Question
Hello,

I am a healthy 40-year old with no history of medical problems. I'm a practitioner of yoga and Pilates. I live in New York and walk everywhere. I'm quite active. I've developed some problems that are obviously hard to diagnose. Thanks in advance for reading this lengthy post.

Two months ago I had an operation to remove a bone spur in my right foot. I walked with a cane for a month. At the end of the fourth week I noticed a slight pain in my left knee. The pain grew to an intense burning with shooting pains. The ER said it was a sprain.

The pain moved to my right knee before dissipating almost completely with rest and 100mg of Tramadol a day. After walking at work, I would feel mild pain, but nothing major. Then suddenly after two weeks of improvement, I was seized by an attack of intense pain in both knees that left me incapacitated. This time the pain was an intense pinching and burning that started in the kneecaps and extended to my upper thighs. I went to a PCP, who told me to take motrin and do physical therapy to strengthen my legs.

Within three days, the pain was so excruciating I went to the ER again. I also developed numbness in my feet and lower face (mouth area). The knee pain was the pinching and burning but with shooting pains up the backs of the legs and calves and pins and needles as well. `the steady, throbbing pain was in the back of the knee and inner thigh. They gave me a shot of toradol, which cut the pain some.

With rest and Tramadol the situation in my knees improved, though I developed mild lower back pain at this time. I also had a flare up of some upper back pain associated with pinched nerves from being on the computer all the time. I've had physical therapy for this, but it flares up from time-to-time. I saw an orthopedist who took x-rays. He said it was not a sprain and that he did not think it was my back necessarily. he referred me to a rhuematologist and a neurologist.

This same day, I had a gentle massage of my entire back and legs. When I woke up the next day, my knee pain was gone, and it didn't come back for four days. By the end of the next day, though, my lower back pain was so excruciating I was sick to my stomach. It was a burning, pinching pain. After 150 mgs of Tramadol, I was able to sleep.  

With rest the back pain has abated. I was off my feet for four days, icing and resting, and I felt good, Went back to work today, and by midday, the pinching and burning in the back of knees was fairly intense. There was a mild aching in the back.

The pills are making the pain bearable, but I can't stand not knowing what this is. Plus, I think it's only bearable because I spend most of the week in bed.

If you have any ideas, I would be truly grateful!!

Answer
Dear Wendy,

Thank you for your question.  I appreciate that you gave some detail about your experiences.  Unfortunately, your question to me may be based on some misconceptions.  To give you the greatest benefit from my answer, I抣l first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not revealed by the complaints or findings mentioned in your question, though they may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as being born, strenuous physical activity, sleeping posture and mattress condition, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to what may cause the various complaints you describe in your question or if these may be related to a vertebral subluxation.  Even if it were possible to guess at what may be causing them, however, it is not pertinent to the matter of whether you will benefit from being free of vertebral subluxations.  In order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone who has had the history you describe better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  So, having one抯 spine checked for vertebral subluxation is tremendously important, but it抯 not for the purpose of dealing with the difficulties or pains you describe.  In other words, non-therapeutic straight chiropractic can be of benefit to any spine-owner, but perhaps in ways that you may not have considered.  It抯 not that you should see a non-therapeutic straight chiropractor FOR these concerns ?you should visit one in an effort to be free of vertebral subluxations, even WITH such matters in your history.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  

Additionally, your question deals with the limited objective of therapeutic care.  Remember, what we抳e covered here is about non-therapeutic matters and the two objectives are not the same.  Further, and quite importantly, even though this is not a service that I would provide in my field, I would say to you that diagnosis under the best of circumstances is something of an art.  It would be irresponsible for anyone to give you a guess by e-mail or the web about your situation.  Diagnostic work and therapeutic advice is difficult enough when done properly.  It becomes a riskier proposition when done poorly.  Even though you are frustrated with the course of things, you would still be better served getting opinions from someone with first-hand knowledge about you, not a limited acquaintance through internet correspondence.  Anyone who is willing to speculate about your situation by e-mail is providing you little more than a guess and perhaps a dangerous one, at that!  

All that said, it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor, even if you still elect to have therapeutic attention for your reported concerns and/or symptoms.  If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or directly at [email protected].  

Wendy, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.