Q: I don’t think this is the normal ‘bad back’ complaint. I’ve had a bad back for probably over ten years. However, I’ve been to osteopaths and they’ve really helped relieve the pain, it’s not cured. To cut a long story short, I think the reason for my back pain is actually that my hip is ‘locked up’ and while the pain is felt in my back, the actual problem lies in my hip.
Every morning I wake up with my right hip feeling tight, this feeling goes all the way down to my feet. When I walk and run I can feel my stride isn’t right and the right leg has a smaller range of movement than my left. I can stretch, not sure which muscle it is, kind of between my bum and my hamstring….and I can feel my leg and foot relax. This stays relaxed for a short time before tightening up again.
My gut feeling is that a nerve in my hip is constantly aggravated – it doesn’t cause me direct pain but I think the muscles in my leg are tightening up to protect that nerve. Maybe the stretch releases some of the pressure on the nerve? Also, my big toe nearly always feels numb, like when you have pins and needles which make me think it's nerves.
Does this diagnosis seem probable? Do you think acupuncture could help by ‘re-setting’ the nerve?
A: We have to say, if this doesn't sound too odd, that we (well, this particular 'expert' anyway) love the challenge of a problem that has been treated and held at bay for years without having been fully sorted out. You will know from reading around the subject that acupuncture is particularly well-regarded as a treatment for back pain, as our factsheet shows
but then again, so it osteopathy, and we would be fairly sure that if the problem was a structural one, the osteopaths would have taken care of it a long time ago.
It is possible that the nerve is being constantly pinched and inflamed (entrapment is the technical term) which means that a cycle develops of inflammation causing irritation causing inflammation, and so on. Acupuncture has a fairly good track record as a treatment for inflammation, but again, the osteopathy should also have corrected the gait to the point where the nerve should gave settled down.
So, the points of interest are first the numb toe, which from a conventional understanding point to a nerve issue but from a Chinese medicine perspective indicate a loss of 'qi' or energy in the extremity, and second, a strong sense of asymmetry between right and left leading to tension and muscle spasm in the right leg. Our first questions would be about what happened when the pains started, and in particular whether there was any hint of a rotational injury, for example being throwh forward while wearing a seatbelt or twisting to pick up a heavy object. There are a number of subtle injuries caused by 'twist' injuries where the internal geometry of the body is thrown out of kilter, and these tend to resist attempts to deal with manipulation to put them right. It is rather like a functional, rather than structural, disturbance.
The numb toe could be either a systemic problem, and itself be the tip of a larger iceberg where more toes and fingers will follow eventually, or it could be an indicator of a simple blockage in the channel system. These can have profound effects; a small airlock is, after all, enough to stop a whole central heating system working. A skilled practitioner should be able, by using the pulse at the wrist, determine which is the case.
It is a rather unusual problem, and although we always stand by our public position that all of our members are equally skilled enough to be able to work from a Chinese medicine perspective on every patient who comes through the door, there are some styles of treatment which your problem suggests might be more worthwhile investigating. Our experience is that Japanese acupuncture styles are particularly good for these kinds of subtle functional shifts, and in particular for looking at these kinds of rotational problems. That said, most practitioners would be able to offer a number of very effective treatments for some of the problems you report, and we are confident that you may find that acupuncture treatment can just take you that step further, after the osteopathic treatment has set the scene, towards recovery.
If you contact a BAcC member local to you, we are sure that they will give you an honest assessment based on a face to face view of what they may be able to achieve and possibly also who may be the practitioner best suited to see what they can do.