LOWER BACK AND LEG PAINFEMORAL NERVELower back and leg pain usually, but not always, emanate from the lumbar spine.
From the upper lumbar spine, a pinched femoral nerve may cause lower back and leg pain that radiates along the side, front or inner part of your thigh.
If the femoral nerve is involved then it is likely that the knee reflex will be disturbed, and weakness of the quadriceps muscle may develop, leading to a marked limp. The leg may then 'give' particularly on stairs. You can test the muscle by springing on your leg. If it gives at the knee, then the quadriceps thigh muscle is suspect. SCIATIC NERVEFrom the lower lumbar spine, a pinched sciatic nerve causes lower back and leg pain which extends usually down the back of the leg, reaching into the calf and foot.
If the sciatic nerve (L4, L5 and/or S1 nerve roots) is involved, then the Medial Hamstring reflex, or the Achilles reflex will diminish. Weakness of the lower leg muscles or great toe may occur. Sensory changes on the lower leg, the side of the foot, or top or sole of the foot are possible. In the initial stages the skin becomes more sensitive. As it becomes more serious, the skin becomes numb.
FEMORAL NERVE: Roots L1, L2 & L3 (thigh pain especially) SCIATIC NERVE: Roots L4, L5 & S1 (lower leg pain especially) TINGLING IN LEGS AND FEETThe disc joint, the facet joints, a restricted spinal canal, the piriformis muscles and Meralgia Paresthetica can all cause tingling in the limbs. So can a host of neurological conditions.
CHIROPRACTIC CARELower back and leg pain requires first and foremost a careful examination in order to determine precisely where the nerve is being irritated. Is it in the upper lumbar spine? The lower lumbar spine? Which level exactly? A Lumbar Facet syndrome? The sacro-iliac joint? In the groin? Could it be something more serious, possibly from the prostate gland?Firstly the physical exam will enable your chiropractor to determine more or less where the problem is. But to be honest, sometimes it is extremely difficult to be absolutely sure which level of the lumbar spine is involved. Quite often more than one disc or facet joint is playing up, giving a distorted or confusing exam. That's where an X-ray, and better still a scan can help your doctor narrow down precisely where the problem is. That is very important, because if s/he treats the sacro-iliac joint when the problem is at L4-5, then you probably won't improve. Vital are exercises and rehabilitation, or the problem is likely to return within a short period if you have had lower back and leg pain. Even though the pain may reduce quite quickly with chiropractic care, if you have pain radiating down the leg, then it is best to assume that it will be about two months before you be sure that all is healed. Reduced sitting, and avoiding couches, deep "comfortable" chairs and car seats is important. Sitting increases the pressure in the disc and inhibits healing. For more about the Lumbar Disc Syndrome, click here. SURGERYGood surgery can produce wonders with a bad lower back and leg pain sciatica where there is significant weakness and numbness in the leg. Immediate relief of pain in the leg is the rule. But if the surgery doesn't go well ... then a lifetime of backpain awaits the patient.This is not chiropractic scare tactics. "Failed Back Surgery" is a phenomenon the medical world has written about prodigiously. 'Can you wait?' is the question. The New England Journal of Medicine reports on research in which 281 candidates were randomly referred to surgery or alternative care. The surgical group did indeed have much faster relief of leg pain (4 weeks -vs- 12 weeks) but - and here is the interesting part - after one year, there was no difference between the two groups, and a blinded investigator could not tell the difference. Can you wait? You can be sure that after a proper trial period of manipulation your chiropractor will refer you to the appropriate surgeon should s/he not be winning, which is unlikely. We treat sciatica on a daily basis. Journal of Neurosurgery - spine."Although 1.5 million lumbar MRI scans are carried out each year for sciatica (at a cost of $1.5 billion), only about 300 000 (20%) reveal a herniated disk amenable to surgery. About one third of the surgeries fail to relieve the sciatica. As a consequence, about 1.2 million (80%) receive no clear dialgnosis and 100,000 have spine surgery that fails."
FROM THE COALFACEMr Kort ironically is very long. Over two metres tall. For nine months he had dreadful pain last year in the lower right leg. His doctor was convinced that it was a sacro-iliac syndrome, but Gert wasn't getting better. In fact it was getting worse. He was limping badly and had to stop his favourite sport - volleyball.We hit it off from the first consultation. He noticed my tie which has in very faint letters written across it the words: 'Jesus Christ is Lord.' Like me, Gert is a Christian. Whilst he did have a fixation in the right sacro-iliac joint, it was immediately clear that this was no SI syndrome. All the orthopaedic tests were negative, and the test that gives me the shivers was strongly positive. Raising his left leg, produced pain in the right leg. This was a typical case of lower back and leg pain that chiropractors see on a daily basis. Gert had a slipped disc. The long and the short of it is that Gert responded magnificently, if slowly. I made him take two weeks leave, with absolutely no sitting, and then part time for the next month. Within six weeks he was much improved and at twelve weeks had very little pain. (He took a mattrass to work, and lay down every half an hour for five minutes, and did the exercises I prescribed.) More important the Crossed Sciatic sign became negative (slowly), and the strength returned to his calf muscle. He is back playing competitive volleyball. The long summer layoff is a problem in Europe - when everybody goes on holiday. Gert played plenty of beach volleyball on his vacation with no trouble. But the first training camp - exercises, not active volleyball, did his back in. They made him do double leg raises, a definite NO-NO exercise. He came in three weeks ago looking like the leaning tower of Pisa. He's fine again, and we are considering whether it's time at 45 to consider stopping competitive volleyball. Certainly there will be no more training camps! Is this an unfair case to claim a chiropractic success for Chiropractic care of lower back and leg pain? Was it simply help 'from above'? Probably! INTERMITTENT CLAUDICATIONLower back and leg pain may also be caused by an artery in the groin blocked with cigarette ash. The leg pain typically gets worse with exercise.USEFUL LINKSMonthly newsletterYou will then have access to these newsletters, and more as they become available:Chiropractic Help, Issue #07- Root-of-all-Healing/ Garbanzo beans /Chickpeas Chiropractic Help, Issue #06 - Safety-on-the-Stairs/ Ginger Chiropractic Help, Issue #05 - Safety-in-the-home/ Red foods Chiropractic Help, Issue #04 - Whiplash-and-the-Joints-of-Luschka/ Parsley Chiropractic Help, Issue #03 - How to stop falling/ Danger of a low fat diet Chiropractic Help, Issue #01 - Tingling the arms and hands/ Apples Sign up here:
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