Pain, tingling and burning lower legs, shin, calf, foot

by Ann Marie

I hurt my back twisting and lifting a bed. I got some massage and acupuncture and it resolved. A few months later I started to get tingling in both my legs so I went to a physio. After a couple of sessions of physio my left hip seemed to lock and made a loud noise whenever I walked. Waking up one morning I felt a very sharp pain on the outside of my hip, the hip was still locked, as I went to go to work I felt an extreme sharp pain in 3 places around the upper thigh (front, back and front to the middle), it lasted a few seconds and then I was left with the pain at the back of the leg, sciatica.
Back to the physio and I was referred for MRI. It showed a massive focal herniation at L4 L5 with the disc deviating to S1 nerve root and compressing the left root and touching the right. I saw a neuro surgeon who said there was no need for surgery.

Some physio sessions later and I felt good and back to normal but then I started to get tingling and pain in the groin in my yoga class. Over the next few days this progressed to sharp shooting pain in the genital area. I am now apx 18 months since the original injury and I now have some lower back pain, sharp and aching buttock pain, inner thigh pain, pain behind butt to the middle of the knee, calf pain, shin pain and pain into my foot and big toe. I am also getting pain in the genital area and my period pain was a lot worse than normal last time. I also get lower abdomen pain. I find that I get pain in the genital area and also inner lower leg when I cross my legs. Sitting in general makes things worse. Walking can improve things after a while, the first few minutes might be worse.

GP said my SLR test is good. I've been going to physio and osteopath. One said I need pelvic floor work, another said my sacrum destabilized.

I am starting to think that it is not all coming from my back and that there is something with my hip and pelvic floor. I am considering trying a chiropractor but a physio told me that with the injury in my back I should not have any manipulations done so this makes me nervous to try it. I would be grateful for any suggestions you have. Thanks.

Hello Ann Marie,
I too suspect there may be more than one condition here, so let's start with a few simple tests; please report what you feel as accurately as possible if you want a reliable answer from me.

(1)Sitting in a kitchen chair, flex your head forwards onto your chest, and then ask hubby to straighten first the good leg, and then the naughty one parallel to the ground.

Is one leg much tighter and even painful with the stretch; if not, ask him now to dorsiflex the toes and foot towards your head; is there now a difference in the leg compared to the other?

(2)Lying on your back, pull your knee to the chest, then towards the opposite shoulder, make a circle of the hip, and now drop your knee into the lotus position; is the other leg significantly different?

Are you doing lower back exercises at home every day? Yoga is great, but if you have a disc injury that hasn't healed, bending and twisting will only aggravate it.

Accurate and specific answers please.

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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