Question
Hi I'm a 41 year old male just retired from the military. before retiring I was a military police officer and had to wear heavy body armor for many years specially after 9/11. Well back in April of this year (2006) I start to get spasms/twitches mainly in my calves, legs and arms and at the elbow (right arm).  lately I'm experiencing spasms around my left knee.  This will come and go and sometime lasts 12-24 hours or more.  I also suffer from back pain lower and upper.  My family doctor is a DO and can do adjustments.  He has been adjusting my spine for the last 6 months on an average once every two weeks.  Currently my spine feels (upper between the shoulders) like it is twisted and it goes into the back of my head with headaches. my lower back will ache at times and my right leg will get a dull ache down the backside.  I was wondering if my spine is out of alignment can this cause spasms in my arms around the elbow and in my leg around the knee as I have mentioned.  Also my doctor has ran blood test on my electrolytes and thyroid all came back normal.  However he did state my B12 was at the low end of normal at 94 and he has recommended B12 shots because I'm hypothyroidism and this could effect adsorption of B12.  I currently take synthyroid for being hypo.  Any idea if I need to see a chiropractor for the spasms and spine.  Thanks for your time.

Answer
Dear Allen,

I think that a chiropractic evaluation would be a good ides.  Even though your DO has training in spinal manipulation, it tends not to be as extensive as a chiropractors training.  The Do's training is more like a traditional MD's and has much less focus on the spine and musculoskeletal issues.  I am sure that you DO is competent, but a chiropractor may look at the problem differently.  To look at the differences, as well as the similarities in training, check out this link:

http://suncoasthealthcare.net/chiropracticinformation/chiropracticeducation.html

In relation to the thyroid problem, your DO is absolutely correct that the thryroid problem can cause B12 absorption difficulties, but you may also have a deficiency in something called intrinsic factor which is produced in your stomach.  Intrinsic factor facilitates the absorption of B12 into the system.  If you have a deficiency, then B12 shots, or sub-lingual (dissolved under the tongue )B12 supplements will help.  In addition I would encourage you to read a few books on these problems to get a greater understanding of the problem.  A good start is:  Living Well with Hypothyroidism - Mary J. Shomon.  For more check out this link:   

http://suncoasthealthcare.net/patientresources/recommendedreading/index.html

Allen, it is obvious that you are experiencing chronic issues, and these should be addressed.  If you DO is not giving you the results you need I would get a second opinion.  Make sure that you ask the chiropractor about his/her training, what post-doctoral training they have, and if they additionally have someone in the office to specifically address the soft tissue component of the problem.  It is likely that your problem will require more than just spinal manipulation such as physical rehab, and deep tissue massage.  If you need any further help in finding a good chiropractor, check the following links for doctors with certifications:

www.idealspine.com
www.srisd.com
www.grastontechnique.com
www.pettibonsystem.com
www.activerelease.com

Respectfully,
Dr. J. Shawn Leatherman