoiding that food I knew I shouldn't have been eating anyway.
I hope someone benefits from my experience.

[Jstjude]

Thank you. That really did help. I will look into the things that you said. Thank you so much. It was really nice of you to go out of your way to post this. (((Hugs)))

[Dave_Law]

I meant to say my wife's followup visit was 3 months, not 6 months.

[Oliadal]

Hello, I have exactly the same condition. I'm wondering how much disability this is according to medical standards. Could you please send me an email ***@****
Best regards, Oli

[Oliadal]

Hello, I've exactly the same issues. Do you know how many percent disability this is? Please send me an email ***@****