Q. After chiropractic treatment for hiatal hernia, I experience abdominal discomfort. Why?

Answered by
Dr. Naval Mendiratta
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 31, 2020

Hello doctor,

Two months ago, I was diagnosed with a very tiny hiatal hernia. My chiropractor found my stomach is pushed up very high, next to my esophagus. He was able to push it back down, but with a lot of painful force and manipulation. Ever since I have been getting sicker and sicker with episodes that are so debilitating that I can no longer work. They happened occasionally at first, but now three to four times each day (always upon weakening) and last for hours at a time.

It begins in my mid-abdomen. I feel and see pulsating in my abdomen and get a wet sensation as though the fluid is leaking out of my chest or belly. If I push on that area (or usually all by itself), I get an instant rush of blood to my head and start to feel fuzzy. My face turns bright red and becomes so hot that I get nauseous. The redness sometimes stays, sometimes goes away. But what always follows immediately is intense heat throughout my whole body, like my spine, muscles, and nerves are on fire everywhere from my head to my palms to my mouth to the soles of my feet. Then I start to shake uncontrollably, with the shakes progressing into worse tremors in my left thigh and right biceps. The shaking definitely seems to start from the abdomen or groin area. If I press my thighs or groin or even touch them lightly, my legs increase in spasticity. When these episodes end, I feel completely wiped out (blurry vision and hard, tired muscles), but I never return to normal. I always feel shaky and not myself.

I have been at the doctor's twice when these episodes were happening. The first time my BP was a bit high at 130 mmHg (usually I am spot on at 120/80 mmHg) and the other time my vitals did not change at all during the episode.

Other information, possibly related:

My left thigh and knee are filled with fluid, but my orthopedist attributes that to a popliteal cyst (is that the same as an aneurysm?) he found behind my knee. He gave me a Cortisone injection four days ago, but so far the swelling in the front of my thigh, my knee, and my calf have not gone down.

I was also told that I have an umbilical hernia and two inguinal hernias. I also have a history of localized scleroderma, which I understand, can weaken the connective tissues and blood vessels. Recent blood tests for ANA and rheumatoid factor both came back negative. Not sure how that is possible when I was diagnosed with a positive ANA and localized scleroderma (Morphea) 25 years ago.

I am very scared. Do you have any idea of what is happening to me? Or what tests I should have done? Not sure if this is GI related, vascular, rheumatology, etc. But I need to find a way to calm these spells so I can go back to work.



Welcome to

Well, the symptoms do sound a bit different and something we need to look into.

As per the issues, I hope they have looked into any form of venous obstruction i.e. super vein obstruction. Any compression on that vein can cause the face to turn red and a bit of low blood pressure. But it is a very rare thing to happen. A CT (computed tomography) of the chest would be advisable to rule out this compression causing the symptoms.

But yes, it does not explain what is happening in your legs. The symptoms do see to be of hypersensitivity. Do these symptoms happen after a hot water bath as well? Do you feel any shock-like sensation from the neck below?

For the popliteal cyst, it is a bakers cyst. It is totally different from aneurysm, as aneurysm will be pulsating and moreover it is a very unusual site for it to happen. Normally, it does respond to injection Cortisone, but sometimes if the injection does not go in the right place it can persist. You may need to repeat the injection after a month or so incase it is persisting.

As for localized scleroderma, it is a benign form and ANA can go negative at times. We can either call it a lab error or at times the body does act through to make it negative. How much has been the skin extent in your scleroderma though?

To summarize, we need to figure out a cause for your symptoms. Scleroderma does not explain it. We need to see if it is an SVC (superior vena cava) obstruction. Of the rarest cause, with the spasticity happening in your legs on touching I would like to rule out any brain condition as well. These sound like paroxysmal dyskinesia.

I hope this helps.

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