Cervical stenosis case file

Cervical stenosis graphic.

Cervical stenosis case file is a condition missed even by the experts.

Cervical stenosis case file is a fascinating detective story.

This page was last updated on 29th February, 2020. This is about a spinal condition.

An elderly man, let us call him Mr S, gave me and half a dozen doctors cause for thought; three of the specialists ended up in court. His medical doctor and I were the lucky ones to escape his wrath. Said patient was a retired judge.

He consulted me initially two years ago with acute pain in the upper right thigh of some months' duration, with no known cause.

It turned out to be a routine case of meralgia paresthetica quite unrelated to his neck.

It's a condition, known as a double crush syndrome and seen not infrequently in our Chiropractic clinic where the nerve is pinched simultaneously in the back and groin. 

In his eighties, he had been terrified that the pain in the hip would prevent him from finishing the fortieth leg of a pilgrimage.

Cervical stenosis case file

Cervical stenosis case file reveals how a neck problem can cause you to sprain your ankle.

Sprained ankle

In passing he mentioned that he had sprained his ankle about a year previously and that it was still weak and causing some pain. Could that be the cause of groin pain? he asked. I agreed that it could, by altering his gait. At this stage, he had already consulted his doctor and a physiotherapist concerning both the weak ankle and the pain in his opposite thigh; no one was thinking of a cervical stenosis case file in the making.

The pain in the hip responded relatively quickly, and after a few weeks he went off on his extended hike in Spain; the last two hundred kilometres. As a young man he had started the long pilgrimage from Groningen in Holland to Spain, known as the Santiago de Compostela. The Holland leg is called "de Pieter pad". He finished his forty year pilgrimage, and returned some two months later for maintenance care of his hip. In passing, he asked again about his ankle.

A confession. In the ten minutes set aside for routine maintenance of the hip, lower back and groin, I completely missed the fact that he had quite profound weakness in the ankle; it was the cause of the sprained ankle, not a consequence of the injury.

He continued to consult me every two months, not unhappy, despite the lack of progress in the ankle. He also had a stiff neck that required mobilisation. My initial thinking was of a routine sprained ankle; not his problem as it turned out.

One year ago he returned urgently from an extended holiday in the Greek islands to consult me. I was immediately very concerned. He had extreme gait disturbance and some signs of what I thought was a possible lesion in the cerebellum, or perhaps a TIA affecting that part of the brain that controls coordination. He also complained of tingling in the hand, particularly in the pinkie side of the hand.

It was only then that the penny dropped; the weakness in his foot was not local, but rather neurological in nature; the sprained ankle happened because of the weakness, not vice versa. I referred him immediately without treatment to his doctor for an urgent consult with a neurologist.

The neurologist decided that he had carpal tunnel syndrome and referred him to an orthopaedic surgeon.

Tingling in arms and hands

The orthopaedist concurred that the tingling in his arms and hands were from CTS and proceeded to operate on his wrist; a cervical stenosis case file was the last thing that passed through his mind; when you have a hammer in your hand, everything looks like a nail.

Mr S continued to walk like a drunken old man, and being a man of some influence, bypassed all the fools treating him and went to a specialist clinic. The diagnosis after an MRI of his neck: Cervical spinal stenosis.

Large bony spurs in his neck were not only affecting the ulnar nerve to his arm, but also directly on the spinal cord, affecting his lower leg.

I'm glad to say that both Mr S's medical doctor and his chiropractor have both escaped his ire, though we both too completely missed the boat. I'm not proud of myself, but this Cervical Stenosis Case File been a great learning experience. It's not called a "practice" for nothing.

Make serious mistakes with a judge, and you can lose your pants. Luckily, his GP and I still have ours, but certain medical specialists found themselves in court. Tingling in the pinkie simply cannot be carpal tunnel syndrome which affects the median nerve.

Spinal stenosis case files do not occur in a vacuum. After whiplash injuries, and repeated episodes of cervical facet syndrome that was badly managed, immobilisation arthritis sets in. Sometimes, perhaps combined with poor diet, or other factors.

Median nerve sensory distribution in the hand causing tingling in the fingers.

Carpal tunnel syndrome never affects the pinkie.

Sprained ankle is very rarely caused by cervical stenosis but should be considered in the older patient.


I sometimes am concerned that too much manipulation of neck, even by a qualified chiropractor, despite the fact that we distract the joints before manipulation, may not be healthy. And how much is "too much"? We just do not know.

Self manipulation certainly causes repeated trauma to the neck.

Chiropractic maintenance care

Whilst this is an extreme case of cervical stenosis, most chronic neck pain conditions can be well managed with an occasional, but regular chiropractic treatment.

Maintenance care nevertheless is not for every patient.

Nutritional supplementation is advisable too. You could make yourself a chicken bones bouillon, proven to help arthritic sufferers, and regularly enjoy a fatty fish soup, which is a rich source of omega-3, also proven to help prevent the inflammation associated with arthritis; or take take krill oil capsules.

Freshly ground flax seed nutrition information gives you more data on yet another rich source of omega-3. Add a tablespoon to your cereal every morning, or to the cookies and bread that you bake.

Flax seeds in a coffee grinder.

Low GI bread is so easy to make with the use of a bread machine. It literally takes me less than five minutes, every other morning. Adding a protein source like homemade hummus, and extra olive oil lowers the glycemic index.

Sourdough bread recipe made from 100 percent wholemeal.

It is all about getting away from the artificial chemicals that food companies add to their products, and taking responsibility for your own health.

Your organic green food also has an anti-inflammatory effect, especially if you dribble olive oil over it. What could be easier than these recipes for swiss chard, the easiest of all vegetables to grow in the home garden?

Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

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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Interesting questions from visitors

CLS writes:

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.

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Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is 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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