Question
QUESTION: About 2 weeks ago, I had my second visit to a chiropractor where I was undergoing conservative (mild) spine realignment therapy.  During the process, there were several pops in my thoracic spine area.  This has happened before while getting a massage.  The chiro said that it was fine, but to me, he did not sound convincing.  There was no immediate pain, but about a week later, I felt stiffness, pain and now itchiness in that area.  I think the itchiness suggests nerve damage.  I am seeing my PCP in a week, but do you have any advice on what to do in the meantime?

ANSWER: John,

There is no reason to assume that itchiness has anything to do with nerve damage.  Sorry, but there's no connection.  The popping sounds are what joints do when you push or stretch them, whether it be from a massage or from a joint manipulation from a chiropractor.  No immediate pain implies no acute strain or injury.   Symptoms a week later do not seem to make sense.  It is not uncommon to get some post treatment soreness, sort of like exercising new muscles.  'But a week later?  I guarantee that your PCP will have no idea what to tell you, except, maybe, "take to aspirin and call me in the morning."   I would suggest you have a conversation with your chiropractor and stick to his/her initial treatment protocol to treat whatever it is that your are being treated for.  Lastly, I realize you are a lay person, but understand that there is no such thing as "re-alignment."  You are likely receiving joint manipulation.   It alleviates pain, promotes better joint motion, and some other stuff, but it does not re-align your bones.  'Just keeping things clear here..

'Hope this helps,

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Thanks for your reply.  There is such a thing as neuropathic itch that people with spondylitis, MS, and people with damage to the nervous system suffer.  It suggests nerve irritation.

Answer
John,

Yes.  True.  But getting your spine adjusted by a chiropractor does not damage your nerves and cause you to itch a week later.  If you had MS and it was bad enough, the chiro and your PCP should have detected this on physical exam.  Blood tests and xray would help uncover ankylosing spondylitis (I'm assuming that's the spondylitis you are talking about).  You can also itch from dermatitis, early stage shingles, and eczema.  Nerve "damage", as YOU suggested, would be quite painful or show up as loss of function.   Having an underlying neurologic disease or skin disease is another story.  The odds of you having an underlying neurologic or skin disease that is provoked by chiropractic joint manipulation, with symptoms only of itching arising a week later are quite remote...unheard of as far as I know (though you suggest my knowledge is only 7 of 10...).   I'm simply responding to your query.  

'Regards,

Dr. G