Sit pain > 3 years

by Lisa
(Texas )

I've had sit pain for more than 3 years. It is incredibly painful in my lower left buttock near bottom panty line. I have no back pain, have tried piriformis injections, epidural injections, PT, bursa injections, but still unable to pinpoint the source of the pain.

I've tried several prescriptions, but only a couple have made it tolerable for a good part of the day. I've read about all kinds of things about issues with SI, Pudendal Nerves, Piriformis, Sciatica. I'm 42 years old, weigh 125, and can't sit for more than 30 minutes at a time. Now the doctors want to try an SI injection along with medial branch block injections because my last MRI said "minor facet hypertrophy at some of the lower lumbar levels.

He says that if this doesn't pinpoint it, he's not sure what to do. I'm feeling like I'm at the end of my rope and am going to have to just live with it. Which is a terribly depressing thought. Anyone else have a similar story but with a happy ending?

Hello Lisa,
It may seem trite, but why on earth are you only thinking chiropractic now?

Having said that, this doesn't look straight forward. From what you describe, it would appear that you are having ischial pain, perhaps coccyx and perhaps hamstring insertion.

Could I ask you to do a couple tests please.

Bend slowly forwards, and compare the tightness in the buttock and back of your thigh. Are they equal? Now backwards, and then to the side, first right and then left.

Sitting in a chair, ask hubby to raise your right leg parallel to the ground, and then slowly flex your head and neck. Now the left leg. Is there any difference?

Some of the deep pelvic muscles attach to the ischium; starting the Kegel exercises would certainly do no harm. Find them at Chiropractic Help using the search function.

Personally I would start doing a lot of soft tissue work on the hamstring and buttock muscles around the ischium; then more controversially, those deep pelvic muscles are best reached rectally; you'll have to do some homework to find a chiropractor, or other, who would do that; take hubby with you.

Every chiropractor would start looking for sacroiliac fixations, and in the lumbar spine.

If you run your finger down the crease between the buttocks, is there any deep coccyx pain?

Let me have some answers, and perhaps we can take this further.

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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