Case Study: the pain of vascular ischemia

Every pain case I treat ends up having some nerve component involved even without any typical neuropathy symptoms like burning, electric pain, paresthesia, etc. which goes over looked and untreated much of the time. However, vascular origin pain is even more rare to be caught and treated outside of something like angina.

I had an 82 year old man in my office a couple months ago who had severe right quad pain which presented any time he spent time sitting, which would slowly dissipate as he got up and moved around. He has some long drives he has to do on regular occasion and this was forcing him to stop multiple times for each trip and still go through a lot of agony.

He also had a triple bypass some years back and they did take blood vessels from the right thigh for that bypass. Checking his femoral artery we could barely feel any pulse at all. It's already a twisty area as the iliac transitions into the femoral artery so add bending from sitting on top of a surgery induced deficit in the circulation of the area and any external occlusion from the surrounding tissues and you have some seriously diminished blood flow to that leg. His main external restriction popped up as the external iliac artery passes the inguinal region and becomes the femoral artery, which is quite common.

This is something that responds well to manually working with the iliac to femoral artery and any potential irritations and problems around that path. Naturally you want to make sure the patient is a safe candidate for manipulation of any blood vessel (luckily this patient is medicated for and checked regularly for clotting safety and related issues), but this is a case that would not have been likely fully resolved any other way. One session and 90% of his pain was gone, and we're working though the rest of it as we address other issues.

Don't just think muscles or even nerves. The muscles, outside of acute injuries, are always the lowest priority and just following the orders of the brain, subject to more important tissues and structures (If the brain doesn't feel safe allowing tension to a restricted nerve/blood vessel, sensitive vascular structure etc....your muscle doesn't get to work normally, and pain can ensue from that alone).

I highly recommend the Barral Institute for vascular manipulation classes, and when I can find the time I teach techniques for isolating where the precise area of problem is and what it's actually doing.