Expert: Dr. J. Shawn Leatherman - 4/17/2007

Question
I am 49 years old and have severe scolosis.  I have been diagnosed by my Chiropracter that I have fractured my SI joint.  I experience low back pain radiating to the right hip. I cannot stand for very long periods of time and when I squat to work in the garden my legs hurt extremly.  I cannot sit on the floor and when I sleep on my back, my right hip feels like it has a knife in it unless I place a small pillow under it. I sleep on my side with a pillow between the knees ok. My feet burn and at times my toes feel numb. When I awake in the morning my heels hurt too. I do not have any urinary problems. I am doing exercises to strengthen my core and had been wearing a Sacral belt. I have been undergoing Chiropractic treatments since 1979. I feel like my quality of life has greatly diminished and would like to know how to restore it.

Answer
Dear Barb,

If you have just been diagnosed with a fracture in the SI joint then you should not be getting adjustments right now.  Any movement in the pelvis and low back will prolong the healing of a fracture.  Stability of the area is what you need until the fracture has healed.

The chiropractor should have referred you for a CT scan if a fracture was seen on x-ray, and then if confirmed you should have been referred to an orthopedist for fracture management. If the chiropractor is adjusting you in any way, please do not let him continue until the fracture has healed! Get an orthopedic evaluation, fracture management is outside the scope of practice for a chiropractic physician...I have played a support role in fracture healing with dietary supplements that help to speed healing, but the orthopedist the expert in this case.

Now concerning the burning of the feet and numbness in the toes, this is connected with the sacral plexus of nerves in the low back.  Specifically the L5, and S1 nerve roots supply sensation from the feet to the brain for interpretation.  Therefore it is likely that you have some inflammation of those nerve roots either by compression or irritation.  Conversely, the plantar fascia which is a tissue covering on the bottom of the feet can mimic the pain you have described.  The plantar fascia involves the tendons of the foot and a fibrous covering that can become inflamed an painful.  Heel pain which is worse in the morning is a hallmark of this condition.  If you flex the feet back toward the head and push on the bottoms, it will likely reproduce the pain...if so then it is probably plantar fascitis (PF) rather than a nerve root problem. PF can be helped with stretching of the foot, the calf muscle and vigorous friction massage on the bottom of the foot.  in addition night braces can be worn to stretch the foot/calf at night.

Hope this helps Barb.  Once the fracture heals, then you can start to incorporate more rehab activities and manipulation of the joint again.  The scoliosis issue can be addressed as well...there are techniques for structurally remodeling the spine and reducing scoliosis.  these techniques require traction and specific rehab exercises.  To learn more check out:  www.idealspine.com

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