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Back, Hip and Pelvis Pain (Page 1)

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Hi guys, newbie here. Smile

I'm just wondering if anyone can advise me on which course of action I should take regarding my back, hip and pelvis pelvis problems.

Since I was 17 years old I have suffered from lower back pain. I'm now 28 and although I still suffer from lower back pain it is more severe nowadays. Back when I was 17 to around 19 the pain was more localised at the base of the spine where as, today, it's at the base of my spine, to the left, sometimes swaying to the right, in my left hip joint and also around the lliac crest on the left hand side. At it's worst I get spasms to the point I cannot even move.

Back story: At the time when I was 17, I had a heavy lifting job and after a couple of treatments from a chiropractor I was as good as new again. He said that my sacroiliac joint was twisted in relation to my pelvis and used wedges to re-align the joint. I must add that from the ages of 14 to 24 I was training heavily in Martial Arts.

At the age of 23 I suffered an infection with triggered rheumatoid arthritis which lasted for around 9 months. This went straight to my right ankle.

From 23 to 26, I was pretty much problem free. It was when I was 26 (nearly three years ago) that thing have got worse and worse. My back began giving me a lot of problems in the thoracic region. This was at it's worst during the night after around 5 hours sleep. More problems came about when my lower back also started to play up. What the cause of all of this was, I don't know? Sad These problems got so severe that I went to see an Osteopath to be told that I had "shunted" my left hip to which proceeded to treat me by laying me downn and yanking my leg outwards which resulted in a almighty clicking sound. Over a course of a month I saw this Osteopath around 6 times, but unfortunately the recovery was up and down and inconsistent; after a treatment, I would go to work the next day and feel great, then after the next, I would be back to square one.

I've been suffering with these symptoms now for nealy 3 years and have seen 2 chiropractors and 1 Osteopath. Over these 3 years I have been taking dyclofenac everyday and if I miss a days medication, I am suffering with spasms. I can't help, but feel that my left leg joint isn't in place properly after the Osteopath pulled it out. It's never been the same since.... well, to be honest, it's been a lot worse.

Regarding my thoracic pain, I am managing to deal with it now after a chiropractor treated it ( by pushing forward on the spine to click it), but I do have to keep it in check by stretching backwards and forcing my chest out to click it back every now and then.

As anyone would know with back pain, it's a curse. I've been suffering for years now and miss working out and Martial Arts. It's a depressing situation to be in.

Any help would be greatly appreciated.

Adam
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replied January 1st, 2010
Extremely eHealthy
Time to stop the chiropractor and the osteopath and get yourself to a spine specialist, either an orthopedic surgeon that specializes in spines or a neurosurgeon that specializes in spines.

I would suggest the orthopedic surgeon that specializes in spines for you to see.

All your symptoms could be caused by problems with your spine, especially since your original pain started with your spine.

Once you've been evaluated by an orthopedic spine surgeon, you will know which direction you need to go in for help with your pain and the various areas that are causing a problem.

Get to the spine surgeon as soon as you can.

Good luck and keep us posted.

Fran
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replied January 1st, 2010
Extremely eHealthy
hi adam
youve been battling this for years and what you are missing is a diagnosis.
i'm no doc but ive had so many problems myself i've learned a lot from the drs.
i recently saw my neurosurgeon and we were discussing pain. this neuro said he likes to focus on the highest point of the pain as it is usually the focus of where the mechanical problem lays. another way of trying to diagnose area of problem is to look at a dermatome map of the body. google it and you will see which nerve roots affect which areas of the body.
your problem seems to fall in the L1/L2 area of the spine.
without proper testing you will never know. it might be disc or calcium protrusion putting pressure on the L2 nerve root. after all this time i doubt that snapping or pulling on the spine will ever solve the underlaying problem.
i recommend you contact a surgeon who specializes on the spine. he will check muscle strength, reflexes, circulation and sensory sensations. he will study a mri scan which will show soft tissues and bones. then hopefully he will provide diagnosis. he will then be able to suggest a treatment plan. his treatment plan may very well be physical therapy. the fact that you feel better when you bend spine backwards makes me think the mckenzie physical therapy technique might give you relief and get the disc back in shape if in fact that is the trouble. you will never know unless you get a knowledgeable spine surgeon to study the situation.....pete
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replied January 1st, 2010
Thankyou for your advice guys. It reassuring to know there are people out there who can help.

I have been seeing a Rheumatologist for the last 8 years on and off which recently lead to two MRI scans and numerous blood tests. The blood tests didn't show anything up, but there was reason to suspect that there is some degeneration of the disc at the base of my spine. I have since been told by a Chiropractor and a Osteopath that the operation of my discs are fine and that many 28 year old athletes would show identical wear and tear.

I will take your advice and ask to be referred to someone who specialises with the spine. Preferably a Orthopaedic surgeon. My mother questioned why I was still seeing a Rheumatologist when the blood tests showed everything in that department is fine.
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replied January 1st, 2010
Extremely eHealthy
hi adam
discs are funny things. sometimes just a slight problem can give major pain so if mri showed a slight bulge it should be checked against your symptoms....pete
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replied January 1st, 2010
Ok, hopefully the spine specialist will be able to make a sound judgement from his own assessment. Smile
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replied January 1st, 2010
Extremely eHealthy
" have since been told by a Chiropractor and a Osteopath that the operation of my discs are fine and that many 28 year old athletes would show identical wear and tear."

Not a good answer for your pain,

It may be true that "many 28 year old athletes would show identical wear and tear", but those many are not in pain and you are.

The majority of people, if given a spine MRI would show various problems with their discs. But the majority are not in pain and have no symptoms of their disc or spine problems, therefore, no treatment is necessary.

The key to the findings on a spine MRI is this.

Do the MRI views correlate with the physical symptoms that the patient has the examination findings.

Just because the findings are minor does not mean that they are not causing a problem for a particular patient.

A good spine surgeon will examine the patient, listen to the patient and what the patient has to say and how the pain is, what increases the pain, decreases the pain and how the patient functions.

Then the good spine surgeon will examine the MRI views and see if anything on them matches the symptoms and descriptions the patient provides.

Terms such as mild, moderate, severe, and what you where given are very subjective terms and adjectives to describe anything, let alone disc problems and nerve compression.

One person's mild is another's moderate. What may not cause pain and be a problem with one person, has another doubled over in pain and unable to function.

An orthopedic spine surgeon is your best bet to see and be evaluated. Get a new MRI done, as anything more than 4 months old is not usually accepted as a valid view of what is going on with the spine. Too much can change in that short period of time.

Good luck and let us know what you find out.

Fran
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replied January 2nd, 2010
Thanks Fran. I will take that on board and keep you updated on my development.

Smile
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replied January 3rd, 2010
Experienced User
I agree, you have got to see a doc and get properly evaluated.
At the risk of being ambushed I will comment that (taking this as just one example) if your sacroiliac is twisted something twisted it. Could be from a traumatic injury from Martial Arts. But lots of people do M-A and don't twist their sacroiliac. Yours probably did because the muscles were not supporting it correctly, allowing it to get injured.
When your hips are off, it throws your whole body off, including your back.
As you are athletic and are willing to do some exercises I will suggest what worked for me. I got 5 menus based on my postural faults. This is much more comprehensive than just doing the "Cobra" stretch. So you are not just exercising. You are moving in ways which will put your body back in alignment. He will give you specific e-cises for your thoracic and lumbar spine as well as hips. I have tried everything and if you stick with the menus and think about your body and what is going on, egoscue is the one thing that works best.
IMHO, unless you are one of those 10% where something is completely jammed and not moving, a chiropractor will not help. You cannot just force something back in place and expect it to stay there. You need to get the muscles working correctly and then things will go back in place naturally. Of course this is a lot more work and most people aren't willing to put in the commitment. But like the saying goes "You get out what you put in".
Once you start to feel what "right" is, walking is a gentle way to reinforce correct muscle usage. How much? 100 miles per month for 1 year is what the doc said.

Hop this makes sense. Good Luck!
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replied January 3rd, 2010
Hi awaq, thanks for your input. Just for your information, the only injury (I was aware of) I have sustained through Martial Arts is a shoulder injury. I am, however, looking in posture and e-cises. Smile

I agree you get back what you put in. While I would say my posture is pretty good, my trade can put me in a lot of bending down/foward postures for long periods of time.
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replied January 3rd, 2010
Experienced User
"I have sustained through Martial Arts is a shoulder injury."
To bad your osteo messed you up. They should be gentle with no abrupt "dislocations". My right shoulder is knocked out of place from some trauma. He put it in as far as he could and then I got the reflex back in my left leg. Funny how all this stuff is interconnected. You may want to try to find a new one. I found they don't solve the problems but they are a good start and are a great complement to egoscue e-cises. A good osteo will tell you what he finds "twisted L4 / concave L3 / no motion at L4-L5" and that gives me guidance when I do my egoscue posture work.


"my trade can put me in a lot of bending down/forward postures for long periods of time. "

The obvious problem is your back extensors get tight. What is less obvious is your psoas gets short and tight. This muscle goes from the front of your hip and attaches to T12 and L1=L5. if it is tight, it puts constant compression on your lumbar spine. It can also strain your iliolumbar ligament. I'm pretty sure you have this. If the right psoas is tight, the left is weak and this will shift your whole torso to one side.

My right psoas is so tight it twisted my spine to the right and pulled my ribcage down and to the right. One P/T had me spiral in the opposite direction. This did me no good and twisting the spine herniated my discs more.

The best stretch to do is egoscue's progressive groin stretch using the tower. It is time consuming as you can spend 20 to 60 minutes 5x /week to get it to let go. I don't feel any particular tightness now but I still do it most every morning for 20 minutes and I feel much worse if I don't. So something is going on.

Also, you really have to be body aware and think about what you are doing. This is where input from a good osteo is invaluable. For example, when doing the stretch, I have to consciously push my left lumbar back to the ground to untwist my torso. That is, create distance between my right hip and left lower rib cage. If not, my left toe goes numb from nerve compression. My osteo taught me this from his findings.


Here's one doc's thoughts:

Rather than talk forever on all the causes of back pain and all the treatment options, I decided to talk about just two. -- That is, two of the most overlooked reasons for chronic back pain and frequent injuries. Both are structural with nutritional components.

First involves the abdominal muscles. Many therapists mention the abdominal muscles when someone comes to them with an injured back, but they just tell the patient to do more exercises such as crunches. The abdominal weakness is from some digestive issue almost all the time. The digestive issue creates abdominal distension causing those muscles to fatigue and this spasms the lower back. You know your abdominals are involved if you have [back] pain when you are lying flat on your back and the pain goes away or gets better when you put your knees up (or under a pillow). You'll also have more pain trying to get up from that lying position. After standing for sometime, the abdominals will no longer be able to support you, so you'll also more than likely have some back pain standing for prolonged periods. Many times you'll have a "sway" back posture. Figuring out what is causing the digestive problem is the goal to fix the lower back pain, or at least support it. This is especially true if the pain is aggravating any lumbar discs. The most common digestive issues are a food allergy, fungus in the gut, too much sugar or caffeine, and bad "trans" fats.

The second most common type of low back pain involves the iliolumbar ligament. This short and strong ligament connects the fourth and fifth lumbar to the iliac crest (pelvic bone). Irritation to this ligament often causes that one-sided lower back pain as it tries to stabilize the joint between your lumbar spine and the pelvis. The abdominal issue can cause these ligaments trouble as well. A disrupted gait is the number one reason for chronic iliolumbar ligament pain and inflammation. When this ligament loses its support, the stage is set for other injuries to occur, such as disc problems and spinal misalignments. Actually, the involvement of this ligament is a very common reason for a chiropractor to constantly need to adjust your lower back. The bone will never stay in place if the function of the ligament isn't restored. Sometimes this involves direct ligament treatment. Nutritionally this is where carbohydrate intolerance/insulin resistance becomes important as having glucose/insulin issues will "wind you up" in one direction and throw off your gait - leading to an iliolumbar ligament sprain. Check out my two gait articles for more information.
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replied January 29th, 2010
Hi guys, just a quick update....

I have an appointment booked on the 15th of Feb to see a Orthopaedic Surgeon who specialises in the spine.

I will update this thread with the outcome.

Thanks

Smile
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replied January 29th, 2010
Extremely eHealthy
Fantastic news. Please remember to bring your MRI views with you to the spine surgeon so that he/she can look at them.

Some advise. Hand over the MRi views and hang on to the MRI report, don't give the MRI report to the spine surgeon.

You want to be sure that the spine surgeon you are seeing can actually read the MRI and make his/her own diagnosis.

Believe it or not, there are many spine surgeons that can not read an MRI and base their diagnosis on the report only, in otherwords they diagnose a patient base on someone else's opinion and not their own.

You never want to deal with a spine surgeon like that.

Keep us posted on what the doctor says.

Good luck

Fran
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replied January 29th, 2010
Great, thanks for the advice Fran.

I got the impression from my docter that this specialist will want to do his own MRI scans as my previous scans are dated.
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replied January 29th, 2010
Extremely eHealthy
Usually, if they are more than 4 months old, they are considered having little value, unless it is to compare something that is being watched over time.

Sounds like a good idea to have a new MRI done. There are different things that a spine surgeon may want to have emphasis done on or might want to have a contrast dye used to see something more clearly.

That's why I always advise that the spine surgeon should be the one to order the MRI so that the exact MRI needed is done and not a general one.

Good luck

Fran
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replied February 4th, 2010
Thanks Fran.

Up until today my back and hip has been the best it has been for around 2 years.... the reason for this, I believe, is due to my return to the gym resulting in muscle strengthening in my back, and more importantly, flexibility through daily stretching exercises.

Through going to the gym, I was nearly 70% away from being able to run again... but each time I tried, I could feel the pain return at the base of my spine. Daily routines were manageable and spirits were high.

Today, however, my sciatica has flared up... I think this is a result of falling asleep in a awkward position while travelling at work. Sad The sciatic pain is focused in my left hip, deep within, and at the base of my spine (but only there when I move my pelvis back and forward).

Really looking forward to my appointment on the 15th. I just hope it's not the typical case where my back is at it's best when I am being examined, and then... the next day, when I'm at home, it flares up again.

Even though the MRI will speak volumes, I can't help but feel that I may be suffering from piriformis syndrome... the symptoms are identical to mine.. which relates to my promoted recovery due to stretching...
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replied March 5th, 2010
Hi guys, so I have some results from my latest appointments....

After numerous blood tests and MRI scans, it turns out that even though I have a torn disc, this isn't the problem. I have been diagnosed with Sacroiliitis caused from Ankylosing Spondylitis.

My specialist has referred me to have Tumor necrosis factor (TNF) inhibitors as part of my immediate treatment.
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replied March 5th, 2010
Extremely eHealthy
hi adam
well you got your diagnosis after all these years and its not the diagnosis you expected.
what it means is a lifelong battle against a disease that doesnt go away.
when you first hear that you have a disease as serious as this it can be devastating. i know this from experience. but its not the end of the world. you can still live a fairly long life. it will just be more difficult.
in time i think you will be thankful for what you do have. think of each day as the best day of your life. enjoy it as best you can. take pride in what you can accomplish.
one way to combat the sadness of this battle is to help others who are in pain. by doing so you forget your own pain.
you sound like a fighter so i expect you will forge on and do the best you can.
one dr told me the worst thing you can suffer from is a problem with your thinking. this disease will only affect your bones and joints. your thinking and emotions will remain in tact.
i hope you stay around and post your experiences and little victories.
i have been fighting a disease that is quite similar to yours since i was 17 yrs old. i'm 68 now. so i know a lot about hanging in there in pain.
one thing you can count on. the drs are always improving their treatments. in the many years i've been ill i've seen many many new treatments.
keep us posted as to your progress. we will always be here for you whether youre having a good day or a bad one.....pete
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replied March 6th, 2010
Hi Pete, thanks for your reassuring post... and yes, I intend to fight on and not let this disease get the better of me! Smile At present it's a very up and down hill battle; one day you think you're making progress, and then the next, you're back to square one.

Since January, I have been in the gym 5 days a week, and it's helped a lot, but despite only having 2 rest days on the weekend, I'm stiff as hell come Monday morning. Hopefully swimming on Sundays will help.

Thanks for all your support and I hope to be helping other with stories of my own little victories as you put it.

Smile
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replied March 6th, 2010
Extremely eHealthy
adam
do you think alternating the swim and gym days would help. i would think the swimming would loosen up the tight joints and tissues better....pete
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