Tingling in feet and legs
(Keywords: SLUMP TEST for Sciatica, tingling in the feet and legs, micro discectomy, Chiropractic Help )
This orthopaedic test for a pinched nerve in the lower back is a complex manoeuvre that comes in a simpler form called the Flip Test which you can do at home to test if your tingling in feet and legs could be coming from your back.
Actually, even that is an over simplification because the Flip and Slump tests are only for a pinched SCIATIC NERVE.
The lower back supplies two main nerves to the legs that can cause tingling in the feet and legs. It's the onset of leg pain that gets the surgeon excited, and that you don't want!
At our femoral nerve page
you will appreciate that the pain and tingling from the lower back may
radiate to the groin and top of the thigh, and the Slump Test will be
negative. Instead we use a Femoral nerve stretch test, which is far more
difficult to administer, and has no place in a self-help site such as
this. It's best left to your chiropractor.
Chiropractic research for pinched nerves.
In interesting research, three neurosurgeons and a
chiropractor evaluated the effectiveness of micro diskectomy versus
manipulation in a pilot study for patients with pain and tingling in the
feet and legs from a pinched nerve in the lower back.
All forty patients had first undergone three months of conservative medical and physiotherapy without relief of the leg pain.
After three months there was clear benefit in
The cost of the chiropractic care was less than 10 percent of the surgery, with zero risks and side effects.
The flip test is a simplified version of the slump test for sciatica.
In the Flip Test, you can test for a impingement of the sciatic nerve at home. Sit in an ordinary upright chair, and somebody else raises first your good leg parallel to the ground, then lower it remembering the pull in the good leg.
Now ask your examiner to raise the naughty leg. Is it significantly tighter or more painful in that leg? If it hurts only in the back, not the leg, then you have no frank sciatica, only the first stage.
In the full slump test for sciatica, progressively more stretch is placed on the sciatic nerve but that is best left to an experienced chiropractor.
Micro diskectomy is a far less invasive procedure than normal back surgery, the surgeon is able, using an operating microscope, to remove a part of the facet joint that may be pinching the nerve root and any disc material from under the nerve root.
Under risks mention is made of recurrent herniations (immediately or later), cerebrospinal fluid leaks due to damage to the dura, nerve root damage, bladder and bowel incontinence, bleeding and infection. The authors assure that these risks are relatively low. "Quite rare".
How soon should you rush off to the doctor or chiropractor?
It depends. Pain on the left side of the chest? I'd phone the emergency rooms right now. An old niggle in the back that you've had for years? No rush.
Having said that, last week my wife bent over, and twisted to lift a corner of the carpet for sweeping. She felt what she described as "a bottle exploding at the bottom of her back". Not good. She was stuck forwards in what we call an antalgic posture. The sign of Pisa. Because the swelling and inflammation hadn't yet started, the Slump Test for sciatica was negative. But wait three days... and I would have had drama on my hands, in the bosom of the family.
The long and the short of it is that I reduced that bulging disc within three hours of the injury, she spent the rest of the day in bed with an ice pack and doing half-hourly lower back exercises ...
A second treatment two days later, and within five days she is almost painfree during the day, except for prolonged sitting and early morning discomfort. Of course, I'm exhorting her to follow the 50 percent less pain rule. Today we'll start the rehab exercise program.
For more details, Chiropractic Research ...
In normal circumstances, if you wait a few weeks before seeking the advice of your chiropractor, you will probably be in for weeks of treatment.
My point? When you know you've done a mischief to some part of your body then it's better not to wait. Dealing with a disc herniation before the swelling and inflammation starts, before it starts referring down the leg and the Slump Test for sciatica is strongly positive, makes good sense. Likewise a bad dose of bronchitis - don't wait for the pleurisy before contacting your doctor.
I see little point in writing a story about Mr John who hurt his back, went to the chiropractor, who performed a miracle and Mr John is back playing championship golf or tennis.
Such things happen, actually quite regularly. But I prefer to write about the bizarre, the funny and the tragic things that happen at the chiropractic coalface. For such, I make no apology, take my books for what they are. Controversial and fun.
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USEFUL LINKS @ Slump Test for sciatica
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Interesting challenges of the day
1. Mr B came initially for a painful and stiff neck and then asked whether chiropractic could help the cold numb feeling running down the side of his thigh for six months. Meralgia paresthetica is a double crush syndrome with the nerve affected in the back and groin. He's 80% improved after five treatments.
2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.
3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of her foot. It started after a long drive in the car. After six treatments she is 60 percent better, but it's slow and is going to take the full 6 weeks to heal.
And now a setback, after lifting her child she now has leg pain. It's going to the be difficult.
7. This lady is a 70 year old woman, is on maintenance care for a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection after a total shoulder replacement. After four operations he is incapacitated.
8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.
9. This man is a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. I reassured him it's not hip arthritis.
10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.
11. Mr C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.
And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.
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