[malawigirl08]

I have had a consultation with a Chiropracter and he has said looking at my x-ray that I have degeneration of the lower spine and that is what is causing my SFPN. As you may know I have been having difficulty getting a diagnosis from our NHS so wondered if you thought this was plausable.
He is charging £35 per session and I would need to attend a few sessions per week - I don't mind this if I get a result, your thoughts please.
I only have PN in my feet and it has been present for 10+ years.

[kwinkler]

Its possible. Have you had a MRI of your lumbar spine, as it would should if the degenerative changes were actually affecting the nerve roots. It would also get a look at the disks, which regular radiographs are extremely insensitive at assessing.

[JoanB]

I dunno...my latest neuro is claiming that my PN is from nerve impingement due to degeneration/stenosis/narrowed disc space(?) and that PT will help it.

I am very skeptical, not of what the MRI said, but of that being the cause of my PN. But I'm doing the PT his doc buddy prescribed so that they can't claim that I'm a bad, bad girl. That's just my take on the situation, and I could be full of you-know-what. I often am.

[Dr. Smith]

Originally Posted by malawigirl08

I have had a consultation with a Chiropracter and he has said looking at my x-ray that I have degeneration of the lower spine and that is what is causing my SFPN.

Hi malawigirl08,

Is he saying that the spinal condition IS the cause, MAY BE the cause, or he THINKS it is/may be the cause? If the first, I'd sure like to know where he gets his crystal balls.

I have a similar condition (DDD in lower back) that I wondered might be causing my PN. Two neurologists (one specializing in PN only) and an orthopedic surgeon assured me that it was not the cause, because my symptoms were nearly equal in both feet. Apparently, from what I've read, it's unusual for impingement to be the cause when PN is bi-lateral, but not impossible. How unusual/improbable? I have no idea; haven't been able to find an answer to that yet, but the prevailing opinions are significantly against it.

Bottom line, I don't know how a chiro (or anyone else) - no matter how good s/he is - could determine that to be the cause based on an x-ray alone. I'd be very skeptical, and definitely want another opinion (from someone other than a chiro - like a neuro or ortho). YMMV.

Doc

[Jomar]

One member that had, or thought they had RSD in her ankle eventually tried chiropractic for the ankle and of all things it was the fix for her.
I don't recall how many yrs she suffered thinking it was RSD before trying the adjustments.


So If you have a good feeling for the chiro, a few adjustments to give it a try shouldn't hurt, but if nothing at all changes then say "no thank you- it doesn't seem to be doing anything for thing for me."

My chiro adjusts, elbows, wrist, ribs, ankle, foot as well as spine and upper cervical spine (atlas/axis).

[glenntaj]

--for spinal-based nerve compression to produce neuropathic symptoms, but generally these compressions, especially of the nerve roots, will produce symptoms that are not limited to the typical burning nerve pain and/or numbness that small fiber neuropathy is associated with; there are generally disruption with large fiber modalities as well (sensory, motor, or both).

And, yes, while it is possible for there to be bilateral symptoms with spinal compression issues, due to likely asymmetry of disc or osteophyte problmes, generally the symptoms, even if bilateral, tend to be asymmetric as well (one side is worse than the other).

All this leads me to question the diagnosis of SMALL FIBER neuropathy--small fiber neuropathy affects the unmyelinated or thinly myelinated nerves that subsume the sensations of pain and temperature and of most autonomic functinos, and is much more likely to have a systemic etiology (metabolic, toxic, autoimmune) than a localized one.

I have neuropathic symptoms both from an idoipathic body-wide acute onset small-fiber syndrome AND from cervical and sacral spine compressions, and the symptoms are rather distinct; the former involves primarily generalized neuropathic pain and the latter shoots or tingles along very specific nerve pathways (such as, in the case of my right-side C6/C7 cervical radiculopathy, along the medial nerve of my right arm and into my thumb/forefinger/middle finger).

[Dubious]

Originally Posted by Jo*mar

One member that had, or thought they had RSD in her ankle eventually tried chiropractic for the ankle and of all things it was the fix for her.
I don't recall how many yrs she suffered thinking it was RSD before trying the adjustments.


So If you have a good feeling for the chiro, a few adjustments to give it a try shouldn't hurt, but if nothing at all changes then say "no thank you- it doesn't seem to be doing anything for thing for me."

My chiro adjusts, elbows, wrist, ribs, ankle, foot as well as spine and upper cervical spine (atlas/axis).

I am very discriminatory about application of chiropractic care in unorthodox settings however, I agree with Jomar on this one. If you are boxed into a corner, traditional allopathic approach has nothing to offer you then 6-12 visits to a chiro would not hurt anything. Adverse events are unbelievably rare in chiropractic and is reflected in their extremely low malpractice premiums. I would stop there however, unless you saw improvement and then I would continue only in 4 week blocks of diminishing frequency in care over time. Stranger things have happened and you apparently have nothing to lose by trying...

[fabdou]

malawigirl, almost EVERYONE over the age of 30-35 has degenerative changes in their lower spine. It is a part of the aging process. There is no way any clinician can attribute the diagnosis of SFPN to those degenerative changes based on plain X-rays. At the least, a CT scan or an MRI would be required to show compressive changes to your nerve roots of stenosis of your spinal canal. As Glenntaj states, neuropathy secondary to degenerative changes is usually one sided and not localized to just the feet. I would not recommend paying for chiropractic therapy in this instance

[Rrae]

Originally Posted by JoanB

I dunno...my latest neuro is claiming that my PN is from nerve impingement due to degeneration/stenosis/narrowed disc space(?) and that PT will help it.

I am very skeptical, not of what the MRI said, but of that being the cause of my PN. But I'm doing the PT his doc buddy prescribed so that they can't claim that I'm a bad, bad girl. That's just my take on the situation, and I could be full of you-know-what. I often am.

Could you elaborate on the PT you are receiving.... This is the route I will probably be going for starters.... Is your PN bilateral? And if so.....what is the PT targeting?
In my case - I've battled bilateral burning neuropathy in legs - of which I had an SCS implanted. The SCS does cover over the burning pain.....but now I'm dealing with horrendous lower back pain (a knife is stuck in my back )
Xrays have shown that I too am dealing with 'multi-dimensional' degenerative issues, as Fabdoe has indicated - very common

Your post caught my attention and I was just curious of what I might expect when I pin down someone who will take a serious gander at this lower back issue.

Does anyone have any feedback on non-surgical spinal decompression, as is used with those DXR-9000 machine thingy's I've inquired about this over on the spinal forum and have got some good feedback......
Just wondered what our PN friends have to say about this?

I too have been told I have RSD, but it isn't really clearcut. One Neuro diagnosed SFN via nerve conduction blah blah....but nothing really adds up. I'm kind of in a vortex of unknown origin

Anyway, I hope you get improvement, Joan......keep us posted

Rae

[Dubious]

Originally Posted by fabdou

malawigirl, almost EVERYONE over the age of 30-35 has degenerative changes in their lower spine. It is a part of the aging process. There is no way any clinician can attribute the diagnosis of SFPN to those degenerative changes based on plain X-rays. At the least, a CT scan or an MRI would be required to show compressive changes to your nerve roots of stenosis of your spinal canal. As Glenntaj states, neuropathy secondary to degenerative changes is usually one sided and not localized to just the feet. I would not recommend paying for chiropractic therapy in this instance

Fabdou is absolutely right. The chiropractor would not treat your degenerative changes. No one can....it's a diagnostic imaging finding...who knows if those changes are generating pain? One never knows if they are symptomatic since according to the literature, 80% of a population at age 50 will demonstrate degenerative changes on x-ray (don't know how many of these hurt though). Manipulative therapy is very good for musculosketetal pain disorders, certainly not clear cut in your case, and I think would be worthy on a trial basis if nothing else is helping you.