[50F] Severe lower back pain post-chiropractor appointment

Patient Description

A 50-year-old female presents with severe lower back pain that started shortly after a chiropractor appointment. The pain is sharp at times and radiates into the backside and hips, making it difficult to sit, stand, walk, and bend. The patient has been experiencing this pain for the past 4 days and finds some relief by lying flat on her back. Additionally, she reports daily neck pain rated as 2/10 on the pain scale. The patient also experiences numbness, tingling, and weakness in both legs, along with decreased reflexes, but denies any loss of bladder or bowel control. Her medical history includes a car accident 30 years ago and a blood patch procedure due to complications from an epidural. She smokes about 10 cigarettes a day and has been doing so for 30 years. The patient is currently taking muscle relaxers for her back pain and acknowledges the need to drink more water. Recently, she traveled to Branson, MO for a 5-day vacation. Her family history includes cancer and stroke. She was diagnosed with high cholesterol and high blood pressure 6 months ago and has an allergy to Phenergan. No other medications are currently being taken.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Lumbar Radiculopathy (Sciatica): This condition occurs when a nerve in the lower back is pinched or irritated, often due to a herniated disc or spinal stenosis. The sharp pain radiating into your backside and hips, along with numbness, tingling, and weakness in both legs, are common symptoms.

    • Treatment: Treatment typically includes physical therapy, pain relief medications, and sometimes corticosteroid injections. In severe cases, surgery may be necessary.
  • Muscle Strain or Ligament Sprain: The adjustments during your chiropractic appointment might have strained your muscles or ligaments, leading to severe pain and difficulty moving.

    • Treatment: Rest, ice, compression, and elevation (RICE) are common initial treatments. Over-the-counter pain relievers and muscle relaxants can also help.
  • Spinal Disc Injury: The chiropractic adjustments might have exacerbated an existing disc issue, such as a herniated or bulging disc, leading to severe pain and decreased mobility.

    • Treatment: Similar to lumbar radiculopathy, treatment may include physical therapy, pain relief medications, and possibly surgery if conservative treatments fail.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Avoid Strain: Try to avoid activities that exacerbate your pain. Resting in a comfortable position, such as lying flat on your back, can help.
  2. Apply Ice or Heat: Ice packs can reduce inflammation and numb the pain, while heat packs can relax tense muscles. Alternate between the two for best results.
  3. Over-the-Counter Pain Relief: Non-prescription pain relievers like ibuprofen or acetaminophen can help manage your pain. Always follow the dosage instructions.
  4. Stay Hydrated: Drink plenty of water to stay hydrated, which can help with overall muscle function and recovery.
  5. Gentle Stretching: If you can tolerate it, gentle stretching exercises may help relieve tension in your lower back.
  6. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Worsening Symptoms: If your pain, numbness, or weakness worsens or does not improve with rest and over-the-counter treatments.
  • Loss of Bladder or Bowel Control: This could indicate a serious condition called cauda equina syndrome, which requires immediate medical attention.
  • Fever or Chills: These could indicate an infection, which would need prompt medical evaluation.
  • Inability to Walk or Stand: If your mobility continues to decline, it's important to seek medical help.

Remember, while these suggestions can help manage your symptoms, they are not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask


What is lumbar radiculopathy and how is it treated?

Lumbar radiculopathy, often referred to as sciatica, occurs when a nerve in the lower back is pinched or irritated, typically due to a herniated disc or spinal stenosis. Treatment usually involves physical therapy, pain relief medications, and sometimes corticosteroid injections. In severe cases, surgery may be necessary.


Can chiropractic adjustments cause or worsen spinal disc injuries?

Yes, chiropractic adjustments can potentially cause or exacerbate spinal disc injuries, such as herniated or bulging discs, especially if there is an existing condition. It's important to inform your chiropractor of any pre-existing back issues before treatment.


What are the initial treatments for muscle strain or ligament sprain?

Initial treatments for muscle strain or ligament sprain include rest, ice, compression, and elevation (RICE). Over-the-counter pain relievers and muscle relaxants can also help alleviate pain and reduce inflammation.


When should I seek urgent medical attention for back pain?

You should seek urgent medical attention if you experience worsening symptoms, loss of bladder or bowel control, fever or chills, or an inability to walk or stand, as these could indicate serious conditions requiring immediate evaluation.


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