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Lumbar Stenosis Case file

Lumbar stenosis case file brings you an anecdote from a chiropractor.

This page was last updated by Dr Barrie Lewis on 21st April, 2019.

The typical signs and symptoms of low back and leg pain in the elderly are often not pretty; there may be numbness and even severe weakness in one or more of the muscles; but they are not necessarily the monster they are assumed to be. Given time, it's astonishing what can be achieved with chiropractic help.

Mr S, a 75-year old man, with a decade and a half long history of lower back pain, and with onset of tired, aching legs about 18 months ago whenever he walked more than 50 metres, gave cause for concern. He walked in a stooped manner, in slight flexion, which brought relief from his discomfort.

Extension of his back produced immediate low back pain and bending to the side produced a tingly, numb feeling down his right leg.

He obtained relief from the ache in his legs by sitting and lying down.

My favourite, the slump test, for a slipped disc was negative. Nor did he have any bowel or bladder problems which may accompany a severe case of lumbar stenosis.

Part of his underlying problem was a short left lower limb plus a tilted sacrum that give him a moderate scoliosis. Interesting research about leg length inequality is unequivocal; it produces more arthritis in the knee, hip and low back. 

The red label below shows the arthritic facets.

Spinal stenosis scan.

Lumbar Stenosis Case file

A lumbar stenosis case file often has symptoms down the leg with minimal low back pain.

The label below on your reading left, marked R, says "scoliosis"; done to make the graphic narrower for smartphones.

Spinal stenosis lumbar AP x-ray.

In Mr S's LUMBAR STENOSIS CASEFILE I was quite certain his short left leg contributed to the arthritis in his low back. How you might ask?

Lumbar stenosis lateral x-ray.

Short leg syndrome

People with a short leg, and there are a great many of us (I am one), are more likely to develop fixations in the lower joints, and it is this immobilisation of the joints that is the cause of the degenerative changes that we found in Mr S's lumbar spine.

Read more about immobilisation arthritis.

Medicine's theory

Medicine believes this degeneration in the lumbar spine is the natural affect of aging, call it wear-and-tear. Like grey hair. To an extent this is true, but the full blown degenerative arthritis in the joints of every lumbar stenosis casefile is not normal and natural aging.

Sometimes, this it is indeed the case after trauma like a serious car accident or a fall from a height on the buttocks, or infection. But in the majority, science is now proving that it is joint fixation that stagnates the fluids that lubricate the joint cartilage, causing the prolific arthritis.

Regular, specific exercises, and an occasional but regular Chiropractic adjustment of fixated joints, is what we believe is the correct approach; prevention, long before the wear and tear develops.

Backs are the most strange and unpredictable things. Despite a very poor prognosis, within three weeks Mr S was standing up straight, and could walk several kilometres without the fatigue in his legs. We've started the rehab phase; he's on these exercises every morning for life. They only take 2 minutes; you can get them from Chiropractic Tips.

What did I do? I adjusted his sacrum, lying on his tum, using a Thompson drop protocol, part of the usual Sacroiliac Joint treatment. Then we adjusted the fifth lumbar vertebra which was fixated, lying on both sides. Using a drop technique, it's gentle but firm, with no audible releases. Bob's your uncle. He can walk again.

Remember, this is only an anecdote. Chiropractic can't cure every case of spinal stenosis. In fact, Mr S isn't cured.

I don't believe in cures with backs, any more than one can be cured of diabetes. He must come under management of his back to maintain the progress. He is more than happy, having suffered for 18 months.

Help for Sciatica Pain

Spondylolysthesis (pronounced spondylo-lys-thesis) is the longest word I know in the English language. German can boast of several hundred longer words!

A "spondylo" or "spondy" occurs when a vertebra slides forwards on the vertebra below, sometimes crushing the spinal cord, or the nerve root in the process, causing leg pain, and sometimes weakness and numbness in the legs. Spinal Stenosis.

There are different causes, one of them being degenerating facet joints.

Leg pain

There are of course many causes of leg pain and it would take several long texts to include exhaustively all the possible causes. For example, I have a relative with a very rare autoimmune disease. Only six cases exist in the UK; the classic signs are late onset of asthma and severe vasculitis of the lower legs. It's not included, obviously, in our list of common causes of leg pain.

There are many exercises that you can do for relieving sciatica; gently and sensibly done they will make a huge difference.

At Chiropractic Help.com we are planning a major upgrade in 2012 with more videos of exercises and sciatica stretches.

Here's an update of interest; it's happening, see below. In the meantime, these chiropractic tips have some basic lumbar exercises, always an important part of sciatica pain cures.

Every successful lumbar stenosis casefile includes a disciplined set of exercises done daily; before getting out of bed is the best time to do them, in my opinion. Just like you brush your teeth, whether they hurts or not; it's called prevention.

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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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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% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's 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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