healthy athletic 45 year old woman

by christy
(charlotte nc usa)

I was acutely stricken 4/2016, started 4 days before with pain in right groin, assumed just needed stretching; woke unable to stand more than an L shape, bent at waist facing floor, barely walking a few steps with pain in the right buttock, inner thigh and right quad.

Mri results indicated a possible anterior L4 disc sequester with nerve irritation; also had knee buckling in right and numbness in left calf.

I still have electricity feeling behind my left knee and right quad is visually smaller.

Neurosurgeon gave me steroids and pain meds.

I have returned to yoga and gym but still feel odd;
worried for a recurrence mainly. The quad still aches;
it has been 5 months since acute onset.

Chiropractor helped, neuro said do not return.

Hello Christy,
I always say the direction counts; are you better than a month ago and still improving? Are the signs improving? For example, I'm sure you had a strongly positive femoral nerve stretch. Is it less strong.

The knee jerk reflex is almost certainly zero and will probably never return; that's not critical but regaining the size and strength of the quad is vital. If you have numbness it may continue but you can live with that.

I'm concerned that you still have pain in that quad, and I presume it continues to give on steps and even walking. Do you have a marked limp?

Also is of concern is that you have tingling in the other leg too.

You are right to be concerned about a recurrence; be extremely careful if you're back at the gym. Something there probably caused it in the first place. Are you doing daily back exercises at home?

A sequestered disc is extremely serious and you're lucky not to have been operated on. I've had one myself, so I know the pain you've been through.

It's really your decision what to do from here. There is a certain amount of risk have further chiropractic treatment, particularly by an inexperienced person, but your chiro has helped you, so you say.

Frankly there's also considerable risk if you do nothing; you may end up with a permanently weak quad. In my book it's vital that the femoral stretch is less painful and tight, and the quad is slowly regaining strength.

If the quad reflex was unaffected then there's a whole question of the diagnosis. I'm a little surprised a L4 disc gave you pain in the groin. Did the tingling and pain continue down the inner lower leg?

Lots of questions, Christy and no easy answers. I myself have recovered completely with chiropractic care, but many chiropractors wouldn't touch a sequestered disc. In fact I wouldn't have for the first twenty years of my career.

Good luck, I hope this contributes.

Let me know how you get on. In good grammar please; I spent nearly as much time correcting your no so smart phone English as writing this reply!

Dr B

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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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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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