Adductor pain along with pain between big and second toe

by Hattie
(Asheville, NC, USA)

Patrick's Faber test

Patrick's Faber test

Adductor pain along with pain between big and second toe is probably two different conditions.

I am a 55 year old female with no previous bouts of back pain. For the past 14 months I have had steady progression of worsening pain that started as a pins and needles sensation in the web space between big and second toe.

The progression has been: extreme buttock pain (both sides) followed by shooting adductor pain (right leg) and finally pain on the top of both feet and web space between big and second toes.

I've had lumbar and pelvic MRI's that showed a small protruding disc at L4, disc disease or spinal stenosis. Nerve conduction test revealed chronic L5 S1 radiculopathy.

I've had 6 epidural and 2 obturator block injections with limited benefits. The most pain relief was provided by the first obturator block injection (7 glorious weeks).

I am at my wit's end dealing with the pain and limitations of activity. Pain is worse when sitting or standing; somewhat better when lying flat.

Neurosurgeon and orthopedist have given up on me since I don't have a glaring herniation. Could this be piriformis or SI joint issue?

Hello Hattie,
Let's start with four little tests please; after no painkillers for 24 hours.

1. Bend slowly forwards, then backwards, and then to the side, right and left. Tell me EXACTLY what you feel in the back, and comparing legs.

2. See below the Slump test for sciatica. Let me know precisely what you feel.

3. Lie on your back and pull first the left knee to the chest, make a circle and then pull to the opposite shoulder. Is the right hip and groin different?

4. Sitting with a little oil on your thumb, run it down through the groin, starting at the ASIS (google it) and heading down the inner thigh. Is it particularly tender, or different right and left.

5. Drop the knee into the Fabere position. Is there a difference right and left?

6. Press hard on the joint between the second metatarsal and the toe. Is it very tender? Compare sides. Is there callus under the forefoot. Does it feel like a sore foot? It could be metatarsalgia; see link below to foot pain.

Let me know. Answer ALL questions as accurately as you can.

Dr B

» Adductor pain along with pain between big and second toe

» Adductor pain along with pain between big and second toe

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Interesting challenges of the day

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 have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is 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 is 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 pain-free. 

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 is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has 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 stroll 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; he has a short leg.

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. X-rays 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 few months 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 is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year 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 could not 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 should not be treating the elderly most medical sites state but that is so much bunkum.

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