Question
Hi! I have a question I was hoping you could possibly answer for me. I am a 31 year old female. In June 2005, I started to experience pain in my lower back. I attributed this to a science class I was taking at the local college. It required me to sit on a bar stool for 4 hours, 4 nights a week. The pain gradually decreased; however, it stayed a steady dull ache. In December, I began to experience weakness and a general achy feeling in my legs. During this time, I had a strange rash to appear. In January, I made an appointment with my physician. I explained to him that I had been feeling achy, like the flu, and my legs sometimes felt like jello. He ordered blood tests which showed that I had a severely high sed rate as well as I tested positive for the HLA-B27 gene often seen in patients with Ankylosing Spondylitis. He referred me to a rheumatologist who ordered more lab work, X-rays, and a CT Scan of my pelvis region. The X-rays and CT Scan looked great, I tested positive for lupus; however, my sed rate was through the roof. He immediately started me on Indosin-SR and monitored me for six weeks. As the swelling went away, the pain become extremely bearable and I almost forgot about it at times. He eventually diagnosed me as having undifferentiated spondylosis as he stated my symptoms were vague and hard to pinpoint. He said we would have to wait and see if any new symptoms developed. That was in March of 2006. Three days ago, I started to experience a numbness and tingling in my right arm and hand. It felt as if I had slept on it wrong, but I hadn抰 been to sleep. It continued the rest of the night. The next morning it was gone when I woke up. By afternoon, it had not only reappeared but it started to spread everywhere on the right side of my body. I was numb and tingling from my ear to my toes. It was very scary and strange. I felt almost semi-paralyzed. It continued the rest of the day and all day today. Today the numbness is in my left arm, hand, and foot as well. I don抰 understand what is happening. My fingers are numb as I am trying to type. I have never had anything like this happen to me before. It is like my body is asleep and I can抰 wake it up. Any suggestions you could possibly offer would be greatly appreciated. Thank you so much - Melissa  

Answer
Melissa,

With the information that you have given me, I understand and totally agree with what has taken place with your care so far on the medical side.  I can also identify with the frustrations that your doctors and you must have.  I can also understand the "generic spondylosis" diagnosis...your doctor doesn't want to label you with a condition unless you actually have it and it can be documented.

Concerning Systemic Lupus Erythematosus, I am assuming that you must have tested positive for ANA (anti-nuclear antibodies)in your blood. Lupus manifests as an auto-immune condition that develops multiple antibodies against your own body.  Specifically against DNA, RNA, proteins and double stranded DNA.  Concerning the high ESR rate, this is an indicator of body wide inflammation and is nonspecific, but definitely an important marker to gauge and to get reduced.

HLA-B27 is an arthritide marker that can be raised in a few other conditions as well such as: Reiter's syndrome, Acute Anterior Uveitis, Grave's Disease, and Juvenille Rheumatoid Arthritits.  These are other avenues to consider, however you don't really fit the clinical profiles for these conditions.  To rule these conditions out, your doctor can look for specific markers on arthritic blood testing profiles, and quite frankly this has probably already been done.  Of the above, Reiter's syndrome would be the most likely because it manifests most commonly with sacroilliac pain and inflammation. Reiter's Syndrome is also sero-negative for rheumatoid factor like Ankylosing Spondylitis is. It is important to note that Reiter's syndrome is linked to a previous infection...most common organisms are:  Chlamydia, Campylobacter, Salmonella and Yersenia.  Think of any previous infections or sicknesses you may have had 3-6 months before your back pain started.

Now concerning the tingling, SLE (lupus) is a strange disease because it can affect so many differnet organ systems in the body.  This is truely multifactorial and can manifest symptoms in many ways.  When there is neurological involvement, it is the central nervous system that is affected predominantly.  The neurological portion of the disease is usually cognitive/psychosis (mental illness), but other neurological things can occur.   Your initial symptoms of tingling in the arm would have been considered peripheral nervous system, but with the tingling progressing over the entire body, that could be considered of a central origin.  This could be related to your previous Lupus diagnosis and should be reported to your doctor.

On the other hand, tingling could be unrelated, and may be the result of a host of other conditions, especially when systemic and not local.  This could be an initial indication of Multiple Sclerosis (MS) which is positive for HLA-B27, but should also show other blood markers (HLA-Dw2, HLA-A3, and HLA-B18).  The best diagnostic for MS would be an MRI of the brain associated with a clinical history.  

Are you having any other strange symptoms that seem to come and go? -- eye problems, headaches, foot pain, pain upon urination, dizziness, hearing loss?  These are symptoms of Reiters and of MS.

The most important thing to do is to document all of your symptomatology so that your doctor has the clinical presentation to correlate with your lab and diagnostic test.  Now if all of the testing comes back negative for Reiters, MS patients do get some relief from Chiropractic care as do patients of lupus, but it will not fix the problem. IF MS is not the cause then a chiropractic work-up and evaluation would be an appropriate step. Concerning the elevated ESR, there are dietary concerns to help manage inflammation in the body as well as auto immune problems.  Many patients with auto-immune and inflammatory conditions have food allergies that go undiagnosed.

Increase intake of omega III fatty acids such as DHA and EPA 4000-5000mg per day for a month to start ( make sure you get a product that is molecullarly distilled.) Eliminate refined carbohydrates from your diet:  breads, pasta, baked goods, candy, snack foods etc..., increase fruit and vegetable intakes to more than 10 servings per day, eliminate all artificially sweetened snack and beverages from your diet due to their neurotoxic effects.  This includes aspertame, nutrasweet, splenda, and a food additive MSG.  If you need a sweetener for drinks etc, use a natural extract called Stevia, you can find it at most groceries if not on the internet easily.  In addition tumeric, garlic, boswelia, curcumin, bromain, papain, and other pro-enxymes will help in further inflammation reduction.

Any other questions I can help you with Melissa, or further details you might want clarification on, please ask.  Also please do some research on the above mentioned topics so that you gain a more complete understanding.  I have only touched on the high points and there is much more information for you to gather.

Respectfully,
Dr. J. Shawn Leatherman