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Case Reports
. 2019 May;8(5):1765-1768.
doi: 10.4103/jfmpc.jfmpc_254_19.

Pitting oedema in a polio survivor with lumbar radiculopathy complicated disc herniation

Eric Chun Pu Chu  1 , Aaron Ka Chun Chan  1 , Andy Fu Chieh Lin  1
Affiliations
Case Reports

Pitting oedema in a polio survivor with lumbar radiculopathy complicated disc herniation

Eric Chun Pu Chu et al. J Family Med Prim Care. 2019 May.

Abstract

We report a 58-year-old male with sequelae of polio who presented with low back and left buttock pain, and pitting oedema of both legs for four months. The patient had a history of poliomyelitis at the age of 1 year which resulted in bilateral lower leg weakness, particularly on the left side. Magnetic resonance imaging showed cervical spinal stenosis secondary to posterior osteophyte formation, left paracentral disc extrusion at L2/L3 and L3/L4 levels with compression of the traversing L4 nerve root. The findings confirmed a diagnosis of lumbar radiculopathy caused by a herniated disc. The patient subsequently underwent a chiropractic treatment. The painful symptoms and pitting oedema in this case resolved with spinal adjustment in addition to scraping therapy to strengthen bilateral low back and the gluteal muscles. This case provides circumstantial evidence of a scarcely mentioned association between pitting oedema and lumbar radiculopathy caused by disc herniation. The pathophysiological mechanism is elusive, but might involve a complexity of cytokine-mediated inflammation and interconnection between somatic and autonomic nervous systems.

Keywords: Chiropractic; disc herniation; lumbar radiculopathy; pitting oedema; poliomyelitis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The patient presented with bilateral swelling of the legs to knees, more prominent on the right side (left). Oedema was reduced in both legs after a few treatment sessions (right)
Figure 2
Figure 2
The initial surface EMG (left) revealed multiple levels of paraspinal muscle spasm. The post-treatment surface EMG (right) showed almost normalization of the paraspinal condition. At this time, his spinal complaints had resolved along with the disappearance of the leg oedema
See this image and copyright information in PMC

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