L3 Herniated Disc/Nerve Root Compression Evaluation

[@marion3780]

After right hip fracture surgery with one long and a short titanium rod placement, I have all the symptoms of L2, L3 nerve root compression. I have been recovering from the surgery for 5 months but felt the symptoms right after surgery....thinking it was normal and it would get better. Surgeon referred me to physotherapy - didn't help except to strengthen the muscle, and also acupuncture, which helped minimally. Thigh is 2-3 mm shorter than the other. I have a CT scan booked next week in my area, then a neurosurgeon when one is available which would be 800 km. away. The pain is so limiting and lying down is my only respite. Thank you for the info in this video.

[@crystalcoleman8668]

Good video , I have l3l4 disc herniation, just developed the upper thigh pain in R thigh. After sitting for 15 20 mins , half hour , I cant even walk when I get up , its horrible, I had no idea what it was , I thought , Oh boy is my hip going out now , then I googled l3l4 symptoms and that came up. Already had the mri, PT , going to Inj next week, We shall see.

[@gtsquad1326]

Thank you. Very informative. My MRI diagnoses is the L3/L4 disc herniation. Also compressing the descending right L4 nerve root. Please comment on this and how this is cured. I also have a lot of pain. Been suffering +- 5/6 weeks. Thank you. Thomas.

[@mitchellmontesano8769]

Hi Paul. I've been having lower back pain that radiates to the right hip and groin and also getting searing pain and numbness on front of right thigh. I looked up Meralgia Paresthetica symptoms, and i do have them. The pain is electrifying and horrible. It comes and subsides throughout the day. The lower back pain is constant dull ache. Feels better when lying down but comes back once i get up walking. Im wondering if i have a herniated L3 or 4 that's compressing that subcutaneous nerve?. This video was the first of many I've viewed that i felt described my issues. Very good video

[@kerryparaskevoudi3568]

I also experience weakness in hip flexion, and at the same time or a day before I also have back pain. However both symptoms resolve usually within 2 to 3 days.

[@OrthoEvalPal]

Hi Kerry, Not much to worry about if the strength comes back quickly.

[@scottgreig8831]

Does a bulging disc at l3 nerve is also pinched mri states would that also affect left leg hip groin?

[@Miki-ic3wg]

Is it possible for the L3 L4 herniation to effect both legs? My husband has trouble lifting both. They are very weak when walking. He has had his legs give out on him even. Going to make an appointment with an Orthopedic spine surgeon. Just saw this video and thought maybe this is his problem. His job is very physical and he's had herniations at other levels with pain but this weakness is new.

[@dg9015]

My PT has loss of sensation L5 S1 since February but also weak hip flexors

[@calivalley9056]

I’m have the same issue with numbness in right thigh that turns to tingling and burning with prolonged standing or sitting, 47, but after doing several weeks of PT my mid-back is giving me horrible pain that radiates into my ribs. Leg is still numb, MRI scheduled.

[@KO-ye8lm]

L3-L4 nerve compression is one of the most painful experiences. Epidural Steroid Injections can help a little with pain, but often times insurance carriers won't make this a medical emergency and make someone wait weeks or months before they get the injection. Meanwhile, chronic suffering and nerve damage is done due to untreated nerve compression. It's absurd. A person with a compressed nerve (seen on an MRI) and in constant pain should be immediately booked for an epidural steroid injection. If that fails, they should be re-evaulated for minimally invasive surgery or other type of surgery. And avoid Chiropractors if you have a compressed nerve. They are not medical doctors. And can do more damage. But I'm not surprised people flock to them because our health care system delays prompt medical treatment, thus causing people to seek substandard care.

[@thisisbob1001]

Good. Knows his stuff

[@nhosurkar]

Have the same issue. Slight disc bulge at L3 L4 with pain in thigh region. It all started with back pain, but slowly progressing into more of a thigh pain and less of low back pain. Cannot walk a step without pain. While sitting and sleeping, absolutely no pain. Quads are very tight

[@ConfinedInMyMind]

Just herniated my l3-l4 2 months ago. Before that I had pain on the inner quad muscle on the side of the knee, like a burning soreness. Sneezed a few weeks later and was in excruciating pain. Was bed ridden for a month, got an inversion table and the traction really helped me walk and move without pain along with physical therapy. I still have tightness in the hip flexion, quad and even in the arch of the foot. Laying down is no issue. But I recommend doing traction and spinal Decompression.

[@jelel9698]

I had a herniated disc too and it affected my femur cutaneous nerve. I had pain, burning sensation, needles, weaknees, etc.. after 7 months of light running and doing all kind of exercises for my hip, abs and legs, I am almost fully recovered. I would say I am 95% recovered with no pain at all and full leg and hip strenght.

[@ConfinedInMyMind]

Jele L I’m glad and delighted to hear that! Gives me hope. Which disc did you herniate and how was the pain/mobility right after herniation?

[@jelel9698]

@@ConfinedInMyMind I herniated the L3 disc. The pain was excruciating and literally could not move for first 2 days, I had to stay in bed all day. After a few days I was able to walk with difficulty and my back was crooked and I still had pain. But once the pain on my back subsided, I tried to go run on a treadmill and this is when I hurt my nerve and when I started having all sort of nerve pain on my lower back, on my thigh and my groin. I also lost some sensation on my inner thigh and some pain on my lower ab that hurt a bit. I had trouble raising my knee because my hip hurt and it was very weak. I also had a clicking noise on my hip when raising my knee and bringing it down. You need to be very patient and try to do light exercise for your lower body, it make take several months for the pain to go away completely. The strange thing with me was that I felt so much better in a lapse of one day. For some reason, after 7 months, one day I woke up and felt so much better.

[@ConfinedInMyMind]

Jele L Oh wow. I was bed ridden for almost 4 weeks. I was able to get up but crooked and a lot of difficulty walking. I lost sensation in the femoral nerve and inner thigh and difficulty raising the leg. Still get tightness in the hip flexion. But it’s getting better day by day. I appreciate your insight. It’s giving me something to look for and a realistic time table! I had the same symptoms as you.

[@kevinjoines7954]

Do you recommend any textbooks or resources to help clarify this sort of differential diagnosis?

[@OrthoEvalPal]

Hi Kevin, you may want to check out my playlist showing all levels and common signs and symptoms. kzbin.info/aero/PL_jx_nSzcqqF0YWPOi8rFAargrzl4mHX0 I've also podcasted about this www.buzzsprout.com/325448/1134935-episode-47-l3-nerve-root-compression-signs-and-symptoms.mp3?blob_id=2639300&download=true Enjoy!

[@kathyfrancis1613]

I have these exact symptoms- weakness, buckling knee, severe thigh pain from L3 L4 nerve root herniation. I also have constant numbness from the knee to ankle. Would I need to see a neurosurgeon or an orthopedic spine surgeon?

[@OrthoEvalPal]

I would see a neurosurgeon

[@idcdrums]

Hi Paul. Can you help me understand why the L2 myotome of hip flexion is affected so drastically in an L3-L4 intervertebral disc herniation? I would expect the L2, L3 nerves to be spared in that situation. Thanks!

[@OrthoEvalPal]

Hi Isaac, I am totally with you an that and I go through this quite often with my daughter who is in her 4th year PT school. L2's are super, super rare. Not sure I have seen 2 in 28 years (over 500 lumbar discs) There is carryover. L3 = quads = proximal hip flexion. In sitting, hip flexors are shortened and quads are lengthened a bit. (Hip flexors are actively insufficient) All of my L3 HNP's were weak in hip flexion. All of them had surgery for L3 and recovered strength. I should review this video again because it is quite old. Good question!! Take care!

[@OrthoEvalPal]

@@joeylopez1697 Great question! They don't always follow an exact pattern. Over the years I've learned that there can be a little bit of carry over from one level to another. The surgery that fixes the problem is the best way to know that your clinical diagnosis is correct.

[@OrthoEvalPal]

@@joeylopez1697 Also surgery of the L3 disc completely resolved his issues

[@OrthoEvalPal]

@@joeylopez1697 I don't do a lot of treatment videos because I worry that people don't have the right diagnosis before doing the treatment activity in everybody is so individual that the programs should be custom made

[@carissahughes9991]

I've had multiple problems since last May. I have been doing physical therapy as well as back pain. I am 27 and I have a hard time even with the steroid injections. I am as well in the Military and they said I don't need Any surgery but I don't know what else to do. I am just stunned. Any advice?

[@OrthoEvalPal]

Without fully evaluating you, it's hard to make suggestions.

[@m.j.y.l]

Hello, I'm writing to you from Turkey. thanks for the information... I had surgery 58 days ago L3/L4 herniated disc. The hernia had burst. I had physical therapy, medication and needle therapy for eight months, but it never went away. last time I had surgery, I had a hernia burst. now I have a very small pain in my hip. and I have tingling in my leg, but not all the time. I'm better than before surgery. exactly how long will it take for these complaints to pass? And I want to ask, is tingling a good thing? does it indicate sciatica healing? is it because my heart is damaged by pain and tingling sciatica? Thank you doctor :-) regards...

[@marragonn]

Hello Paul, I have an egg-sized spot on my left thigh (towards the outside) which often tickles and is a little numb (but no pain in the thigh). I have uneven hips (my left hip is higher) my right leg has less muscles than the left. I consider my lower back to be really strong (absolutely no pain there (I regularly do reverse hyperextensions)). My lower back feels really strong. But my hips are pretty stiff (I cant do high karate kicks anymore (kicks with an angle higher than 90 degrees)). I also did those strength tests, and to me it seems I have no strength problems in my thighs or legs. I suspect my hips to be the problem. That the squeeze of the nerve happens there, and not in the lower back. Does that all make sense? Under consderation of my uneven hips, stiff hips etc? I tend to do hip/leg stretches (frog position etc.) but this only seems to help temporarily I think.

[@chrisjhel5621]

my husband has the same case but his left thigh gradually reduce,we already check up and had a MRI..why it is that his tigh gradually reduce?

[@bearaffiliate]

I can't find excercise for L3 on the internet. Mostly they are for l4 l5 S1. What excercise is suitable for l3?

[@lizwiebe9309]

Would having him do a squat also evaluate for L3 disc pathology?

[@onlinevoice195]

What does narrowing of L2-L3 meaning and how to treat it? The back pain radiates to the right hip, but no numbness on the leg.

[@OrthoEvalPal]

It's the small holes where the nerves exit the back. Be sure you get a good diagnosis first.

[@onlinevoice195]

@@OrthoEvalPal thanks for your reply. The diagnosis was just narrowing of L3-L4 that caused back pain. Will chiropractic treatment help?

[@tonysorice5142]

i have lL4 L5 S1herniated disc bluge disk mri send leveing left root my doctor hit with that relax hammer on my both kness noting move no reflex what do you think,

[@TheRooftopSHOUT]

Follow up?

[@samp1040]

Any update on this man? Have the same L3-4 herniation with compressed nerve root(CT scan). 4 weeks since initial pain and weakness in dorsiflexon persists but slowly improving. Neuro requested MRI to decide on surgery.

[@OrthoEvalPal]

Hi Sam, He had surgery and is doing great!!

[@jaehochoi903]

The quads innervated by L3 and L4 - how come knee ext is not affected?

[@tehilovely]

Are you a dr. ? I would love to know more ...

[@OrthoEvalPal]

I am a physical therapist

[@chaibasil]

When the patient is in prone, and you flex the knee, the low back is going into Hyper extension, right?

[@OrthoEvalPal]

It can if quads are tight.

[@houssemkhelifi424]

Thank youu x)

[@OrthoEvalPal]

You are welcome Hous!

[@myuk7665]

What are the best exercises for this

[@OrthoEvalPal]

Can't give exercises unless you know exactly what the problem is

[@ConfinedInMyMind]

If you have quad and hip flexion tightness/weakness. I recommend going to physical therapy. You’ll need to spine mobility exercises. Piriformis stretch, wig wags, hip flexor hangs, and hamstring stretches. Also doing nerve glides. Then under supervision doing weight bearing exercises. Squats, crab walks, walking, stationary cycling. Hope you feel better.