Right leg giving way, paralysis after only 2 minutes walking or standing
by Nigel H D
Maigne's syndrome comes from the junction of the thoracic and lumbar spine.
Right leg giving way, paralysis after only 2 minutes walking or standing is most likely a nerve condition, but the arterial blood supply to the leg should also be considered, particularly in smokers.
I cannot walk more than two minutes - already at a halting pace with a limp - before snap pain strikes from the groin, down the back of the thigh, into the outer calf and into the arch of the foot and big toe. The pain takes my breath away, leaves my heart racing and makes me nauseous and will only go away after I return to lying down.
Previously, I had cramps in the outer calf, stiffness in the outer upper thigh/hip and semi-numbness at the very top of the thigh near to the pubic area. (All of this is on the right side but the left arch is sometimes painful as well.)
My lower back, centre, hurts when I lean forward if seated on the floor, back straight, legs parallel in front - it pinches. There is no pain on sitting or getting up from sitting, which is unlike when I had prolapsed L3, L4 in 2005. Then, I had no referred pain. Now, I have mainly referred pain which can be severe and very debilitating.
The condition started about seven days ago with a tight SIJ which then changed to tightness around the upper outer thigh and calf, which was again winding and only helped by sitting down.
Physio says the nerve is pinched but thinks it is not disc related and is perhaps another muscle pinched the sciatic nerve. Palpations on the joints in the mid-lower back really felt like a "knot" was being successfully dealt with but my expected relief never lasted. The paralysis only came on yesterday after a ten minute walk with to the shop carrying a 6-7lb carrier bag. Could that have kicked it off?
I am male, 48, weighing 14st, 5lb/201lb/91kg in a sedentary job who exercises, stretches and is slim and body aware.
A recommended chiropractor works about 4 minutes' walk away, on a good day, but I fear I cannot get half that way till the leg paralysis and 8.5/10 pain begins.
I hope you can help as you have others.
Hello Nigel, Apologies for the late reply; I've been away for a month.
There are a number of potential causes of your pain. When you have pain walking, immediately relieved by sitting down, then the examination needs to start with the pulses in the ankle and foot. Intermittent claudication occurs mainly in smokers; lack of blood to the leg.
Then numbness in the pubic area comes from somewhere high in the lumbar spine; it could be a condition of the femoral nerve or the superior cluneal nerves.
However, the outer calf invites the Slump test for sciatica. Find it at Chiropractic Help using the search function in the navigation bar on the left.
Then, if it's groin, I always check the hip joint.
For paralysis, called paresis if it's of a more temporary nature, look up our leg pain muscle page. Which muscle is weak? Is it actually weak, or just feel a bit feeble due to pain? Can you raise the big toe?
All of this as you can see is quite involved; you need to find an experienced thorough chiropractor or medical doctor, methinks. They will check the reflexes, test for numbness and do other tests.
These are just a few preliminary thoughts; then one goes on to whether it affects the bladder, and so on.
1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.
2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.
3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree.
Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.
4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.
He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.
5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.
6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.
7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.
8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.
9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.
10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.
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. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.
13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback
since working above his head. Trapped nerve tests are negative but he
has advanced degenerative joints of Luschka; after just two treatments
he is 50 percent better. Can we reach 90?
And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
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.
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.
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