"When Routine Tests Show Nothing" – Solving Persistent Leg Numbness in a Hirayama Disease Patient

Hello, this is Dr. Son’s Rehabilitation Medicine & Chiropractic clinic.

Today, I want to share a profound clinical success story involving a 20-year-old patient. This case illustrates how a holistic, neuro-mechanical approach can solve debilitating pain that standard hospital tests—and even prestigious university hospitals—often miss.

1. The Patient's Story: Living Life Standing Up

This young patient had a history of Hirayama Disease (monomelic amyotrophy) during his student years. Although the primary condition had stabilized, he was left with a new, agonizing symptom: extreme numbness in both feet.

  • The Agony of Sitting: The numbness became so unbearable when sitting that he had to remain standing most of the day.

  • Sleepless Nights: The paresthesia intensified at night, making restorative sleep impossible.

  • The "Normal" Test Results: He had received three lumbar nerve blocks at other clinics with zero relief. Even after an EMG and extensive testing at Seoul National University Hospital, he was told there were "no abnormal findings." He was prescribed Lyrica (pregabalin), but the numbness persisted.

2. The Science: Why the Tests Failed

How can a patient be in so much pain while MRIs and EMGs look normal? The answer lies in Neural Tension and the Adverse Mechanical Cord Tension theory.

The Mechanism:

  • The Hirayama Connection: Hirayama disease involves the forward displacement of the dural sac during neck flexion. Even after the "active" phase ends, this can leave the Upper Cervical Spine (C1-C2) and the cranial base in a state of chronic mechanical stress.

  • The Dural Chain: The nervous system is not a collection of isolated wires; it is a continuous "chain" wrapped in the dura mater. Tension at the top (the neck) creates a "pull" all the way to the bottom (the sciatic nerve).

  • The Sitting Trigger: When the patient sits, the sciatic nerve is naturally stretched. Because his neural chain was already "pre-tensioned" from his upper cervical misalignment, sitting pushed the nerve tension past the pathological threshold, causing the severe numbness.

3. The Integrated Treatment Approach

At our clinic, we looked beyond the lower back and addressed the entire neurological axis.

  1. Upper Cervical & Chiropractic Adjustment: We aligned the C1-C2 vertebrae to release the "anchor" of tension at the top of the spinal cord.

  2. Sciatic Nerve Block & IMS (Intramuscular Stimulation): We targeted the deep muscles surrounding the sciatic nerve.

    • Clinical Note: During the first session, the muscle twitching was so violent that the guardian rushed over in concern. This hyper-reactivity (denervation supersensitivity) confirmed that the nerves were severely sensitized and that we had hit the exact source of the dysfunction.

4. The Result: A Return to Quality of Life

After just one month of targeted treatment, the neural tension dissipated. The "twitches" calmed down, the nighttime pain vanished, and the patient could finally sit comfortably again. We have successfully discharged him, advising him to return only if symptoms recur.

Closing Thoughts

Pain is real, even when it’s "invisible" on an MRI. If you have a history of neck issues and are now experiencing mysterious leg pain or numbness, the cause might be a global tension in your nervous system.

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

chson@daum.net

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