The toe dorsiflexor muscles pull up the great toe and little toes. This action is important only for karate experts, technical rock climbers and NFL place kickers. Most patients with an L5 nerve malfunction will have weakness of these muscles and not know it. In fact, I like to think that the EHL (extensor hallicus longus- great toe dorsiflexor) is the “canary in the coal mine”. That is, weakness of this muscle absolutely confirms an L5 nerve injury and weakness is very common with injury to this nerve. If the tibialis anterior (TA) muscle is weak along with great toe weakness, this confirms that the TA is an L5 innervated muscle.
In many cases, vertebral fractures can be treated through conservative methods such as bed rest, a back brace or pain medication. However, patients with osteoporosis or whose fractures have caused severe, long-term pain may benefit from a minimally invasive procedure such as vertebroplasty to relieve symptoms. This procedure is also recommended for patients who are too weak to undergo spinal surgery, or have a malignant tumor within the spine that has caused vertebral damage. Vertebroplasty is most effective when performed on fractures that are less than six months old.
Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.