sciatica / mid-upper right back pain and numbness/tingling right arm.

by jim breneman
(rhinelander, WI 54501)

sciatica / mid-upper right back pain and numbness/tingling right arm.

I have been having issues with sciatica for almost a year. For the past 2 months have been going to a chiropractor because of the sciatic pain. He did an xray and told me that my L5 and S1 have a 28 gap with normal being 5. He said this was compressing the nerves and causing the pain.

After about 2 months of adjustments twice a week, I now have severe pain and a knot in the upper back, rhomboid area along with this pain I now have numbness, pain and tingling that runs down my entire right arm even into my fingers.

My chiropractor believes this numbness is unrelated to the pain in my upper back. He says this is from C4 and C5 in my neck. I have been out of work the past 2 days and have another appointment scheduled for tomorrow.

I am concerned that he has caused the pain in my back, and the numbness in my arm. If I lay completely flat the numbness subsides somewhat but the second i sit up or stand my arm goes numb again. What injury do I have and what would the correct treatment be ???

Hello Jim,
You're in a tough place.
Let's take these one at a time. The sciatica, pain down your leg, is it improving? Do you also have pain in your lower back? Think back, did your chiropractor raise your leg (probably lying on your back) in the beginning? Did it hurt in your leg? back? Can you remember how high?

Do two tests for me:

Bend slowly forwards, then backwards, then to the side. Do you get pain in the back, is the sensation, tightness, tingling in the legs the same? Does it hurt in the naughty leg?

Sit in a kitchen chair and do the Slump test for sciatica ... Does it hurt, or feel very tight in your leg?

The new pains? Did you have any midback, neck, arm issues prior to consulting the chiropractor? Old injuries?

Did he also adjust your midback and/or neck whilst treating the lower back? Every time? Occasionally? Did you have pain after the treatment?

Turn your neck to the right and then look up. Any neck arm pain ...?

Go to Search this site … and type in Upper Limb Tension Test. Do the test and let me know the result.

There are two schools of thought in chiropractic. One adjusts only the problem area, in your case the lower back. The second 'full spine' who will adjust other parts of the spine, especially if they find subluxations there.

I hover between the two, personally. Both have their merits, but I have in the past also hurt people, causing problems. It's not nice to visit a doctor and go home with a problem you didn't previously have! It's known as Chiropractic Iatrogenic Illness …

My best advice: Phone and ask the secretary to make an extended appointment. Tell her you have some important things you want to discuss.

Talk about it freely and honestly. If he is evasive and doesn't want to listen, then my advice is to go elsewhere.

It's a situation I've faced many times. There isn't a doctor alive who hasn't been involved in iatrogenic illness - doctor-caused disease. It's a nightmare in Medicine with a quarter of a million Americans actually dying of it every year. Iatrogenic illness ... It affects us in Chiropractic too.

This too will pass! I hope.

I hope this contributes.

Dr b

By the way, are you doing any lower back exercises ...? I would recommend. Ask your chiro which would suit you best.


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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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