Extreme leg numbness and lower back pain.

by Dee

Can you raise your big toe?

Can you raise your big toe?

I am a 49 year old, otherwise healthy woman. I was shoveling snow about 6 months ago and woke up the next morning in excruciating pain. I assumed it was a bulge and after treatment with prednisone and rest, the pain subsided to a manageable level but my lower back was still "touchy". I exercise regularly and returned to all my normal activities but did experience lower back flare-ups and mild numbness in my toes and feet.

Well, over the last two months, the numbness has increased. The bottoms of both feet was where the numbness really set in. I began stumbling, mostly because I had trouble feeling the ground so my feet would "catch" while walking. I have had several scary falls. The numbness increased and it is surface numbness. It feels as if my skin has had Novocaine. I can still walk and flex my muscles in these areas, however, it is awkward to walk and my balance is way off. My calves became numb. My lower back region is numb to the touch but when pressure is applied, feels tender inside.

Now, the front of my thighs and knee area on both legs is completely numb to the touch. My shins, outer thighs, and groin area also. My genitals are numb. I have had a few mornings where it is difficult to begin urinating. About a month ago, I had issues with incontinence but that has since stopped; it was as if I couldn't feel the sensation of having to urinate until it was almost too late(or actually too late in some cases).

I have seen my primary care doctor and he assumed this was sciatica and some kind of nerve issue. I took a course of prednisone, which did not help at all, and he sent me to orthopedic doctor. I had one MRI that showed "nothing remarkable" but degeneration of L4 and L5. My orthopedic doctor thought the MRI was not very good. He referred me to a Neurologist who ordered an MRI with contrast which was better quality. The Neurologist reviewed the new MRI and said there was nothing that she saw that would explain the severe numbness- mild bulges but no smoking gun. She ordered an EMG which I will have on Monday. I have looked into other things that might cause this numbness and I don't believe this is MS or any other ailment. I truly know that this stems from my spine and some kind of pinched nerve or compressed nerve or bulge or similar. I really believed that the MRI would show something obvious because of the severity of this numbness. My numbness is not going away! I am afraid to do steps and I believe that my legs are weakening; it's hard to lift myself while doing steps. The only pain I feel is lower back; same spot as original injury. Is there something that could be causing this that will not show up on an MRI? I am worried that if they don't find the cause soon, I may never regain the feeling in my lower body. What could this be? Are there any treatments that I could do to help me? Thanks, Dee.

Hello Dee,
You've got me puzzled too. The numbness is crossing several dermatomes and the weakness different myotomes; so it's not a straight forward lower back or disc issue. Also it's not usual to affect both legs.

However it started with a typical lower back strain-sprain, so that makes one think a chiropractic case.

I'd be looking for changes in reflexes and specific weakness; go to our muscle testing page below and see if you can identify which muscles precisely are weak. Can you raise your big toe normally? Can you raise your heel off the ground? Can you bounce on your knee without it giving?

Much of what you describe fits with either a cauda equina syndrome, or peripheral neuropathy, but the neurologist would have picked that up.

Another is a sequestration into the spinal canal but again that should have been seen on the MRI.

Start with lower back exercises done faithfully every morning before getting out of bed; find them in the navigation bar at Chiropractic Help.

I hope this contributes in some small way, but I too am rather at a loss; let me know when you have a diagnosis.

Dr B

» Extreme leg numbness and lower back pain.

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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'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.

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