Expert: Dr. J. Shawn Leatherman - 11/14/2008

Question
Hello. I first experienced numbness on the right side of my right foot and heel in July. I had an x-ray and MRI of my back and the Dr. diagnosed sciatica and sent me to physio. I have been going to physio once a week since then and she does acupuncture and IMS on me and she said my back is very tense all over. About 4 weeks ago I felt a strong electrical pulse from the acupuncture needle she put on the outer side of my right wrist and ever since then my wrist is sensitive to touch and if I push on that spot the side of my hand caves inward. Last week after physio and intense acupuncture and IMS I woke up that night and vomited and I have not felt right since that session. I have been dizzy/lightheaded and 3 days ago I started feeling electrical sensations and prickliness throughout my body and today when I turned around quickly I had a strong electrical "jolt" from the right side of my head down to the right foot.

I went back to my GP last week and he did a series of blood tests for diabetes, cholesterol, thyroid, nerve function, etc and an x-ray on my wrist and all the tests came back fine.

I am also going through a divorce and have been under a lot of stress for the last 8 months.

Is it possible that all of this is a result of stress, a pinched nerve or is the IMS and acupuncture aggravating an underlying condition?

Please help me with some insight as I don't know why my body is reacting this way except perhaps for stress. Thank you for your time.  

Answer
Dear Callie,

First of all, sciatica is a non-specific diagnosis which basically only means pain down the leg.  True sciatica can be caused from disk bulges or nerve root compression in the back/spine, or by the muscles in the buttocks.  Without the results of the MRI it is hard to ascertain what is really the cause.  Not to mention, radiating pain down the leg is often misdiagnosed as sciatica when the actual cause of the pain is sacroiliac joint dysfunction.  A correct identification of the offending tissue is critical for effective rehab...Oh, I am assuming that the doctor probably did not perform an examination of the back either...By the way asking you to bend over an touch your toes and asking if you have local pain does not constitute an examination.  Most general practitioners rarely perform adequate musculoskeletal or orthopedic examinations.

Increased stress is a huge factor.  It is well known that high stress levels increase body wide inflammation levels, lower immune function and increase pain transmission.  So yes this can adversely affect the entire body and stimulate strange symptoms.  You need to find a way to deal with your increased stress:  deep breathing techniques, cardiovascular workouts, journaling, hypnosis, yoga... whatever works for you.  

On the other hand, I would suggest that you also need to assess the quality of care you are receiving at the physio...Has any of it helped?  Why have they not altered their treatment approach?  Are you performing any active exercises or stretching?  If not, why not?  Not to mention, effective rehab techniques are normally utilized 3 times a week for at least a month, not once a week.  Also, what are they rehabing...ask them why they have designed this approach...what is it supposed to do for you and what tissues is it addressing? You need to ask straight forward questions and expect straight forward answers in return.  I think it would be advantageous for you to get a second opinion.

If you can get more information for me, I would be happy to follow-up with you and generate a more comprehensive idea of your situation.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net