Expert: Dr. Paul Newhart - 2/15/2008

Question
I injured my back in September 07 (twisted whilst pulling my chair in). Since then I have seen (no kidding) more
than 10 therapists. None have really helped. I won't
bore you with the details, but is seems now to be a
problem with the muscles in and around the hip.
Possibly piriformis syndrome or psoas syndrome. I know
nothing much about this stuff, but my most helpful
therapy has been looking up on the internet and then
doing various stretches. This has not entirely fixed
the problem though. I am now seeing a chiro who seems
to be better than the others, but I don't feel I am
relly getting better.

The main problem is that no therapist seems to be able
to (or want to) diagnose it fully. Obviously it is hard to do, but mos of them just plunge into their therapy.

I guess there are a couple of questions. First, based on my symptoms, what is it likely to be. An MRI shows very slight disc herniation but I don't think it is that. I have sicatic pain but also muscle pain in the hip/buttock area on my left side. Worst areas seem to be piriformis, psoa, gluteus & hamstring, but as I don't really know physiology I am not sure. Second question - surely there are tests that can establish what the problem is? No one has done any real tests,at least nothing that I would call empirical. Thirdly, is chiropratic the best answer for this? I feel that it probably is but after 3 treatments I seem not to be improving, in fact it is getting worse right now. Hope you can help, many thanks, Fraze  

Answer
X ray would be your first phaze.  If misalignment is present, that needs to be addressed, as well as addressing the muscles in question.  MRI would be next, but that won't give too much information on the muscles.  There are strength tests for the above muscles that a good chiropractor should perform.  The main treatments we use for this condition are as follows:
Address the inflammation, calm the spasm, address and fascial issues, adjust, and rehab to strengthen