Expert: Gerald Anzalone, D.C. - 4/20/2008

Question
I have LBP and pain in gluteal region. My NMRI shows no pathology. Pain is increased during hyperextension of the back and prolonged sitting. When externally rotate right leg I hear poping sound and have less pain in gluteus for a while. I went to chiropractic and after 2 treatments I have even more pain. What can be source of pain and could chiropractor make te problem worst?

Answer
Milos,

I would need some more information than you provided in your vignette to give you a more accurate answer, but in general, the symptoms you describe appear to be consistent with that of a degenerative or herniated disc. Disc herniations may not always be detected with conventional MRI, as the spine is placed in a relaxed position when the individual undergoing the scan is placed in a recumbent position. MRI studies that provide a weight-bearing study are more accurate.

If the treatment you received from your chiropractor has worsened the pain, that is an indication that you are probably better off with a change of technique. For example, rather than manipulation, you would probably do better with some form of mechanical traction. Many chiropractors use a technique called flexion-distraction; a special treatment table is used to flex the spine forward (opposite of the position that seems to exacerbate your condition). You might also do better with a rehabilitative exercise. You might also try acupuncture.

Often in treating low back pain, both the patient and supervising doctor  must experiment to see which modality offers the best result.

I hope that this answers your question.