Frustrating chronic glute and groin pain and tingling on outside of calf and foot

by Julie
(Seattle, WA)

Slump test for sciatica.

Slump test for sciatica.

Frustrating chronic glute and groin pain and tingling on outside of calf and foot needs careful evaluation.

I've been diagnosed with gluteal bursitis and sacrum pain, both on the right side. I have tingling down the outside of my right calf. PT seems to make it worse, but the thought of stopping movement doesn't seem helpful. I have refused (so far, the cortisone shots since that seems like a way to mask the problem rather than fix it).

I used to be a runner, I bike commute daily (15-20 miles), I weight lift (but stopped about 3 months ago), I also do some gentle yoga. It has been a year of chronic pain (on the right side of my body) that came in during a PT sessions for a tight left hamstring.

It is also thought that the femoral nerve is entrapped. The inner groin pain and tingling are quite distracting but they vary in intensity. Last week it was almost zero; this week it is about level 5. I tried adding back the woodchop weight exercise after having my PT watch me and I think that has aggravated things.

Also, stretching my inner thighs aggravates the groin pain. I feel like there are multiple issues; sacrum, femoral nerve, possibly something in my foot? I have had plantar fasciitis for years and wear orthotics. I am very frustrated.

I see a massage therapist, acupuncturist, PT, and OT. I was seeing a chiropractor but I felt like he started working on me without checking out how my body was doing that day. that seemed concerning since it fluctuates so much. Any advice you could offer would be very appreciated! Oh, I had back xrays and they were fine.

Hello Julie,
Yes, I can understand you must be frustrated.

First a few general thoughts. Remember, exercise is meant to improve your health, not make you frustrated and miserable. Sit back, and take a good objective look at your whole program.

Secondly, have someone stand behind you, place their hands on your iliac crests to check if they are near level, and then have you bend forwards; do you have a scoliosis?

Thirdly, I'm questioning the diagnosis, but remember I can't examine you. With tingling on the outside of your calf, and a tight hamstring (so often not that at all but a tight sciatic nerve) this points away from the femoral nerve; where exactly in the foot are you feeling it?

Take a look at the Maigne's syndrome page at Chiropractic Help using the Site Search function in the Nav bar on the left.

To test my theory, sit in a kitchen chair, flex your head onto your chest and have some raise your lower leg parallel to the ground, first left and then the naughty leg. Do you get pain in the back? Where? Is the right leg much tighter than the left and is there pain in the calf. Is this in reality a sciatica?

If you bend forwards, is the right leg much tighter than the left?

And lastly that pain in the groin and inner thigh. Lie on your back and pull your knee to the chest, to the opposite shoulder and then into the lotus position. Compare with the left hip. What's the difference?

Take each of these points, test them and make careful precise notes if you want me to be of any further assistance. Vague replies don't give me the information I need.

I'm not surprised the woodchop weight exercise aggravated things; bending and twisting.

I would recommend you start our simple lower back exercises EVERY morning in bed before arising.

Lastly, I'm not surprised you stopped seeing that chiropractor; we're not all lazy like that.

Dr B

» Frustrating chronic glute and groin pain and tingling on outside of calf and foot

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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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