Pes cavus/leg symptoms with disk cause?

[Trex023]

Hi,

I've been having problems in my leg(s) for two years now, and having trouble finding the cause.  I know I have had a herniated L5-S1 disk for the past four years that hasn't healed, which probably explains some of the symptoms. However, my question is, could a laterally herniated disk (without central canal impingement) cause symptoms of claw toes and pes cavus? My foot structure has become worse and worse over the past two years. The right foot has more severe pes cavus/claw toes, but both legs have sciatica symptoms - the disk is herniated both to the left and right.  I haven't heard of anyone getting high arches from a herniated disk, does this usually result from a different neurological disorder?

Other symptoms include classic sciatica with lots of pain in the bottom of the right foot and both calves, mild weakness (both legs, worse right) and mild foot drop (right), frequent spasms and fasiculations (both), foot pain mostly aggravated by walking (right) but sciatica aggravated by sitting (both).

I'm trying to figure out if I need to address my disk problems (with surgery or otherwise) or if this is something else going on.

Thanks!

[Gurps123]

Hi , Yes it can 100% .. the same thing has happened to me over the past year.  I injured my l5/s1 and had a central disc protrusion without significant nerve root impingement.  Within a few weeks both of my feet lost muscle mass.  That was strike 1.  Six months later I reinjured the disc to the right side.  Within a few weaks I developed Achilles contractures and a subtle pes cavus which had been diagnosed.  Its a shame that doctors and people in the medical world cant understand this.  Yes there are many people who have l5/s1 disc problems and have no foot problems at all or they have flat foot. From my understanding the l5 controls many of the lower leg muscles including the tibialis anterior which is one of the common reasons for a cavus foot. Its all a knock on effect.  After my first protrusion all I had was weak intrinsic muscles of the foot. Then the second protrusion was too much for my body to handle - weakness, spasticity of the legs and contracture sets in! The muscle imbalance and weakness caused from the lower back is what results in the cavus.  Its such a shame that people arent educated around this and I had to find out the hard way! Gurpal

[Dr Sharma]

Hi there.  Pes cavus is caused due to malunion of calcaneal or talar fractures, burns, following compartment syndrome, residual club foot and neuromuscular disease. Others are idiopathic and non preogressive.  Neuromuscular diseases lie muscular dystrophy, charcot marie tooth disease, polyneuritis, intraspinal tumors, polio, cerebral palsy and spinal cord tumors.
The other symptoms of pain, weakness, spasms, are attributable to sciatica and the disc problems. Consult a neurosurgeon and a physical therapist to check what could be the done to ameliorate symptoms, with a trial of physiotherapy to surgical decompression as the last resort. Take care.