hip and thigh weakness after minimal exertion

by Jane
(Toronto, Ontario, Canada)

In early June of 2013 I noticed a slight feeling of tightness in my right thigh near the hip bone. Within days I was experiencing rapidly increasing muscle fatigue in my right leg, most noticeably in the hip and upper thigh. As the weakness progressed, my ability to walk distances of more than a few hundred yards or to climb more than 3 or 4 stairs became alarming. The symptoms matched everything from chronic fatigue to MS to early stage ALS. At rest, I felt no pain, weakness or fatigue.
I went to a chiropractor who did extensive testing with a device that measured activity in my spine, compared weight distribution in my legs and took some sort of x-rays of my feet. I was prescribed expensive custom made orthotics and a year long chiropractic plan was laid out that promised to fix my problem.
After two months and 14 chiropractic sessions I saw/felt no improvement at all and in fact felt I was deteriorating further. At my wits' end, a friend reccomended visiting a kinesiologist who within 10 minutes of hearing my story, focused the problem down to a talar destabilization that had the effect of throwing my entire left leg out of whack.
(Incidentally I have no pain, restriction or swelling in my foot.) My ankle in the area surrounding the talar joint has been gently bound with elastic tape and from this (seemingly) tiny stabilization, the strength in my hip and leg appear to coming back.
I am thrilled to be improving but absolutely furious that the chiropractic treatments costing me more than a thousand dollars I could ill afford, along with the expensive orthotics that if I were to wear would hamper my progress, were prescribed as a cure and that 2 months after beginning treatment the diagnostic tools produced a readout that indicated my health had been vastly improved even as the distances I could walk had decreased to the point of considering a cane to help support me on short walks. More treatments, I was told, would see me actually feeling the benefits that had already appeared on the diagnostic test.
I was misdiagnosed - and worse, when I asked if a break or a strain or a tumour could have been missed by the diagnostics, I was asdured that all was well, it was just my brain that hadn't caught up and that was still sending messages of weakness and fatigue.
My question: what do I do now to address this inadequate diagnosis and treatment?

Ho-hum, I'm not sure, Jane. I share your doubts and anger. Frankly, I'm always rather dubious of a "year-long" programme. At least you had the sense to bail out after two months.

But I'm still sceptical of the talar destabilization diagnosis. I really can't see that causing neurological weakness in the thigh muscles.

A couple questions:
1. You have no pain at all in all of this hip weakness? There's an important distinction between weakness because of pain, and pain-less weakness. Weak with no pain?

2. Is the knee jerk reflex normal?

3. If you prick your leg with a pin, is it the same as the other leg?

4. Lying on your back, if you pull the knee to the chest, opposite shoulder, rotating in a circle... no stiffness or pain?

5. No back pain at all? Good health?

6. If you press in the groin and around the hip, first in the good, then the naughty leg... no difference?

Have you seen a neurologist? My feeling is that you still don't have an adequate diagnosis. Until you do have, it's difficult to make a serious complaint against any one. There's certainly no harm in writing to the chiropractor concerned to express your anger. Were you examined properly by the chiropractor. Not just the device checking your spine... reflexes, orthopaedic tests, range of motion of hip and back, precisely which muscle(s) are weak, sensory changes in the leg?
Obviously it's great that you feel you are improving. Wonderful. Let's hope and pray the improvement continues.

Obviously thoughts about the nasty neurological diseases still lurk. Interesting research that they may be caused by a high carb/ low fat diet. Make sure you are eating the healthy oils. Fatty fish, olive oil, avocados, freshly ground flax seed, walnuts to name a few.

I hope this contributes, let me know.

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 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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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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