Pain mainly groin and hips upon standing from seated position.

I am a mail carrier and first noticed pain in my left hip when stepping down from my vehicle. This was around March 2013. I would have periods of pain and then some relief, my hips began to snap with each step, but then not.

I started feeling excruciating pain when getting out of a chair or vehicle. It seemed any side to side movements while seated would bring on pain.

Lifting my legs while lying down is painful. The pain has progressed to 90% of the time. Walking on uneven terrain with weight in satchel or arms have become extremely painful. Any pulling on my legs, such as trudging through snow is unbearable.

I have seen my family doctor who prescribes pain relievers and prednisone. I've done two rounds of prednisone, and have had significant relief, but I know I can't take it long term.

I have been seeing a doctor of physical medicine, too. He had an MRI done which revealed: T11-12 mild disc bulging, L2-3 posterior disc bulge and borderline protrusion into inferior foramina, L3-4 posterior disc bulge and borderline protrusion into neural foramina bilaterally, degenerative changes of the facets with buckling of the ligamentum flavum contributing to dorsal pinching of the canal and early central canal stenosis. L4-5 posterior disc bulge with borderline protrusion into the neural foramina bilaterally to encroach upon the exiting nerves, Degenerative changes of the facets and buckling of the ligamentum flavum contributing to dorsal pinching of the canal and moderate central canal stenosis, as well as effacement of the lateral recesses. The is moderate neural foraminal stenosis. L5-S1 mild disc bulge into the neural formina slightly encroaching the exiting nerves.

It's interesting, and significant that you mention no back pain. Just hip and groin pain.

There's a close correlation between the mid to upper lumbar spine and the hips. Traditionally, we think of the spine causing the hip pain, but it in fact works both ways. Bit of chicken and egg.

But for my money, I would recommend you concentrate on the hips for the present, rather than major back surgery.

Do a little test for me. Lying on your back, pull your knee to the chest, then towards the opposite shoulder, and then rotate the hip. First the less painful one, then the worse. Compare perhaps with another family member of the same age. What's the difference?

Then lying down again, place the foot on the opposite knee, and let your leg drop into what's known as the Patrick Fabere position. Google it. Sore? Stiff? Where, back or groin and hip?

Difficulty putting on a shoe?

Family history of hip problems? Your age?

Get an xray of your pelvis if one hasn't been taken. See if you can send it to me, plus the report, as with the mri.

Let me know.

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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Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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