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What could be the reason for pain, numbness, and muscle weakness in the left foot, along with restricted spine movement?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

For the last month, there has been extreme numbness and muscle weakness in the dorsal part of the left foot. For the last two weeks, there has been pain along the left leg; the toes of the left foot are extremely weak. I am unable to move my toes and raise my left foot. In addition, there is a limited extension, rotation, and flexion of the spine, with sensitivity in the lumbar spine (left side) and radicular pain.

Kindly help.

Thank you.

Hello,

Welcome to icliniq.com.

I went through your CT (computed tomography) lumbosacral spine images (attachments removed to prevent the patient's identity) and have made the following observations:

  1. Lumbar lordosis is maintained.
  2. Vertebral body height and alignment are maintained.
  3. There is evidence of multilevel marginal osteophytes noted mainly at L3, L4, L5, and S1 levels.
  4. There is evidence of mild irregularity of the inferior end plate of L3 and superior-inferior end plates of L4 and L5.
  5. A concavity in the inferior end plate of L4 is suggestive of a schmorl node. Schmorl nodes are protrusions of the cartilage of the intervertebral discs through the vertebral end plates. In acute stages, it might cause inflammation leading to back pain in the patient.
  6. The narrowing is noted in the intervertebral disc space at the L4-L5 level at the posterior aspect.
  7. All of the above findings are suggestive of degenerative changes in the vertebrae. There also appears to be a mild diffuse disc bulge at the L4-L5 level. However, CT is not the imaging study of choice to diagnose discs, nerves, and spinal cord pathologies. It has low sensitivity compared to an MRI (magnetic resonance imaging) because it offers less soft tissue contrast. MRI is the imaging modality of choice to evaluate the musculoskeletal system. Therefore, to see the nerve root and cord compression, disc bulges, herniations, etc., that might be causing radiculo-myopthy in your case, an MRI LS (magnetic resonance study of the lumber and sacral region) spine needs to be done.

    Hope this helps.

    Thank you.

Patient's Query

Hello doctor,

Thank you for the detailed reply.

Hello,

Welcome back to icliniq.com.

You are welcome.

Thank you.

Answered byDr. Ruchi Sharma

Medically reviewed byiCliniq medical review team

Published At February 6, 2023
Reviewed AtJune 20, 2024

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