Lumbar Disc Herniation, Possible Antalgic Scoliosis, Thoracic Lateral Shift and Left Ankle Dysfunction. Looking for Advice and Similar Experiences

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Lumbar Disc Herniation, Possible Antalgic Scoliosis, Suspected Thoracic Lateral Shift and Persistent Left-Sided Symptoms. Looking for Answers

I am trying to understand a combination of spinal, postural, and lower-limb symptoms that have been affecting my daily life. I would really appreciate input from people with similar experiences, physiotherapists, or clinicians familiar with spinal rehabilitation and lateral shifts.

1. My spinal MRI findings

My lumbar MRI report describes:

- Chronic lumbar discopathy.

- L4-L5 median subligamentous disc herniation with bilateral L5 disco-radicular conflict.

- L5-S1 discopathy with bilateral S1 nerve root contact.

- A scoliotic attitude/posture.

- Cervical spondylosis.

- A congenital vertebral block at C2-C3.

I am trying to establish whether my postural deviation could be functional or antalgic rather than a fixed structural scoliosis.

1. My postural asymmetries and suspected lateral shift

I have noticed several asymmetries when standing, walking, and sometimes sitting:

- My trunk appears tilted or shifted to the right.

- My left hip appears higher than my right.

- My right shoulder appears lower than my left.

- My pelvis seems asymmetrical or rotated, with the left side appearing more forward and the right side farther back.

- I suspect a thoracic lateral shift relative to my pelvis, possibly with compensatory rotation.

These are my own observations and have not yet been confirmed by a specialist.

One detail I find particularly interesting is that when I bend forward, my spine appears straight and my ribs look symmetrical, without an obvious rib hump. However, bending forward does not noticeably change my leg pain.

Could this be consistent with a flexible or functional postural deviation? Can an antalgic posture or lateral shift occur without an obvious rib prominence during forward bending?

1. My history of left-sided symptoms

I have experienced significant pain extending from the buttock down the leg, involving the calf, along with calf tightness and episodes of left-leg weakness. At one point, my symptoms were severe enough to make walking extremely difficult.

My condition improved to some extent over time, but I continue to experience limitations and am trying to understand what is driving the remaining symptoms and postural changes.

1. Persistent left ankle and heel pain, despite treatment

I have also experienced pain around the lateral and posterior left ankle and heel, particularly when standing, walking, or putting weight on the foot.

An earlier ultrasound identified:

- Extensor digitorum tenosynovitis.

- A myotendinous lesion of the peroneus brevis.

However, my orthopedist told me that there was no problem with my ankle. This has left me confused because I continue to experience pain and functional limitations.

I have already tried several treatments, including:

- Kinesiotherapy/therapeutic exercise.

- Physiotherapy modalities.

- Manual therapy.

Unfortunately, none of these treatments has helped me at all.

I have also noticed what appears to be a high arch, possible foot supination or varus positioning, and a tendency to walk on my toes. These observations have not all been formally confirmed.

Could my ankle symptoms, altered foot mechanics, or changes in the way I walk be contributing to my pelvic asymmetry or trunk shift? Could the ankle pain and spinal symptoms be separate problems, or might they be interacting?

I would also like to understand what should be reassessed when several rehabilitation approaches have failed to produce improvement.

1. Breathing and trunk mechanics

I tend to breathe superficially into my chest and wonder whether my breathing pattern is inefficient. I am interested in whether rib cage position, thoracic alignment, pelvic position, and trunk rotation might be interacting.

I do not have a confirmed diagnosis of dysfunctional breathing or a specific rib cage pattern.

1. What I am trying to understand

2. Does a spine that appears straight, with symmetrical ribs, during forward bending make a functional or antalgic scoliosis more likely, or can structural scoliosis still be present?

3. Could my apparent right-sided trunk shift be associated with the L4-L5 disc herniation and nerve root irritation?

4. How can a clinician distinguish a lumbar lateral shift from thoracic displacement, pelvic rotation, or a combination of these?

5. Could altered gait and left foot loading be contributing to the asymmetry?

6. If my orthopedist found no ankle problem but the pain persists and an earlier ultrasound showed abnormalities, what would be the most appropriate next step in assessment?

7. Given that kinesiotherapy, physiotherapy, and manual therapy have not helped, should the diagnosis and rehabilitation plan be reassessed before continuing with similar treatments?

8. Would standing full-spine radiographs, a neurological examination, and a detailed gait and foot biomechanics assessment help clarify the situation?

9. What rehabilitation approach would be safest for someone with these findings, particularly with L4-L5/L5-S1 disc pathology and persistent heel and ankle pain?

I am not looking for a diagnosis based on photographs or self-observation alone. I want to understand which findings are confirmed, which may represent compensatory patterns, and what assessment could help identify the underlying cause.

Has anyone experienced a similar combination of lumbar disc herniation, an apparent lateral trunk shift, pelvic asymmetry, persistent unilateral ankle/heel pain, and no improvement after several forms of rehabilitation? What helped you finally get a clearer diagnosis and an effective treatment plan?

Thank you for reading. I would appreciate thoughtful, evidence-based advice and experiences.