Hello dear As per clinical history majority of leg movement are normal As per my clinical experience surgery can be postponed Please opt for below options Minor physiotherapy exercises atleast for 30 minutes Apply diclofenac sodium gel topical application twice a day for 2 weeks Apply crave bandage application for 5 days Hot fomentation application Voveron xr 50 mg twice daily for 5 days In case of no improvement consult orthopedic surgeon in person for better clarity Regards
If your doctor recommended surgery while your physiotherapist advised against it due to partial weakness and there’s voluntary movement, it’s crucial to reassess your situation based on a thorough understanding of the current condition and its implications. Given that your dorsiflexion strength is at 2/5 and you’re experiencing foot slap, it indicates significant muscle weakness, typically associated with nerve compression, likely from the disc bulges at L3-L4 and L4-L5 levels. Besides considering the mixed advice you’re getting, it’s essential to consult with a neurologist or a spine specialist for a second opinion. They might recommend an updated MRI to see if there’s any change in the level of compression or nerve damage.
In scenarios where weakness is stable and not severe, conservative management with physiotherapy often focuses on specific exercises to improve strength, gait stability, and flexibility. Targeted exercises should be part of your daily routine— aiming at strengthening the anterior tibialis muscle responsible for dorsiflexion. Use resistance bands to start with light resistance, gradually increasing as tolerated.
However, with your power at 2/5 and difficulty handling resistance, it’s essential to closely monitor functional capacity and any signs of worsening, like increased pain, altered gait, or new sensory deficits. If your symptoms or functional capacity deteriorate, it may necessitate surgical intervention to prevent further nerve damage and potential permanent weakness.
In the end, the decision between surgery and continued conservative management should be based on a comprehensive assessment of current symptoms, functional impairment, and potential risks vs. benefits. Considering both the immediate and long-term outcomes is vital. Always seek a detailed discussion of the possible repercussions of both paths with your healthcare providers.
