Expert: Dr. J. Shawn Leatherman - 9/25/2006

Question
About 3 months ago I went to a chiropractor for back pain.  I have scoliosis pretty bad and I kept pulling my muscles.  He began treatment by adjusting my neck.  About a week after the neck adjustment, I started experiancing tingling in my face and last 3 fingers on my hands. (Both sides).  The tingling is in my eyes, corner of mouth and eyes, ears, and worst in my scalp.  Seens like the adjustment sent in a chain of events.  First the tingling, then my TMJ acted up for about a week.  My joint was swollen and I couldn't eat for a while.  Now, my spine is terribly sore, especially around my neck.  I never went back to this chiropractor because he was really rude to me when I asked him if his adjustment could have caused this tingling in my face.  I have however, seen my family doctor.  I have had several massage sessions, a cat scan to rule out a brain tumor, and a normal nerve conduction test done on my hands.  I am at lost as to what to do now.  I am in severe pain and my face is still tingling.  Please, do you have any advice?

Answer
Dear Tera,

Well, first of all if you came to my office for low back pain and scoliosis, I would not have been treating your neck, I would have been treating your back, and addressing the musculoskeletal imbalances.  I hope that the chiropractor you saw had some reason to be adjusting your neck.  Did you have any complaints there, did he examine the neck, were orthopedic tests performed, and did he take x-rays of the neck?   

Now concerning the tingling of the face and hands, yes an adjustment can cause an increase in symptoms if the chiropractor you saw irritated the nerve roots going into the hands or the ganglia (a group of nerve cells outside the spinal cord) in the neck.  Occasionally an adjustment, especially a forcefull one can cause local irritaion to the nerves around the neck.  When this happens, it will usually cause pain within the next 24 hours though, not a week later.  Usually this will subside as well or decrease over a short period of time.  In addition the ganglia and the upper neck have nerve connections to the cranial nerves which supply information to the head, face and jaw.

In addition when the doctor adjusts the neck his hands should not be on the TMJ, and I am not aware of any TMJ problems that would be caused under normal circumstances. But if the muscles of the neck were stressed, this could cause pain in the posterior jaw becasue of the anatomical relationship and proximity.

Remember not all Chiropractors are created equall!!  There are horrible medical docotrs out there and horrible chiropractors as well.  My advise to you is to find a better Chiropractor.  Look for a doctor who has advanced credentialling, and get a referral from someone you trust if possible. Have that doctor do a thorough musculoskeletal examination of the area as well as x-rays if not already done, give you a diagnosis and explain it to you.  

You definitely have an irritation of the brachial plexus which is the bundle of nerves that exits the neck and supplies all the information to the arms and hands.  The good news is, your nerve conduction test was negative, which means that you do not have any nerve compression.If you have sore muscles/spasms, I would suggest that you continue with the massage therapist as they are normally very proficient in body work.

Concerning the TMJ, I want you to wash your hands and stick your fingers in the back of your mouth just above the bottom of the lower jaw and feel for some tight tender muscles.  These are the medial and lateral pterygoid muscles.  Gently at first and then more strongly afterward massage these muscles.  They will most likely be exquisitely tender.  These muscles are frequently and excessively tight when TMJ pain is reported.  Relaxing these two key musles should help.  In addition any library should have a good anatomy text to help you locate these muscles inside the mouth, or research them on the internet for an illustration.

Well Tera, write back if you have any further questions or comments.

Respectfully,
Dr. J. Shawn Leatherman