Question
Hello, my 18 yr. old daughter has been through doctors and tests galore with no relief for the past 2 yrs.  She finally decided to try going to a chiropractor.  She has a very slight herniated disc and her problem is in the L4 & L5 lumbar region.  While her pain radiates from her lower back, hip and down the leg to the ankle it has always been on the left side.  The right side had occassional pain but nothing too troublesome.  Her pain specialist doctor does not believe her disc herniation is the problem.  She got no relief from her back injections and her EMG/NCV was normal as was her bone scan.  Her Chiropractor feels it is from the herniation and gave her electrical stimulation, traction and then cracked her whole back.  The cracking did hurt but she figured that maybe it was because it was her first time and she had hopes that her next visit would prove more fruitful.  The following day, her RIGHT leg (the one which was NOT bothersome) went numb, completely.  It gave her quite a scare and continues to hurt her much more now.  Her next visit is in 2 days and I'm nervous as to whether she should continue with the Chiropractor or not.  Please advise if this is typical.

Answer
Mark,

It is not unusual for referred pain to change in its nature following manual therapy of any sort.  Changing from one leg to another, with the other being "completely numb" seems strange.  My first thought is that the DC must abandon the electric stimulation.  The reason is that it fixes nothing.   I don't know if your daughter has muscular spasm along with the leg pain, or what her medical history is.  Slight herniations of discs are seen in people without pain.  Sometimes large herniations are seen with no pain.  And, as you've experienced, seemingly normal MRI and EMG's are found in patients with radiating limb pain.   Secondly, it is important that the chiropractor assess her situation on her next visit, before doing any traction or joint manipulation.   The DC should do sensory and motor exam, testing skin sensation and seeing if she can heel and toe walk, for example.   If she is okay, then it is safe to try treatment again.  Ask the DC if he/she can provoke or reduce symptoms by trunk positional/directional challenges.  Ask the DC to check for signs of segmental instability, where she could have a "loose" lumbar segment that might appear normal during a supine MRI, but with weight bearing show signs of being lax and causing problems.  'Just a thought given the information you presented...  I'm assuming she's had blood tests for rheumatic diseases...I'm assuming she had a completely negative neurologic exam (again, ask the DC to review reflexes, etc).   The fact that this happened the next day and not immediately causes me not to worry...  Just go back and have the DC review everything.

'Best of luck,

Dr. G