Leaning to the left without any pain

by John
(New Zealand)

Leaning to the left without any pain.

Thank you very much for your wonderful article on the Pias Sign. I have been to my GP who is known for his skill in fixing back problems; he said I am leaning away from the pain.

He sent me to have an MRI and to a neurosurgeon I had the MRI and went to the neurosurgeon. He neuro said that the bulge in discs were not causing the the problem. He said that I had a inflamed joint and prescribed a seven day course of the steroid predisone.

Eight 5mg tablets a day and then stop; I nearly lost my life from the withdrawal symptoms. My GP also sent me to a physio for five visits without any improvement.

I then went to another Physio who had fixed a tennis elbow for me previously. He found four muscles in spasm and two ligaments strained and he fixed them in four sessions.

At no time had I a feeling of pain in my spine or leg. Just a tiredness associated with the ligaments.

The photo of the man in your article looks exactly like me and the ligament is where the arrow is.

Sorry to be so long winded about this but you are the first to precisely diagnose my problem for which I am truely grateful as it arms me against wrong diagnoses in the future.

In the mornings when I get out of bed I am much straighter and I use a stick on my right side to keep myself from leaning to my left.

I am 69 years old and in reasonable good health and living in New Zealand at present
Thank you
John C

Hello John,
Thanks for the compliments; makes my day!

Whatever our theories and disagreements about diagnosis, it would seem that you are getting better; if the pain has gone then the chances are good you will recover completely, or nearly completely.

In my book, getting out of the Pisa sign is vital; if you're still crooked then it means that something is still seriously wrong; in my language, probably a disc that's bulging. In your neurosurgeon's opinion the joint is still inflammed.

Until you are up straight, I would take life very quietly; spend some time lying down each day, not bending, sitting less and certainly no heavy lifting.

Take a look at our slipped disc synmptoms page; use the search function at Chiropractic Help to find it. What's great is that you have no leg pain; that means Grade I.

But did you have pain when coughing, sneezing or straining on the loo? Was sitting difficult? When your doctor, surgeon, therapist lifted your leg, whilst lying flat on your back, did you have back pain. At how many degrees of leg raise?

Did the MRI show a bulging disc? Could you type me the report? Keep to this same thread.

The body has amazing healing powers; do lots of those gentle back exercises, give it another month before doing crazy things and with luck you'll get better.

Look too at the Slump Test; sitting in a kitchen chair, does raising the leg parallel to the ground cause pain in the back?

I'd love to see your southern Alps; I've read many stories, and watched videos, of soaring the mountains to incredible heights. Sigh, just a dream! The prevailing winds striking the mountains will take a glider to over 30,000 feet! When your back's better, take a flip. If you dare! You can read my humble in comparison longest flight at http://www.bernard-preston.com/Baptiso-to-Immerse.html

If you don't come up straight, John, and the Slump Test remains positive, I'd consider an opinion from a local chiropractor.

Good luck, let me know how you get on.

Dr B

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Dec 06, 2015
Still leaning to the left with no pain
by: John Lacy

I am still having the same problem a year on. Since I last wrote to you I have been to 9 more medical professionals. All were unable to fix my problem or identify what was amiss.

I have researched it on the internet and armed with that information I asked my GP to inject my left hand Sacroiliac joint with a local anesthetic
Great joy I was able to walk upright for a few days until it wore off. I felt that that proved that the SI joint was hyper-mobile. As a result we tried a cortisone injection into the SI joint that worked for two weeks. We tried a second injection 3 months later and that lasted three weeks.

After a long walk I am now as bad as ever.
All the muscles and tendons that were in a stressed condition were released leaving just the SI joint ache.

I am convinced that the SI joint is the problem but no one knows how to fix it as yet.
All the Very Best
John Lacy

This is beginning to sound more like the typical SI problem that chiropractors excel with, only perhaps complicated by a short leg.

Has anyone checked your leg length?

Dr B

» Still leaning to the left with no pain

Dec 11, 2014
Still leaning to the left no pain
by: John Lacy

Thank you for your most considered response and helpful comments. I have just seen my eight doctor/physio with no suggestion of the problem.
Because,thankfully, I have no pain everyone is confused.

I can lift both legs vertically with no pain at any point. I can run up and down a stairs with no pain and it seems to help me stay upright.

I have passed the slump test three times with no pain. I can bend sit sleep lie flat do my exercises and all with no pain.

At the end of the day I get a tired ache in the left hand muscle over the hip towards the spine.
It feels like My left hand Tyre[spare] has a puncture.

My last Physio checked all joints in my back for any sign of soreness without success.

Thank you for your caring it is much appreciated.

The mri report is as follows;

No fracture or destructive bone lesion. Conus is intact.Small disc protrusions present centrally at L4-5 and also at L5-S1 disc to a lesser extent. No evidence of canal stenosis.Minor posterior element degenerative changes also noted Minor age related changes of degenerative disease noted only. No fracture or destructive bone lesion identified.

What you are doing is wonderful and many thanks. Hope you enjoy my puzzling conundrum, John.

Hello John,
Yes, it is puzzling. Ask your PT to check for a leg length deficit; or your spouse. Standing behind you with a hand on each iliac (hip) crest, is there an obvious unleveling? Sometimes then a soft insert inside one shoe may help.

I too alas have no other answers, without being able to examine you myself. Keep exercising.

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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