Pain in the hip

by Douglas
(San Clemente Ca USA)

Maignes syndrome radiation.

Maignes syndrome radiation.

Pain in the hip / Maignes syndrome ?

First of all THANK YOU! I have enjoyed your web site and information

I have several good friends that are Chiropractors and respect them all but I continue to get conflicting info. I am 60 and have had life long back issues. I have almost no disc between L4 and L5. This is usually the source of my issues. Three weeks ago I made the stupid mistake of lifting a 55 lb bag over a back seat and felt a strain. I then went dirt bike riding for 5 hours. I had back pain for two weeks but could still move around. I reached up and moved something off the wall over my head with no reaction at the time but the next day it hit me hard. The Chiropractor seemed to stop the pain by moving only L4. Still hurt and went out again two days later I think because I reached up and closed the garage door.

I needed to be driven to the Dr. They loaded me up with steroids etc. for a week but no benefit. I have been on the floor for 8 days now. Sharp pain has moved from the back of my hip to the front but not down my leg. I visited the Physio today and now it seems worse. She thought it was l1and l2 that was the problem since the pain was in my hip. My hip is also numb

I have followed you recommendations on the site for a medial disc bulge because the pain is less if I lean towards it. Not sure where to go from here. Any suggestion is greatly appreciated. I see the doctor tomorrow and hope to suggest an MRI arranged

With appreciation
Hello Doug,
Thank you for the compliments! Pleasure.

First, let's just be sure this isn't a ball and socket problem along with the back problem.

Lie on your back and pull the knee on the good side to your chest, and then towards the opposite shoulder. Remember what you feel. Now repeat on the naughty hip side. Is it significantly different? Where? Have your wife gently rotate the lower leg in and out (rotating in the hip). What happens?

Your saving grace is that you are so active, but you are going to have to slow down / stop for a month.

Your physio may have something. The nerve that goes to the front of the hip / groin is the Femoral nerve, and its various offshoots (like the Lateral Femoral Cutaneous nerve) which can certainly make the side of the hip / upper thigh numb. So it could be upper lumbar.

You've said several times that working in extension, arms above the head... is what seems to provoke the pain. That's good news because it points to facet impingement rather than a slipped disc.

What I would do...

* On your tum, press quite hard on the various facets, challenge them for movement, looking to see whether the spoke is the wheel is in fact at L4-L5 where you obviously have problems, or whether it is in fact higher at say L1 or L2.

* Then I would have you bend sideways, prodding and looking for the real bugger. Is it L4... or higher?

* Then I would do the Slump Test and the Femoral nerve stretch. Slump is for sciatic nerve, lower lumbar, and Fem stretch for mid and upper lumbar. Which provokes the pain?

* One thing to watch out for is weakness of the quad muscle in your thigh. If you knee starts to give, then it's more serious. Reflexes and sensory testing helps confirm all these tests.

Look up Maignes syndrome and Femoral nerve and Sciatic nerve and Meralgia paresthetica by plugging them into the Search this site function at Chiropractic Help.

Strongly suggest you start the lower back exercises at C-H (look in the navigation bar for exercises). Do them every morning before getting out of bed, and in your case several times a day.

Perhaps print this out and take to your chiro.

Good luck, let me know how you get on in a few weeks.

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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