Comments for Back, butt, groin, outside knee, and outside shin pain

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Mar 25, 2016
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Hip from way before turned out to be arthritis
by: Robert

Hi! I was making a lot of contact with you about a year ago to find out what my problem was because nobody else could figure it out. You diagnosed a hip problem before anyone else did. I stopped going to the doctor in July and tried different chiropractors, and doing the Egoscue method. My other hip went bad, and nothing I tried helped, so I went back to the doctors office and saw a different hip specialist. He recommended stem cell therapy based on an X-ray from 17 months ago. I returned a month later and we looked at some new X-rays. They were a lot worse than before. Both sides are bone to bone, with no space between the head of the femur and the socket. Now I will be doing a hip replacement on both sides. Just wanted to let you know what the end result is. Thank you for your help getting the original problem figured out.

Robert

Dear Robert,
I am glad to have been able to make a contribution, and that finally you know you weren't going crazy.

Keep up with Egoscue exercises until the operation, and then ask the surgeon very specifically for a rehab program.

Talk to him about getting the hips as level as possible. I've seen them more than an inch short.

I appreciate you letting me know. Keep well and God bless.

Dr B

Mar 22, 2015
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many about hip pain
by: Robert

No,the Radiologist didn't say anything, I just look at the two sides and see something completely different.
You now think I have FAIS, so should I go to the chiropractor with your recommended treatment from before? Also, what exercises do you recommend. I have had a very bad last few days with the pain and walking. Before it wasn't as bad, but it is very bad again, and nothing I try is working. Thank you, Robert

Hello Robert,
You really can't rely on the diagnosis of someone who has never had the opportunity to examine you; I'm just trying to help you find someone who can help you. Yes, it does seem like FAIS. And it's very treatable.

But you have some cysts in the femoral head which makes it more difficult. A hip replacement before sixty is always problematic, but when you're so miserable, it has to be considered.

I would recommend a course of treatment first though with a local chiropractor to see just how much relief you get. Then a monthly visit is on the cards.

Dr B

Mar 11, 2015
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round many many
by: robert

Use whatever you want. Thank you for the help. I am really concerned about what I see on the SI joint on the xray. The right and left aren't close to being similar. It almost looks like something is broken off on the right side.

I'll go back and check the SI joints but I can't say anything jumped out at me. Did the radiologist make note of anything?

Mar 08, 2015
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Another question
by: Robert

You mentioned a short leg. I have had someone say I had a tilted hip. Would I wear only one foot insert on just the short leg?

Ask your wife to stand behind you and to place her hands on the iliac crests. Top of the hip bones; if you're not sure look it up at Sacroiliac anatomy at Chiropractic Help.

Then simply to eyeball it; are they approximately level? Having a third person standing behind her also helps. You won't get an accurate measure, but if there's an obviously short leg, you'll see it.

The solution is controversial; there are companies that will sell you very expensive orthotics, and perhaps they help. I use either a heel lift, or full inner inside the shoe on the short leg side obviously.

You'll really need professional advice to see how thick it should be, and whether a heel only, or full inner.

Question: this process may be useful to others; would you allow me to use this for a page at Chiropractic Help? Obviously I wouldn't use your name.

Dr B

Mar 08, 2015
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Round a lot
by: Robert

I look forward to your comments about the X-rays. When I look, I see a difference in the two si joints, but not much in the hip, but I really don't know what I'm doing. I will definitely be looking for an fics chiropractor. You have definitely educated me. Thank you for everything.

Pleasure Robert,
I'm making a summary of everything, trying to get all our ducks out neatly in a row.

First I'll do the history. I'd like to email to you for correction and annotation. I have your email address with the xrays. Getting there.

Dr B

Mar 07, 2015
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Another round
by: Robert

Thank you for your advice. I was wondering what you saw on the X-rays. You mentioned that I might recover 60 to 80 percent. I'm an active person and enjoy playing sports like basketball, and boxing workouts. Do you think that will be a possibility again? Thank you.

I'll see if I can get to your file today; I need to see it in its entirety to get the bigger picture. Without having examined you myself I really can't give an opinion on whether you'll get back to active sport. You have a difficult history against you; perhaps best to assume not, but with the right treatment you might just be lucky! Find that guy; he's out there waiting for you.

There's a sport programme for chiropractors called FICS. If you can find a FICS chiro you've a better chance of getting better; talk to your local chiro association.

Dr B

Mar 05, 2015
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Round 8
by: Robert

The Orthopedic Specialist with some other doctor did a brief exam on me. They said they had looked at the xray together before. They told me they felt that there was some degeneration in the socket but it wasn't bad enough to do a hip replacement, and they also felt there was some inflammation. Then they told me they felt I should try stem cell therapy (I live in Tijuana, Mexico and have Simnsa insurance.). I asked questions about it, but they said I could get information about it from two other doctors that I will need to talk with. I didn't feel comfortable with the whole situation, so I basically took over at that point and told them what I wanted to do and my orthopedic specialist agreed to do what I wanted. I told him I wanted to try the shots for inflammation, etc. again, and we decided to go once a week with the shots for 3 weeks. I also told him I wanted to try therapy again because the first time we didn't know what the problem was, but this time we could focus on the hip. I did just a few minutes of research on the stem cell stuff, and I don't like what I have seen so far. I will be doing a whole lot more research. Please advise me. I am very frustrated and confused, and I kind of feel like they are trying to pull a scam on me. Thank you so much for your help. Right now you are my only ray of light to keep me optimistic about the end result, because I feel the others I have dealt with so far are just bozos.

Hello Robert,
I'm sorry you're not closer! This is the kind of challenge I enjoy.

Find yourself a local chiropractor who is ready to do more than just crack your back; you'll need to shop around. Be prepared to go for just a consultation without treatment and assess what your DC has to say. Does he examine you thoroughly and do you have a good feel about him or her? You've been to enough people now to know whether someone is ready to go the extra mile with you, think, spend time, get involved. That's what it's going to take.

Of course, I haven't examined you, but I feel in familiar territory; this is the kind of stuff I deal with regularly. What I would do in terms of treatment:

1. Carefully evaluate and adjust the sacroiliac joint using a combination of Thompson drop protocol and the so called million dollar roll. A point to be taken: In any roll technique where you are lying on your side, the conventional adjustment uses the hip as a lever; this will injure your hip. The doctor's thrust must be with the hand, with a drop, but no pressure on the knee and hip. Important.

2. Some form of electrical stimulation of the soft tissues around the hip.

3. Deep soft tissue massage and stretching of the buttock, TFL and ITB, hip flexors and very importantly the hip adductors.

4. Specific exercises for both the hip and SI joints, and the associated muscles.

5. Accept that for the present running is out of the question, and even walking distances.

6. Have a good look at leg length; a short leg is often contributory to the problem. Not expensive orthotics but a simple heel or full sole inner.

Good luck, Robert. There's a chiropractor out there ready to help you. Find him or her! You won't be cured, but I see no reason why it can't be 60 to 80 percent improved.

Dr B



Mar 04, 2015
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xrays
by: Anonymous

I sent the pictures to the email address that you gave me. I hope it was correct because I sent it to .co like you put, but was wondering if that was supposed to be .com. Thank you so much for your help. I will be seeing both doctors tonight for a second opinion.

Hello Robert,
Yes, they arrived safely; tomorrow I'll set it all out and see if there's any more to add. Hope you get on well with the doctors today.

Dr B


Mar 03, 2015
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Round 7
by: Robert

I saw the neurosurgeon and he said there was nothing wrong with my back and felt the problem is with my hip. He said he couldn't help me because he only works with backs and brains. I just saw my main doctor again today (the orthopedic specialist) who is supposedly a hip specialist. Today he finally put me through some movements and looked at my X-ray and has determined that I need a hip replacement. We are meeting again in two days to get a second opinion from another doctor. I asked him why he felt I needed a hip replacement, and he said it just doesn't look right on the X-ray. This is the same X-ray that he looked at before and said everything looked fine.

Needless to say, I don't have any faith in this doctor. I took pictures of my X-rays on my iPad. How can I send you the pictures. Thank you for your help.

Hello Robert,
Well done on your perseverence in demanding answers; my gut feeling is that the neurosurgeon is right. This has to do with the sacroiliac joint and hip proper.

Well, I understand you distrust of the orthopaedic surgeon.

It's very strange that the MRI had nothing more to say than bursitis; he is saying by the sounds of things that you have total hip degeneration, and thus need a new hip.


Dr B

Feb 15, 2015
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Round 6
by: Robert

I'll jump on one leg only, ha,ha.
1. No problems with the left leg, but the right leg there was a lot of pain shooting down the leg to the outside of the knee.

I looked again at the MRI results letter from my hip, and it says that I have some bursitis. This was back in November, and only the orthopedic specialist mentioned it, but he only said something once in all our meetings and acted like it was nothing. Fortunately, all that pain I have been having has suddenly decreased a lot. The pain mainly comes now when I lay on my right side and then the groin hurts. I still can't walk normal, can't go up stairs, and have no strength along with having pain while walking upstairs, or standing on one leg, etc. do you think I should ask about having a cortisone shot? I was trying 800mg of ibuprofen per day before to get rid of inflammation, but I don't think it was really working. What do you suggest I do? Thank you so much.

This is definitely at least in part a hip problem, Robert. Definitely! By all means show him you can't jump on that leg!

The bursitis is a possibility, but I think something more. When you rotate that hip and it hurts so much, is it also much stiffer than the other side; is the range of motion reduced? Is it much looser? Does it pop or "give" at all?

I would very much like to see a copy of xrays; get it to me on from your camera or digitally from the CD.

Does this case ring any bells? http://www.chiropractic-help.com/hip-and-thigh-pain.html

I'm always reluctant to start any form of treatment until I have a diagnosis; as far as I can tell from what you write, no one has a clue what's the matter with you. So, no I wouldn't suggest ibuprofen.
Dangerous stuff anyway; yesterday a patient with a bleeding ulcer from taking it.

Dr B

Feb 15, 2015
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Round 5
by: Robert

The last time I saw the orthopedic specialist, who is the main doctor handling this, I gave him a detailed paper with all my different pain and problems moving. It was just like my first report that I wrote here. All he did was sit behind his desk and tell me to double how often I take the medicine, and said I could try acupuncture, or I could try another neurosurgeon to see if he sees something that nobody else sees. I will be seeing both the neurosurgeon and the orthopedic specialist next week. Hopefully the neurosurgeon will give a darn enough to spend more than 5 minutes with me looking at an MRI and saying he doesn't see anything. I will try to get the X-rays to you. Thank you very much for your help.

If he doesn't, jump up and down. Tell him you want to be examined properly.

One test I'm not clear in my mind still; if you lie on your back and pull your knee to your chest, and then make a circle, from out to in, what happens. Compare with the normal hip.

Only a copy of the xray of your pelvis needed; take your camera with you to the consultation and ask if you may take a photo of the pelvis. One of the whole pelvis, another close up spot of the R hip. If it's digital you may need help getting a jpeg image out of the program. Ask him could he send you the digital file of your pelvis. May have to ask the radiological dept for it.

Dr B

Feb 14, 2015
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step 4
by: robert

I'm sorry if I'm repeating this but I got interrupted while sending my previous response and don't know if I did it correctly.
When I stand on only my right leg, if the leg is straight, I have pain in my hip, if I bend the leg, I have the pain extend from the hip down the leg.
1. I can't really lift the leg. There is no strength, and I have pain in the groin. It is the same when I try to get into the car. I have to lift my leg into the car with my hands.
2. I didn't really feel any specific pain. I thought I was pushing pretty good with my right leg, but my friend said I was pushing with my good leg better than my bad right leg.
I don't know if I am answering the last question correctly, but I am lying down with my legs straight, and I try to put my right foot on my left knee, then I try to put my right knee to the ground. I don't have the range of motion like the other day. I can only get my knee to go about 45 degrees down, and I have pain in my groin.

Extra stuff. It is kind of hard to pinpoint the pain because a lot of times, it just feels like one big hurt. I have been also thinking it might be 2 problems because when my walking was improving with less pain, the pain was getting much worse when I rested. The last few days, I have been improving some with the pain. The pain hasn't been in the outside of the knee like before, and the burning in the groin isn't as severe as before. My walking isn't improving. I still am walking with a big limp and can't go upstairs. I haven't used my pain medicine in two days and the pain is much more tolerable than before when I tried to go without pain medicine.
Thank you so much for working with me, I feel we are making progress in figuring this out. I have been very frustrated with my doctors because all they do is ask me questions and look at my xrays and mri's, but they never put me through movements to see what I can and can't do.

Hello Robert,
It's a shame you haven't been properly examined after all this time. Anyway it's becoming much clearer now. Definitely hip or groin, and probably also secondarily in the lower back.

Important suggestion:

Go through all of this and make some very precise notes for the doctor for your next consultation.

Exactly where is the worst pain.
Exactly what aggravates the pain and what you can't you do. Include in that the Fabere test where you put your foot on the opposite knee; and that you have to lift your leg into the car, and, and...

Perhaps print out all these musings of ours and make concise notes for the doctor.

Later, once the diagnosis is established we can start to talk about treatment.

Dr B

Feb 14, 2015
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Test 4
by: Robert

I have pain standing on my right leg only. If the leg is straight, the pain is in the hip, if the leg is bent, the pain extends down the leg from the hip.

1. I can't really lift my right leg. There is no strength, and there is pain in my groin. Getting in a car is the same. I have to take my hands and lift my leg into the car.
2. When I pushed with my right leg, I didn't have any real noticeable pain. My friend said that he could feel more pressure coming from my left good leg than from my bad right leg, even though I thought I was pushing pretty good with my right.
I don't know if I am answering your last question correctly or not, but I am lying down with both legs straight, I try to put my right foot on my left knee and put my right knee to the ground. I don't have the same flexibility today as I did the other day. My right knee only goes about 45 degrees down. I have pain in the groin and outside of my knee. It is very tight.
Extra stuff: It is hard to pinpoint the pain on some of these things because it feels like one big hurt. I have been thinking I might have two things wrong also because when my walking was improving with less pain, the pain resting was increasing tremendously. The last few days, the pain has decreased and the pain that was in my knee is pretty much gone and the pain in my groin isn't as severe, but my walking is about the same with a big limp and no strength to go up stairs. I haven't had to use the pain medicine for two days and the pain is very tolerable compared to before when I tried to go without medicine.
I hope I answered your questions. Thank you so much for your help. I feel like we may be figuring this out, whereas before I have been frustrated with these doctors because all they do is ask questions, and look at the xrays and mri, but they haven't been putting me through motions to see what I can and can't do.

Hello again,
It's becoming much clearer now; you DEFINITELY have a hip or groin problem; there may also be a lower back or sacroiliac factor, but this in my mind is PRIMARILY HIP.

Unable to lift your leg into the car; pain in the hip standing. Restricted Fabere test with pain in the groin; pain in the groin lifting the leg; I take it this is both lying on your back and sitting. Can't raise your leg, right? It all points to the hip.

It is a bit of chicken and egg, but when you start limping because of an ankle, knee or hip problem, it often has a knock on effect in the lower back or SIJ.

Ask your doctor:
Is there absolutely no sign of dysplasia, pincer or CAM in the hip? I'd like to see the xray.

Dr B

Feb 13, 2015
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Part 3
by: Robert

1. I'm sure it's in the lumbar.
2. I can jump off my left leg, but I don't have strength to jump off my right leg. I can't stand on only my right leg to put on my pants, etc. I can't go up stairs normally. I have to always go up each step with my left leg first because I don't have the strength to push up on my right leg. If I lay on my back, I can't lift my straight leg up. It isn't really the pain, I don't have strength on the right side.
1. The answers to your questions are yes.
4. I had an MRI on my hip and back, and nobody sees anything wrong. That includes a neuro surgeon, orthopedic specialist, and pain specialist.
Thank you for the help.

For what it's worth I'm not convinced it's only your back.

Please give me more specific exercises to the questions requiring clarification below.

The biggie is: is your hip weak, with or without pain? You can't stand on your R leg: it feels weak. Does it feel weak, with pain, or without pain;

Now a new test, in two parts.

1. Sitting, raise your right knee. Is it painful? Where? Is it weak, can you raise the knee? Getting into the car, is it difficult raising your leg in, with or without pain?

2. Sitting. You need a helper. Try to straighten the knee so that the leg would be parallel to the ground; but at the same time your helper pushes your lower leg, preventing you from straightening your knee. Is is sore? Where? Is it weak compared to the left leg?

Very specific answers, Robert, to these and the questions in the previous second round of tests.

I still don't have an answer to: lying on your back. Both hands on your knee, rotate the hip. Is it stiff and is it sore. Where?

Dr B

Feb 13, 2015
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Second round of tests
by: Anonymous

1. The only difference was lower back pain on the right side when lifting the right leg. Just to be sure: lying on your tum, if someone raises your R knee and thigh, you get R LBP, correct. Perhaps ask your doctor to repeat, and decide if the pain is in the sacroiliac joint, lumbar spine (what level), or back of the hip.
2. Left leg is fine, I can't get off the ground on the right side. Many times, I can't stand on one leg to put on my pants, etc. it feels very weak and unstable in the back and hip area. Clarification please: Standing on left leg, your can't get right leg off the ground, correct? Where is the restriction and pain? In the groin or back? Side of the hip?

You can't take weight on the R leg at all, standing? Again, where is the pain? Groin or lower back?
3. Yes, everything was fine. Good.

1. It is hard to get the right foot to cross the left knee, and the right knee stays back and won't go forward at all. (Stiffness) pain in the groin and overall stiffness. This is the Fabere test and points to a groin problem. Probably your hip.
2. Fairly flexible, but pain in the groin. Sorry, getting a bit lost. Is this with rotating the hip whilst lying on the back? Flexible but pain in the groin? If it's flexible then it's pointing away from advanced hip arthritis, but one of the other hip conditions like dysplasia, or other.

3. I'm not sure, I will be seeing the doctor next week, so I will ask then. This would be a great help to Sherlock!

4. Going forward a little pain in the lower right back, going back up, about two thirds of the way up, there was pain in the lower right back and down the right leg to the knee, side to side is no problem. This is pointing strongly to a lower back condition. The rule is: remember the pain can have two diseases. You could well have a hip and a lower back problem; they feed off each other and serve to confuse the physician. It's beginning to look like a herniation into the IVF, but it's really not clear at what level. Only an MRI can detect this with any certainty. Because you've had this so long, I would insist; they are expensive but warranted.

The last factor to check for is so-called paresis. Specific weakness of a muscle group; finding it helps to detect the problem. I think it likely you have something here because of the weakness you feel in the hip area; but the testing is difficult if you have hip pain.

Thank you, I just want to figure this out and fix it. This has been very frustrating.

Keep plugging away, Robert. We'll work it out eventually. There's something going on. Then to fix the problem is another story.

If you have easy access to a pool, that would help. Meantime you'll find lower back exercises in the navigation bar at Chiropractic Help. Do them very gingerly, because we don't yet have a diagnosis; the rule is that you may feel it a bit, but they shouldn't be painful.

Try in all this yourself to figure out yourself whether this is a)in the hip and groin b)in the lower back or c)both.

Perhaps print this out for future reference.

Keep your pecker up!

Dr B

Feb 09, 2015
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results of test
by: Robert

On the first test I had no problems with the left leg, but some burning sensation in the groin when I lowered the leg on the right.
On the second, there was no problem with the left side, but I can't rotate my foot over on the right side, and there is pain in the groin and outside of the knee. Thanks, Robert

Hello Robert,
Okay, the first suggests this is not a sciatica. Good news.

The second gives a high likelihood that this has something to do with the hip joint.

But first let's confirm this isn't a femoral nerve problem.

1. Lying flat on your tum, ask a friend to raise your flexed knee, first left, and then the naughty leg. In other words, extend the hip passively with the knee flexed. What difference do you feel in the front of the thigh, and does it cause back pain?

2. Stand first on your left leg and spring a little on the leg. Remember the strength and stability of the knee. Now repeat with the naughty leg. Does it feel like it's going to give?

3. Has your doctor tested the reflexes and skin sensation? Any abnormalities?

Now that hip again:
1. Confirm for me that when you rotate the hip, lying on your back that it feels stiff? and painful? in the groin.

2. Lying down place your right heel on the left knee, and allow the right knee to drop into the lotus position. Stiff? Where? Pain?

3. Can you get a copy of the hip xray and send it to contact?

4. Standing, bend slowly forwards, then backwards, and then to the side; do it carefully, off medication. What do you feel? Carefully please, this can make you worse.

Again stick to this thread.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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