Recently a patient who had considered his lack of flexibility normal for him began to experience tingling in his arms and legs. The patient said that regular workouts were part of his lifestyle but over the past four weeks, sitting at home working, and even sleeping caused both arm and leg tingling. As I side note, I have been hearing that working at home has caused physical symptoms for many people working with less than ideal home ergonomics.
He had visited one of my local colleagues who adjusted him and after one visit decided to visit a neurologist whose examination showed normal neurological function but suggested a brain and neck MRI to rule out other potential causes. When doctors don’t know, they test to avoid liability.
Upon initially evaluating him, he leaned noticeably to the right. His flexibility bending forward was poor and his shoulders rolled inward. He said he was always tight and standing for long periods of time made him stiffer.
When evaluating him on the table his legs were very tight as well as his midsection into his arms and shoulders. Taping his feet in neutral relieving neck, shoulder, and back tightness and loosened his legs.
Our initial treatment included myofascial release to the midsection and legs which improved his flexibility and reduced the tingling. Off the shelf foot orthotics were recommended to improve his gait and level the pelvis. He was adjusted and felt an improvement in his overall sense of well-being and flexibility. He also experienced some improvement in his tingling sensations for a few hours.
What causes numbness in the legs and arms?
Flexibility is a common reason for arm and leg numbness. Often, these types of problems develop from how we adapt to our body mechanics, growth spurts, old injuries, and weight. Working out will make us tighter if we are dysfunctional mechanically already. A clue that this is happening is that we work out and then 5 hours later we are again tight and stiff. It is the fascial system, rather than the muscles that will tighten affecting how we move and how our muscles function.
We are all unique and unless the physician’s evaluation is holistic or thorough, looking at how we move, checking us out neurologically, and understanding how our body handles weight or gravity, it is difficult to understand why we are now having symptoms.
Nerve entrapments are the most common reason for numbness. Poor flexibility and core function will cause the shoulders to roll forward making the shoulder inefficient. The result is nerve entrapment under the arms where the brachial plexus innervates into the arms. The soft tissue entrapments will reduce the range of motion and will cause numbness in the fingertips. Entrapments can also be created in the arms and eventually lead to wrist, thumb, and elbow pain with tingling, swelling, and weakness.
Nerve entrapments in the legs can be also caused by tightness in the leg fascia. Nerve entrapments are commonly found in the back of the knee, the buttock, and even around the legs and bottom of the feet. This type of numbness can either be in the foot or in part of the toes depending on the nerve entrapment. Fascial tightness can also result in knee pain, shin pain, water on the knee, hip pain, and even foot and ankle pain. Plantar fasciitis is a common result of chronic tightness in the legs.
Who should you see first to resolve leg and arm numbness?
Chiropractic sports physicians are uniquely trained in neurology, orthopedics, and in chiropractic holistic thinking and are your best first choice. While testing such as brain and neck MRI scans may sound like a good first step, the likelihood that these costly tests are going to show you or your doctor anything that can easily resolve your problem quickly or cost-effectively is remote. As a rule, the more longstanding or chronic a problem is, the more complicated it may be to solve.
Seeing a chiropractic sports physician will include a thorough evaluation, muscular work if indicated, manipulation to improve how you move and exercises to improve how you function. After a few visits, if you have not begun to experience improvement as most people do, they will order tests or refer you to a higher-level specialist. The good news is, that most patients give their chiropractic physician high marks for effectiveness and rarely require that referral.
Is there a benefit to visiting a clinic with multiple specialists? Actually, the more segmented the care is, the more it will cost, and often, the less coordinated the care will be. Many chiropractors take a primary care approach to care where they will spend the time to holistically take your history, perform a thorough exam and perform the treatment and give you exercises as indicated by your progress. This one-stop-shop approach is preferred to the multi-specialist clinic where the one person is a gateway to therapists and physicians doing stuff to you. Since most people improve in a short period of time, simple is better because the chiropractor is more efficient with one person who does everything well. If you need a therapist, the chiropractor can write a prescription although most patients will get what they need while under the chiropractor’s care, avoiding the cost of exercises that can be performed at home or in the office. If a test or higher level of care is required, the chiropractor will order the test or make the referral. The good news is most people will improve with the simple approach and can avoid costly MRIs or other tests that add no value to their care.