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. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain 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.



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