Pain and tingling in feet and legs

Keywords; tingling in feet and legs, chiropractic help, lower back and leg pain, femoral nerve.


Paresthesias, as they are known, are a sign that tissue is starved of either blood or nervous input. Sitting with your legs crossed, for example, places pressure on the femoral artery, starving the muscles in the lower legs of oxygen. The result is tingling with which we are all familiar. The cure, of course is simple; uncross your limbs.

This website is not about vascular causes of tingling legs, but you might enjoy this short story from STONES IN MY CLOG by chiropractor Bernard Preston. 

More commonly, the source of the tingling is an irritated or frankly pinched nerve. It could be in the brain or spinal cord, but more usually the site of injury is where the nerve emerges from the spine, in the buttock or the groin.

This irritation may be from noxious chemicals released from the cartilage within a fixated joint. Starved of oxygen and nutrients, and a build up of waste products within the synovial fluid, they hyaline ending of the vertebrae and facets begin to complain; the result is tingling in the feet and legs.



Two main nerves supplying the legs...


1. SCIATIC NERVE

The sciatic nerve belongs the very lowermost part of your lumbar spine, coursing via the buttock to the leg and foot. SLUMP TEST for Sciatica is easy to do at home.

2. FEMORAL NERVE

The femoral nerve on the other hand emerges from rather higher in the lumbar spine, and courses through the groin to the top of the upper leg, and inner lower leg. However, the pinched nerve test for the Femoral nerve, unlike the Slump test for sciatica, is not easily done at home.


SCIATICA

S1 nerve root

It helps your chiropractor if you can tell him/her precisely where your tingling in feet and legs is. For example, does the tingling go to the side of your foot? However, whilst for 75% of people a sciatica from the L5-S1 joint will go down the back of the thigh and leg, and to the side of the foot, less commonly (see the yellow and green patterns) it may mimic a sciatica from the L4-L5 joint, and go down the side of the leg.

Part of the problem is that an intraforaminal disc extrusion at the L5/S1 level will affect the L5 nerve root, but a more medial herniation would impact on the S1 nerve root. So, the same disc can affect two different nerve roots.


Thus, one can not be certain of which disc is effected by the dermatomal pattern. A careful physical examination of the spine is in order.  That would include range of motion tests, orthopaedic tests, neurological tests, and at least an X-ray.

Sometimes, because not uncommonly degenerative change occurs at several levels, an MRI is necessary to confirm with absolute certainty at which level the offending lesion is to be found that is causing tingling in feet and legs.

MRI has one other not unimportant advantage: it's not ionising radiation. But the cost is huge. About ten times as much as an X-ray.

All these symptoms are common:

  • tingling
  • pain, and
  • possibly weakness in the legs and feet.

How reliable are X-rays? Very useful but in cases of severe radiating leg pain an MRI is mandatory. On a personal note, I recently suffered a severe disc extrusion into the foramen. But that disc, as seen on X-ray, was one of the best in my lumbar spine.

Irritated nerves in the lumbar spine may be affected by a

  1. slipped disk ...
  2. lumbar facet syndrome ...
  3. CHIROPRACTIC HELP LUMBAR STENOSIS ...


Tingling in feet and legs

The most common sciatica refers to the outside of the foot and the small toe. If there is weakness you will have difficulty standing on one foot and raising your heel from the ground.

Try it! Hold onto a chair, stand on one leg and raise your heel repeatedly. You should be able to do it without any sign of fatigue or shaking of the lower leg. An S1 sciatica may make this difficult.

In my opinion, everyone should be doing some gentle lumbar exercises, because we all sit too much, and almost the whole population will experience acute low back pain at some stage of their lives. But this is vitally important if you have tingling in the feet and legs. At CHIROPRACTIC TIPS you will find some suggestions on a few conservative exercises for your back. They only take 60 seconds, literally, in bed in the morning. For more information, click here: CHIROPRACTIC TIPS ...

Tapping on the Achilles tendon tests the integrity of the S1 nerve to determine if it could be the cause of tingling legs.

L5 nerve root

The L5 nerve root is most commonly affected by the L4-L5 disc joint, though the nerve emerges at one level lower. The tingling in feet and legs (and/or pain) is more commonly on the side of the lower leg, and the great toe, though it can affect the side of the thigh too.

If there is weakness, you will be unable to lift your great toe off the ground. This means that you may trip as you walk, as you foot isn't lifted properly in the swing phase. Is your leg tingling, and do you also have weakness?


L4 nerve root

The L4 nerve root is less commonly the cause of tingling in feet and legs and, when it does, it's a real bugger. In my experience it responds less well to manipulation, and better to flexion-distraction. It shares slips with both the sciatic and the femoral nerves.

The knee jerk reflex may be reduced, and weakness can affect the major flexor of the knee, the Quadriceps muscle. The result is a profound limp, and weakness on stair-climbing, as well as a leg tingling.


Femoral nerve

This page is quite long enough, so we will cover the FEMORAL NERVE on a different page. Less frequently troublesome than the Sciatic nerve, the Femoral nerve typically causes pain in the groin and front part of the thigh, and weakness of the Quadriceps muscle. So does hip arthritis, so careful examination is paramount. Femoral nerve damage ... an account of my own severe injury, successfully treated with chiropractic manipulation.

Meralgia Paresthetica

Then there are some lesser nerves from the lumbar spine. One such is the Lateral Femoral Cutaneous nerve. Irritated in the upper lumbar spine by a spinal subluxation, and pinched in the groin where it passes under the inguinal ligament, can cause pain and tingling in the upper thigh.

Whilst meralgia paresthetica is generally considered a "medical" condition, and a difficult condition to treat medically at that, I have had great success in treating MP.

Very occasionally it can be caused by an infection or mass in the abdomen. Fortunately rarely, the usual site is in the groin and jointly in the upper lumbar spine. Read more about it at the upper leg pain page. 


Arthritis in lower back is no more uncommon than grey hair. In one sense it's a normal part of aging.

Any degenerative changes in the joints in the lower spine can have a direct effect on the nerve roots emerging from the spine. Arthritis in lower back however is considered by many in the medical community to be an untreatable disease, except perhaps by anti inflammatory drugs or even more radical lumbar surgery.

Nothing could be further from the truth. In the case at the page above (arthritis in lower back) you can read how an elderly woman with advanced arthritis gained very significant relief of pain from Chiropractic Help.

Frequently the irritation of the nerve is in any case, due to a subluxation, and not arthritic at all.

However, prevention of tingling in feet and legs is obviously better than a cure. Everyone suffering from chronic lower back pain should spend two minutes EVERY morning before getting out of bed doing this simple spinal stenosis exercise ...


Lower back and leg pain: Piriformis Syndrome

A small muscle in the buttock can entrap the sciatic nerve causing a tingling in feet and legs. Because of its attachment on the sacrum there is often an associated sacroiliac joint subluxation...

Read more: Piriformis syndrome ...



Diabetes

Experts say that walking helps heal damaged nerves 

The pain and tingling in legs and feet experienced by up to half of diabetic patients is caused by high blood sugar which damages the nerve. Since walking, cycling, swimming etc improve the blood circulation in the lower limbs it helps the oxygenation of the nerves.

One profound study proved that diabetics who walk regularly don't get diabetic neuropathy. As long as they keep walking. That's big! The research also found that it slowed the progression of any existing neuropathy.

Walking also is one of the simplest ways of reducing blood sugar, that's key because it's the increased blood sugar that is the problem in the first place.

Walking benefits in the outdoors releases the feel-good endorphins from the pineal gland in the brain, increasing our tolerance of pain.

B vitamins, particularly B12, are also known to help nerve pain. Walking benefits ...


Insufficient blood 

All living tissue needs oxygen, nutrients and the removal of waste products. Yet another cause of tingling in feet and legs is a condition called atherosclerosis, or hardening of the arteries.


Yes, you guessed it. Very few smokers escape this nasty furring of the arteries, and it's far worse if their cholesterol is raised, or they are diabetic. Atherosclerosis is the reason why diabetic smokers lose toes and go blind - tissues starved of oxygen. Tingling legs is the norm...In the leg, atherosclerosis reduces the blood flow so that the muscles don't get enough oxygen. When called to exercise, the muscles begin to tingle and hurt due to a condition called Intermittent Claudication.


Chiropractic Help

I'm sure you have gathered that there are many causes of tingling in feet and legs; and we haven't even considered the severe pathological diseases, rare though they may be, also contribute their share to the misery of these symptoms.

Chiropractic Help is based firstly on a sound diagnosis and then, if appropriate, manipulative therapy and rehabilitative exercises.

If it was always successful there would be no neurosurgeons operating in the lumbar spine; yet failure of chiropractic treatment is often not because treatment has failed but other reasons. Expectations of miraculous overnight cures; one click in the lower back putting the bone back into place should have worked. It rarely does when there is pain and tingling in feet and legs.

Pressures from family and the family doctor and insurance that will pay tens of thousands for surgery but are exceptionally parsimonious with conservative care are examples too of why patients go prematurely under the knife.

I continue to be astonished how, given time, rest and common sense many patients recover from seemingly hopeless situations. In fact I myself recovered completely from a seqestered disc, normally considered a medical emergency. Femoral nerve damage.

Tingling in arms and hands

Likewise, tingling in the upper limbs is caused by an irritation of the nerve somewhere along its course from the neck to the hand. The so-called DOUBLE CRUSH syndrome is now well recognised - in conditions such as Carpal Tunnel Syndrome in which the nerve is trapped in the wrist, there is also an underlying impingement in the neck. How otherwise could chiropractic possibly help such conditions as CTS, tennis elbow, frozen shoulder ...



INTERESTING LINKS


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Interesting challenges of the day

1. Mr D has very severe midback back. He bent and twisted, feeding his son, and then laughed. Every breath is a nightmare. A sprung rib is every chiropractor's delight. He or she has golden hands. 30 percent better after one treatment.

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. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

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. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

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. Mrs 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. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

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?


Interesting questions from visitors

CLS writes:

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.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.