Lower back pain - disc problems or glutes?

by worried

Sequestrated disc

Sequestrated disc

Lower back pain - disc problems or glutes?

Suffered lower back pain for a number of years. Had a very bad disc prolapse at L4/5 removed July 2011 and things have been almost excellent since apart from a few minor flare ups which my Chiro has quickly rectified.

For last two weeks have been suffering more persistent and worrying lower back pain and stiffness. The pain is worst on the right side just above or on the top line of my pelvis about midway between my spine and the side of my hip. Lying down for brief periods, doing your exercises and applying heat all seem to help.

Doing the slump test i can raise my right leg fine and lower my chin at the same time. On the left side, i can put my leg out straight but lowering my head increases pain in the right lower back. Am hoping beyond all hope that it is just muscular as desperately fear another disc problem.

Realise only an mri scan will be conclusive but just wondering if you think there is a chance it could just be gluteus (medius perhaps) and if so whether you can recommend anything to alleviate it? Thank you for all the info on your site, it has been very helpful.

Dear Kim,
It's not time to get depressed yet! but yes it does sound like you have a mild grade I disc injury. You make no mention of leg pain.

What you do have is the crossed sign - raising the left leg hurts in the right low back, not in the right leg luckily.

That is both good and bad news. The good first. A
postero medial disc herniation - mild in your case, since there is no leg pain, not really a true herniation (yet) - typically gives the crossed sign.

The good news is that PM bulges usually respond quicker than PL bulges to chiropractic manipulation. But even though the pain subsides quicker than PL, IT STILL TAKES SIX WEEKS TO HEAL.

The bad news? More PM disc herniations end up in surgery with all the complications. My theory, is that PMs get better quickly, and folk very quickly forget they've had an injury, start sitting, bending, gymming, stop the exercises too soon, thinking it was no big deal. Every disc injury is a big deal, as you know, and you never know in advance whether this is one that's going to end up in surgery.

These slipped disc rules are for bad cases, and I don't think you need to take them literally. But I would follow the spirit of them. Bend less, sit less, do your exercises faithfully, be careful. And go on doing them FOR THE REST OF YOUR LIFE every morning before getting out of bed.

Plan to get properly better otherwise it just comes back next week.

There is a place for Massaging bed rest but I doubt you need that at this stage. But if in a couple weeks the slump test is still positive then take a week of this modified bed rest.

Go from Lower back pain - disc problems or glutes? to other Chiropractic Conditions often treated…

I hope this has contributed.


Dr. Barrie Lewis

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May 10, 2013
chiropractic adjustment
by: Anonymous

Dr. B,
Recently I got my first chiropractic adjustment for upper left side pain as it was radiating towards my heart, the doc stated rib 4,5,6 needs adjusting w/o x-ray. After the procedure, I now have tingling/numbness in my left thumb and index fingers. Is this anything to be concerned about? TY

Dear Jai,
Would you mind asking your question on a new thread, this is someone else's. I would suggest at this page, scroll down to the bottom and start a new thread. Arm pain ...

Yes, there is concern, Jai. I'll give a more detailed answer at the new page.

Dr. Barrie Lewis

Apr 08, 2013
by: worried

Thanks for your prompt response Dr B. Am following the exercises faithfully!! Unfortunately i do have some leg pain in the opposite leg (i.e if i raise my left leg during the slump test i get a pain just above my right knee). This only happens when i also lower my chin and it is quite mild, so am hoping this means the problem isn't too severe. I also forgot to mention i spent two days doing the leaning tower of pisa towards the pain, so i think this fits with your conclusion. Hoping for an mri later this week so fingers crossed for a good outcome! Again, thanks for your advice and the info on your website - invaluable!

Also ask your chiro to check if your hips are level. Sometimes an insert inside your shoe can make a big difference if you go into the Pisa sign. Leg length inequality …

Traction aggravates the PM disc injury.

No coughing! Frankly, I'd go to bed for a week for our modified bed rest. Massaging bed rest ...

Dr. Barrie Lewis

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