Lower back pain - disc problems or glutes?

by worried
(UK)


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…

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May 10, 2013
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starstarstarstarstar 		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
Jai

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 B
Apr 08, 2013
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starstarstarstarstar 		response
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 ...

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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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