Leg Pain and Chiropractic

  It is rather common for patients to present with a combination of low back pain and leg pain.  The presence of a patient history that includes leg pain is a “yellow flag” from a historical perspective as we need to rule out the more serious issues of central spine complications.  In the vast majority of patient presentations with leg pain MOST do not include disc or nerve root involvement.   

Leg pain can be as simple as a pain referral in the form of sclerotogenous pain.  Inflammation of joint and muscular tissues of the lower back can cause the perception of pain in a leg.  This means of pain referral would be similar to a patient suffering arm pain due to a heart attack.  They are not suffering an arm issue, it is the inflammation of the heart muscle due to ischemia that will send the sensation of pain to the arm.  Same thing with the lower back.  Once the inflammatory issues of the lower back are addressed with generally a brief course of chiropractic care the leg pain is relieved quickly.  

Leg pain may also be related to muscular issues.  One such issue is a condition called Pirifomis Syndrome.  The piriformis muscle is a somewhat small muscle in the buttocks region that is an external rotator of the hip.  Conditions of the pelvis and lower back can cause relative overuse of the piriformis muscle.  The piriformis muscle has three positions relative to the sciatic nerve.  The piriformis maybe in front of the sciatic nerve, behind the sciatic nerve and, in some rare instances the sciatic nerve can pierce the piriformis muscle.  All have the equal likelihood of causing leg pain should the piriformis muscle become inflamed.  In most cases, once the cause is accurately diagnosed timely relief can be gained with a combination of joint mobilization therapy, soft tissue therapy and self care at home.  

The worst case scenario for the presence of leg pain is the possible presence of problems of the intervertebal discs.  These instances require that the chiropractor be astute and cognizant of the need for a thorough patient history and examination to accurately diagnose the condition.  In some instances chiropractic care may still be a reasonable therapy option, however some do require referral to the patient’s primary care provider or an orthopedist for more complete evaluation with advanced imaging (CT or MRI).   

In the majority of cases a patient with leg pain can see timely relief and long term management from chiropractic care and self care instructions.  Your chiropractor will obviously have a detailed conversation with you regarding your presenting leg pain complaints and the courses of care that are realistic options for you.