Sciatica from a Nerve Root Tumor

Posted On: May 15, 2017

This will be my fourth case reviewing interesting cases from my past practice. I am Dr. David Johnson the director of North Shore Spinal and Sports Rehabilitation. I am licensed both as a chiropractic physician and as a physical therapist. I am sharing my experiences to help educate the public on cases seen by chiropractors and physical therapists. At the time of this case I was practicing as a chiropractor in Lake Forest, Illinois.

This case is that of an active 70 year old woman presenting to my clinic with sciatic pain. The woman was of a smaller stature and very energetic. She would walk around downtown Lake Forest, do her shopping and every time I ran into her she always had a smile. When she presented to my clinic she wasn’t smiling. She expressed to me that she had been having sciatic pain for about two months and it was stopping her from getting around.

I examined her and other than a little decreased sensation over the right L5 web space on the foot and a mild right straight leg raise response she was fine. I took x-rays of her lumbar spine and other than some mild age appropriate degenerative changes they were normal.

I prescribed flexion distraction mobilization for her spine, placed her on flexion-orientated exercises (knees to chest and pelvic tilts) and did myofascial release along the course of the right sciatic nerve.

After the first treatment she came in a day later and reported great improvement. I treated her again but the day after this treatment she was much worse. I tried to calm it down using interferential electric stimulation to no avail. Being concerned, I ordered an MRI at Greenberg Radiology as they were the only game in town at that time.

I got called by one of the two brothers who were radiologists and they told me that she had an L5 nerve root tumor, which appeared benign but was taking up a lot of space.

I called Dr. Ivan Ciric as he was the best neurosurgeon in the area. He came on the line and I told him I was Dr. Johnson and that I was a chiropractor and I had a case for him to look at. He said, “Chiropractor, I don’t work with chiropractors.” He was about to hang up the phone and I blurted out, “It’s a 70 year old women with a right L5 nerve root tumor probably a schwanoma. Will you see her?” He huffed, “Fine.” So I sent her.

She did really well with the surgery, as he was an excellent surgeon. I would run into her from time to time in Lake Forest and she would always have a big smile, give me a hug and tell me thanks. In retrospect I wish I would have thanked her back.