intermittent pain along outside of leg from knee to ankle, awakening with numb foot, burning heel and big toe.

by Tony Smith
(Dublin, Ireland)


Blockage in thigh artery and bypass with graft. Blocked again five months later and 2nd procedure to remove blockage from synthetic artery.

Blocked again six months later and followed with angioplasty procedure, but with little improvement. Now left with intermittent claudication down side of leg and slight pain in knee.

Very cold foot and burning sensation to big toe and heel. Awakening in mornings to numb foot. First discovery of disease through intermittent claudication to calf muscle.


Presently treated with warfarin teva and innohep injected until warfarin stabilized. Normally daily warfarin intake = 2mg.

Hello Tony
The first question is whether the numb foot, especially seeing that it radiates into the big toe is vascular or neurological.

The side of the lower leg and big toe is where a sciatica following the L5 dermatome is typically located. This may have absolutely nothing to do with your angioplasty. Or, it's possible that in the surgery they damaged the sciatic nerve, but this is most unlikely as it runs down the back of the leg.

Two little tests:
1. Bend forwards, backwards, and then backwards coupled with to the side, right and left. Any back pain, any tightness in the naughty leg, any pain or tingling down in the leg? Sciatica, not intermittent claudication.

2. Type "slump test" into the Search this site function at C-H. Does Slump reproduce the pain and numbness in your leg?

As far as the circulation is concerned, make serious changes to your lifestyle... or else! Smoking, weight, walking, diabetes, foods that lower cholesterol like aubergine, hummus, big salad every day, fruit, minimum 5-10 coloured foods per day. Get deep into our Healthy Living Tips page.

Good luck, let me know the results of those tests.

Dr B

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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.



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