Severe pain right lower back, right buttock, right hip, right groin, entire anterior and posterior right leg with numbness from top of thigh to just below knee along outside of right leg.

I’m 63 year old female. My original injury was right patella dislocation while playing basketball at age 15. Right patella dislocation began to occur spontaneously with increased frequency. Conservative treatment consisted of alternating heat and icing, anti inflammatory medications, strengthening exercises. First surgery was meniscusectomy at age 15. Stabilization procedures not done back then. Recurrent right patella dislocations continued necessitating multiple surgeries for stabilization. Six right knee surgeries required from 1970 to 2011.

In 2011 right total knee arthroplasty due to Osteoarthritis and six revisions due to one mechanical failure as disc would spin out, two back to right knee infections, one surgery to do tissue and bone biopsies, one surgery to rule out metal allergies and last surgery to change to different manufacturer of and type of implant. Medical History of Hypertension, Hypothyroidism, Hyper Aldosteronis, Epilepsy, three episodes Deep Vein Thrombosis, three episodes of Pulmonary Embolisms, Sjogrens, Antiphosphalipid Antibody Syndrome, Renal Tubular Acidosis, Vitamin D deficiency, Calcium deficiency, Osteoporosis, Osteoarthritis, Raynaulds Disease, Migraines, Bilateral Retinal Detachments, Drug Induced Bilateral Hearing Loss, Elevated Cholesterol, Elevated Triglycerides, Angina, Functional Heart Murmur, Pneumonia 3 times, Ischemic Colitis, Toxic Colitis, Rhabdomyolysis, Viral Meningitis, Multiple Herniated Disc, Appendicitis, Cholelithiasis, Left Foot Lis Franc Fracture and Displacement of all five bones, Status Post Duodenal Ulcer, Latex Allergy Severe. Surgeries have been Tonsillectomy, Adenoidectomy, Right Wrist Surgery, Two C Sections, Appendectomy, Laparoscopic Cholecystectomy, Tubal.Ligation, Open Reduction and Internal and External Fixation, Lumbar Laminectomy L4L5, L4L3, L3L2, Thoracic Laminectomy. Multiple Anaphylaxis.

The low back pain, right hip pain, right groin pain and right leg pain are all complications from a combination of my above medical issues. The acute pain started about five days ago in the absence of any recent injury. Unable to stand straight due to pain. Pain medication, muscle relaxers, anti inflammatory medications, exercises, rest are not helping to return me back to previous level of functionality. Steroids decrease symptoms but return when weaning off the medications. My back surgeon has retired and I’m unable to see physician who took over is unable to see me until end of May.

Obviously there's nothing simple about this, but in the first instance, after only five days you can't expect to be returning to your previous level of functionality.

Unable to stand up straight, sudden onset, suggests an acute antalgia, leaning forwards or to the side, usually from a disc herniation, but sometimes due to a facet entrapment. This means bed rest with back exercises done every half an hour or so, on your bed. Sit as little as possible; every hour get up and walk about as much as you can. Continued bed rest is not advisable.

The difficulty is that with the pain in both the front and the back of the thigh, more than one nerve root is being effected, and that needs careful assessment and almost certainly a new MRI.

You are going to need professional help; this isn't straight forward. Get it now, don't delay.

General health; take a good long look at your diet; something seriously amiss by the looks of things. Get help from a dietician and be ready to make some radical changes if you want to enjoy your golden years.

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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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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