Numbness & tingling from hips down including groin

by Barbara P.
(Wichita, Kansas, USA)

I am a 70 yr old female with a history of severe stenosis and grade 1 to grade 2 spondylolisthesis (depending upon standing straight or bending)at L4-L5. Seven years ago I had a partial discectomy at that location due to disc rupture as I wanted a more conservative approach to avoid fusion. This surgery was performed by a Neurosurgeon. Since that surgery to present time, I have continued to have lower back pain when standing or walking for extended periods of time. After that surgery, I have had slight numbness on the right side of my right foot that began to move up to my ankle periodically. I went back to the Neurosurgeon when that began as was told that some of the remaining disc matter had probably migrated out and most likely was putting pressure on the nerve.

Approximately 5 years passed and I began to have some numbness in the left foot also. I was concerned so at that time I saw an Orthopaedic surgeon. He told me it was most likely not caused my the L4-L5 stenosis and offered no explanation.

In May of this year I began to have popping on my left side of lower back when I went from a sitting position to standing. Since it did not go away, I went back to the Orthopaedic dr. who said it was a facet joint slipping as the MRI had shown those facet joints at L4-L5 were significantly enlarged but he was not concerned. Five days after seeing him I spend most of the day working at my computer. When I began to stand up both legs, feet & groin felt as they were asleep and numb. I waited for 1/2 hour hoping this was temporary but as there was no change, then went to our local emergency room. I had CT scans of head and lumbar area as they were concerned about possible stroke or Caudal Equine Syndrome. They ruled out those concerns and sent me home. The next day I saw the Orthopaedic surgeon who said my stenosis although severe was not significant enough to cause CES. He did not know what was causing the symptoms as there were dermatomes involved above the L4-L5 stenosis (eg.L1, L2). He said he could do surgery and fuse and straighten that area but it probably would not help the numbness and bowel issues I am having. He sent me to a Neurologist who could not find out the cause either.

I have since had blood tests for vitamin deficiencies and diabetes, which came out normal according to my family doctor. Although am overweight which I am working on, and am prediabetic, my A1c is 5.8, Glucose 106, Tryglcerides 178. I did get more MRIs and CT scans and saw a Functional Medicine Practitioner. I did find out that I have Sacroiliitis, bilaterally and inflamation where the Sciatic nerve goes through the Piriformis muscle but no pain down the back of my leg, just lower back pain and hip pain if I have to walk a long distance.

Added to that problem, I now have numbness all around my thighs, calves, ankles, top & bottom of my feet and toes and groin and also bowel issues. The last 2 days I have tried one of our local chiropractors but felt he was not really interested in anything other than Xray of hip area and aligning and adjusting and hip and lower vertebrae. He took about 1 minute to push and pop and said it would take a long time to correct all the things I having going on in my back. He just did not instill much confidence in me. There are a lot of chiropractors in this area, some specializing in different problems. He did not do any kind of testing of areas as you do and as you have shown online.

I am getting very worried that the longer that my nerves are being compressed, compromised, or entrapped in the lower half if my body, the greater the possibility that this will be permanent damage. I have had this numbness for 40 days. For the last couple of weeks numbness and pressure sensations get worse if when I sit down for more than 10 minutes. I see a Neurosurgeon next week hoping for some ideas of the cause but am concerned he will just recommend surgery as that is his focus. I would greatly appreciate any thoughts and suggestions as to something to try and possible causes of this extensive numbness. I have been very impressed with your web site and am so grateful to have found it. Your knowledge of the human body, your ability to share this knowledge and your compassion for those of us dealing with physical challenges gives me so much hope in you and your profession. I could send MRI or CT pics if that would help you in offering some suggestions. I thank you for any ideas and suggestions you could share with me.
Dear Barbara P,
Yous is a not uncommon sequela after lumbar surgery, even if you had found a chiropractor who would have taken the time to consider your condition more thoroughly. With surgeons, 50% of them graduated in the bottom half of the class and sometimes I think that figure is 60% with chiropractors!

Seriously though, you make no mention of doing a disciplined set of lower back and hip exercises every day. That is absolutely vital; gentle stuff, best done in my opinion on your bed before arising and several times a day. They take only a minute or two. It's time for you to help yourself.

You don't say how overweight, but if your BMI is over 30, do something about it. Those extra pounds are a millstone around your neck, dragging not only your back but hips, knees, feet and the rest of your body down. Find out about glycemic index; it's the only way to safely and reliably lose weight. It means avoiding refined starches that cause an insulin rush, depositing sugars as fat.

It's possible your hip is involved too. If you lie on your back and pull your knee to the chest, is it particularly stiff and sore in the groin and side of the hip? The lotus position?

Yours sounds very like a case of lumbar spinal stenosis; older folk like us, I'm your age, all have some of it to one degree or another. It's wear and tear after a lifetime of hard work. Back exercises, swimming and short walks are what you can contribute to the party and you'd be astonished; they would probably help more than 50%.

Sitting for prolonged periods, particularly in certain chairs and couches is the very devil for a back like yours. Limit yourself to periods of 20 to 30 minutes, make a cup of tea, go to the loo, stop the movie, take a short walk before going back to the chair.

Choose your chairs carefully; they will tell you if they are good or bad if you're listening. But any prolonged sitting will do mischief.

You want to avoid more surgery, Barbara, at all costs; that means doing what you can to help yourself.

Those bowel issues, if they are from your back which is unlikely, then they are serious. More likely is a lack of sufficient fibre; do you have an easy stool movement every day? Do you have a salad most days, plenty of fruit and bread with all the bran in it? Beets are God's gift to the unhappy colon.

I wish I could be more helpful; I still treat numerous folk with stuff like you are having and mostly it's at least partly usually very successful. 100% cure doesn't exist. Maybe start talking to folk about a chiropractor who will take the time to listen, examine you thoroughly and help. And don't get mad when he brings up your weight and lack of exercise; those are things that you must do for yourself; no one else can.

Good luck.

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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