My back just kills me everywhere, weak thighs, tingling in feet

by Charlie
(Albuqueruqe, NM USA)

My back just kills me everywhere, weak thighs, tingling in feet

Hi....can you put this in plain language so it make sense. I am somewhat scared and apprehensive to go Chiro for fear of making it worse?

MRI lumbar with and without IV contrast

Comparison 09/14/12

Indication, low back pain with numbness radiating down to the buttocks and both legs. Evaluate for HNP.


Stable lumbar spinal alignment and positioning. This includes an S-shaped thoracolumbar scoliosis and mild straightening of the nomal lumbar lordosis. Stable minimal retrolithesis of L3 on L4 and L1 on L2. Lumbar vertebral body heights are maintained. Minimal anterior weding of the T11 and T1 vertebral bodies is remote, without superimposed STIR hyperintensity to suggest acuity. Bone Marrow signal intensity is diffusely heterogenous. Degenerative endplade changes and Schmorl's note formation at L3-L4, as before. Postcontrast images demonstrate no abnormal parenchymal or leptomeningeal enhancement.

The technologist obtained images of the thoracic spine demonstrating a left central disc protrusion at T11-12 that moderately compresses the anterior left hemicord. There is possible STIR hyperintensity within the substance of the cord on image 6 -14.

At L5-S1, mid diffuse disc bulge. Moderate bilateral facet arthrosis. No nerve root encroachemnt within the central canal. Left foraminal disc protrusion appears stable with contact of the existing left L5 foraminal nerve segment. Stable mild right foraminal narrowing.

At L4-5, similar bilateral hemilaminectomy appearance. Diffuse disc bulge with superimposed 3-4 mm AP central disc protrusion and transversely oriented annular tear. The disc protrusion is slightly increased in size. Faced arthrosis. Hyptertropys of the remaining ligamentum flavum on each side. Moderate - sever bilateral subarticular zone stenosis is similar versus slightly worsening ot the prior exam with encroachment of the descending nerve roots on each side. Similar mild bilateral foraminal narrowing.

At L3-4, similar bilateral hemilaminectomy diffuse disc bulge. Superimposed 6-7mm Ap central-left central disc protrusion. Central canal stenosis amy have slightly progressed at this level. Residual transversece thecal sac diameter is 5 mm compared to 6 mm previously , and residual Ap thecal sac diameter is 7 mm compared to 9 mm previously. Subarticular zone stenosis remains worse on the left. Similar moderate-sever left worse than right foraminal narrowing. There may be a superimposed left foraminal focal disc bulge, as before

At l-2-3 there may be a bilateral hemilaminectomy as before. Central disc extrusion wiht transversely oriented annual tear appears fairly stable. It measures 9.5 mm Si x 3 mm AP x 10 mm TV. Mild moderate bilateral facet arthrosis and ligamentum flavum thickening. Mild-moderte central canal stenosis appears stable. Mild lbilateral foraminal narrowing, perhaps worse on the left appears stable.

At L1-2, T2 hyperintense anterior left eupdural space mass is NEW. This maybe be a free disk fragment or extrusion. It measures 10 mm SI . 6 mm AP x 8 mm Tv and nerve roots. Mild bilateral foraminal narrowing.

IMPRESSION: New free disc fragment versus disc extrusion in the left anterior epiducal space at L1-2. Otherwise fairly stable MRI lumbar spine

Hello Charlie,
You weren't afraid to consult a neurosurgeon for fear of making it worse. Why afraid to see a chiropractor? Do you think hands are more dangerous than a scapel?

Seriously now. Yes, you have a difficult back with multiple level degenerative changes. I wouldn't expect miracles from anyone, a chiropractor included. Yet spinal stenosis usually responds surprisingly well to McManis Chiropractic traction. And to the Thompson drop protocol. They are most unlikely to make your back worse.

Yes, side posture can worsen it, but that's where the quickest response is often too.

The weakness and tingling in your legs are probably coming from your back, though there are other causes. No diabetes? Weight okay?

The hyaline cartilage that lines the joints in your back is pretty shot. At this link you'll see ways to support it.

Are you doing any lower back exercises ? That's where I would start.

Find a good chiropractor is your next stop. Someone experienced.

I'm not a radiologist, so it's not appropriate for me to interpret that report. Make an appointment with the man who wrote the report and ask him to explain it you. The long and the short of it though is multiple level quite advanced degenerative change. And a probable new slipped disc at L1/L2. That would account for the weak thighs.

I hope this contributes.

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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Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is 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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