Expert: J.R. Strecker, B.S., D.C. - 3/13/2008

Question
"I'm getting a tingle on the left side. I mainly feel it in my foot/lower leg area and also some in my left arm/hand (fingers). I've been to a orthopedic doctor because of neck / upper back and shoulder pain. After a couple of visits he decided to do an MRI and found I had a couple
of herniated discs in the cervical part of my spine and maybe one in the lower part (i cant recall). He also said my body showed alot of wear for someone my age(32yomale).He basically said to deal with it.Which is fine , I don't want to do surgery. While I was seeing him he asked about tingling which at the time I did not have. The tingle I get
occurs mostly when sitting and sometimes when I'm active (basketball). I'm wondering if this is something that could be checked / treated by a chiropractor. I also think its strange that its only on the left side, do you find that odd?"

Answer
Disclaimer: please do not take any of my advice without at least consulting with your doctor(s) first.  If necessary, print this email in its entirety for your doctor(s) to read.  In addition, please do not attempt to use this website or my advice as a substitute for your healthcare needs or as a substitute for the advice of your doctor.  There is no way a thorough health evaluation or assessment of any medical condition can be properly made via email.  Please only use the contents discussed as a guide or tool to address your health matters with your doctor(s).  If any of the information I provide conflicts in anyway with the information your doctor(s) provide, it is always best to default to the information provided by your consulting doctor(s) or to seek additional opinions from qualified, licensed healthcare providers as needed.

Hello T.,

First off, thanks for trusting me with your health.  You bring up a couple great talking points in your letter.  The MRI confirms you have herniated discs in your cervical spine, and we are assuming your lumbar spine as well.  If that’s the cases, according to your letter, you would have about 3 herniated discs in your spine.  That’s quite a bit.  That doesn’t mean your life is downhill or anything, but that is quite a bit of stuff for a young guy who is 32 years old.  Some people can have certain connective tissue disorders that predispose them to herniated discs more than others.  I’m not saying we should jump to that conclusion, but it might be worth mentioning.  The fact that you play basketball tells me that you are active.  Because you are active, perhaps you are into some other sports that might be a little rough.  Who really knows why you have the degeneration that you have in your spine?  I might have a better idea from taking a history and examining you, but unfortunately that’s not possible.  Some of the more practical reasons why you might have three herniated discs are because of hobbies or sports or history of traumas.  One of the most common causes for a joint to degenerate is a prior history of trauma 10+years ago.  This trauma could have been something like high school football.  Or, maybe you were in a bad car accident when you were younger.  These types of things can create degenerative changes down the road, and maybe they apply to you.  Another common cause that can predispose to early degeneration is loss of your normal spinal curves or improper biomechanics.  For example, people that walk around slouched all day may increases the stress in their neck (anterior head carriage) and predispose their cervical discs to herniation.  After all, if you walk around and sit with poor posture for several years, that constant stress to the joints of the spine is going to take a toll on those joints.  Bone remodels to stress (Wolff’s Law) – that’s how fractures heal.  Bones and joints are living tissues.  So if you’re stressing the structures improperly and not taking care of them for several years, you could start to see degenerative changes, such as bone spurs (osteophytes) and disc herniations.  In addition, discs can herniate with one simple instance of trauma, whether it is from a bad whiplash or picking up something heavy while not bending the knees.  You have to take care of your spine and make sure the joints are moving correctly if you want to prevent the acceleration of degeneration from progressing.  To really know what your specific problems are, I would highly recommend seeing a chiropractor.  Not all chiropractors are the same, and so if these issues aren’t addressed, I would keep shopping for a chiropractor that seems to know why you have so many spinal degenerative issues in your spine.  And don’t let the chiropractor say it’s simple misalignment creating your problem after spending only two minutes with you.  You’ll know when you’ve found a great chiropractor when he/she can address these issues with you and figure out what might have caused you to have these problems in the first place.
 
Because of the extent of your condition and because you are still young, I would strongly advise you to seek out a good glucosamine chondroitin product.  The research suggests it works for about one in two.  And you also have a tendency to get what you pay for, so look for a good product.  A couple good products are Cosamine DS caplets the ZAND brand liquid supplement.  Certain products will throw in a substance called MSM, but that’s not as critical as the glucosamine, though it won’t hurt you any.  It might take a few months before you start to notice improvements.  Glucosamine is gentle and passes through your kidneys without causing damage.  Glucosamine is known for rebuilding cartilage – a desperate need for anyone who has degenerating joints such as you.  This is a product people should take the rest of their lives.  Some people are helped so dramatically that their pain of “X-Years” completely goes away after getting on the product.  Again, be patient with this.

Since you are having tingling symptoms from the disc herniation, I would recommend a traction protocol.  Certain chiropractors have fancy, expensive machines, such as the DRX-9000.  It’s not necessary to get the most expensive treatment, since these treatments can become costly, but many patients swear by them.  Traction is a standard protocol for anyone with a herniated disc.  You can find traction therapies from certain chiropractors and physical therapists, depending on how well-equipped the office is.

Another important rehabilitative exercise you should be doing is the McKenzie extension exercise protocol which is indicated for lumbar herniations.  There is a good picture of what it looks like here: http://vendelascity.blogspot.com/2007/07/marathon-training-update.html  Have a chiropractor or physical therapist go over this exercise with you so that you are doing this properly, even though it looks simple.  You want to go into this position very slowly and take your time.  Don’t force anything.  It’s a very popular move in yoga.  When a disc herniates, it moves backwards, so what this exercise does is it extends the spine to squeeze the disc back forwards to a more proper position.  Moving up slowly allows the disc to gently mold to the pressure.  And stay away from any lower flexion stretches and exercises, such as sit-ups or bringing your knees to your chest, as these moves will accentuate the problem of a herniated disc.

Also, every time you do a lot of sitting or playing basketball (because of the running and pounding), you increase the pressure on the disc, and consequently, accentuate the disc herniation, which is a bad thing.  Because of this, your toe tingling can increase during these activities.  So, after you’ve sat for a long time or played basketball, follow up with some McKenzie Extension exercises, as illustrated by the link above, and ice your low back.  When you ice, wrap the icepack in a thin towel and do NOT ice greater than 15-20 minutes, with at least a 40 minute break between ice therapies so that your skin doesn’t get an “ice burn.”  This will help get some of the inflammation out of the low back near the disc herniation.

Is it odd for only one foot to tingle and not both?  No, this is not odd at all.  Actually, it’s a much better sign to have only one leg tingling and not both.  In some cases, it can be an emergency to have both legs tingling.  When both legs tingle, the disc is pressing centrally and generally poses a greater threat toward compressing more neurological tissue.  Discs more commonly herniate backwards and either to the left or right.  This happens a lot because of the anatomy and protecting ligaments in that area of the spine, as well as the mechanism that caused the herniation.  At each level of the spine where discs can compress nerve roots, you have a left and a right nerve root.  So when the disc herniates, it typically will only affect one side, either the left or the right.

And lastly, I think a chiropractor can help you dramatically.  He/she can discuss and review some of the things I’ve mentioned in this letter as well as restore some of the structural alignment and biomechanical joint aberrations and fixations (subluxations).  Many people will have dramatic resolution of sciatic symptoms after just a few chiropractic treatments.  I really think you should get checked so that some of the things I’ve offered can be tailored for your needs.  And if you don’t feel satisfied with your chiropractor, keep shopping around until you find one that you believe addresses your issues and understands your concerns.  Remember, chiropractic is a hands-on profession, so each chiropractor can vary drastically from one to the next.  

I hope this helps a bit.  I’ve given you lots of advice, so go see chiropractor to make sure you’re addressing this before it gets further out of hand.  Best of luck!!

Dr. J.R. Strecker, D.C.