Expert: Scott F. Gillman, DC, DACBSP - 11/9/2009

Question
I recently got an SI joint adjustment (about 3 weeks ago).  Following the adjustment, I have light constant tingling in my calf on the left side (same side as the adjustment) and my left SI joint is tender to the touch.  My sacrum almost looks a little swollen to me.  I have had an MRI and there are no disc issues.  Will the tingling go away on its own?  Do these symptoms sound like something is wrong in my SI joint?  I am really worried, as I went in to the chiro with minor low back pain and now I am dealing with a whole new set of issues.  Any advice would be gladly appreciated.  

Answer
Pam,

It is possible that there is SI joint irritation and that you are experiencing "chemical" radiculitis.   This is where inflammatory chemicals irritate the nerve membrane and cause referred pain or tingling into the lower extremity (thigh, leg, or foot).   The other possibility is that the SI joints are irritated and causing "sclerotomal" pain referral. This is referred pain from the joint.   Keep in mind that we can get referred pain from different body parts, the best example being shoulder pain caused by the heart (heart attack or angina, for example).   Not knowing anything about you makes it hard to know what your situation is, and there are several possibilities for causes and remedies for your condition.   My suggestion is to go back to the chiropractor and tell him/her what is going on.  Sometimes it can be a quick fix, and the problem all along was a minor one, but was an unfortunate consequence of treatment.   Just as you would call you medical doctor if you had a bad reaction to a pill, you should do the same with the chiropractor.  Ask him/her to do the joint tests for SI joint, lumbar joints, hip joint.  See which muscles are strong or weak, e.g. hip flexors, hip extensors, as sometimes this is a clue as to what is going on.   Go through the chiro's neurologic exam (reflexes, strengths of ankle/toe muscles, pinwheel test on skin).   Also ask that the soft tissues get examined.  This includes the tendons and ligaments and fascia that surround the SI joint and extend deep into the lumbar spine.   The last and remote possibility is that you have an unstable disc in your lumbar spine and the SI joint manipulation irritated it.  An unstable disc will not bulge or deform when you are lying down, so the MRI will not pick it up.   Again, this is not the most likely scenario.  

'Hope this was helpful.

Dr. G