Expert: Dr. Victor Dolan, DC, DACBSP - 5/12/2008

Question
Hi, my name is Dara.  I have had several MRI's, seen several different doctors, all to no avail and have hopes that you might could help.  I have had pain in my left buttock/hip radiating down into my thigh for the past 8 years.  It is not a pain that I can't stand, but rather a dull ache most of the time.  Sometimes, at it's worst, I will feel some sharp pains in my buttock area.  The odd thing is that I can flinch my butt muscles and something "pops" and the pain is relieved for a short time.  The pain is exacerbated when I sit or lay in certain positions.  It's almost like when I sit something "moves" and I have to pop it back into place.  I cannot and have not slept on my left side in years.  I sleep only on my right side and stomach, which causes me other problems like waking up with a stiff neck because I can only sleep in one position.  If I stick my left leg out (like a frog leg) while laying on my back, the pain is relieved.  Now, I have noticed that my right buttock is starting to do the same thing, only not as bad...yet.  Perhaps I should give some background medical history as well.  I have had a past diagnosis of systemic lupus and fibromyalgia.  It seems my doctors want to blame it on fibromyalgia, but from my understanding, fibromyalgia is not a problem of "popping ligaments", but rather from pain receptor problems in the brain.  Could this be a symptom of lupus though?  I have been documented as being "in remission" for the past four years, but do question that as I have occasional sun rashes, etc.  I have constant mild pain all over, supposedly due to the fibromyalgia.  The fact that the right side is now starting to do this really makes me question that this is fibromyalgia related.  I "tried" to do some running the other day and ended up with alot of pain the next day in my buttocks and down both legs, with sharp pains in my buttock area.  I am really tiring of this pain and hope you can shed some light on it...maybe give me another idea that my doctors haven't entertained.  Thank you so much for your time.  
Sincerely,
Dara D.

Answer
Hello Dara.  Sorry to hear of your health problems.

Subject: pain/popping in buttocks.

Chiropractic takes in many aspects of health.  One aspect I think we Doctors of Chiropractic are expert in are 'mechanical' problems in our joints.  Lets start here.

Pain/ popping in buttocks.  As i said, first consideration: mechanics.  Xrays of both hips, pelvis and lumbosacral spine.  Pain/ popping, perhaps DJD, degenerative joint disease- osteoarthritic degeneration of your hips, sacro-iliac joints or lumbo/sacral spine?
Have you had Xrays/ and or MRIs of your Hips and lower back? Check this out.

IF your bones/ joints seem okay upon xray/ mri evaluation, then let us move into the muscular arena.  A Doctor of Chiropractic, perhaps a Physiatrist MD, maybe a good Physical Therapist could give you a thorough muscular evaluation (after the xray/ mri checkup) and look for adhesions, atrophy, tight bands, myofascial problems, hypertrophy- perhaps these things could give you the pain and popping you report.  Of course, I would admit my bias towards the sports specialist DC practitioner (wwww.ACBSP.com) for this arena of care.  A combination of soft tissue chiropractic work as well as traditional osseous chiropractic could be a good approach if either of these two areas ( bone-joint,  muscle ) seem to be the cause.

If these areas are not the cause (and they can be ruled in or out through the imaging studies and physical examination) then we move into the 'metabolic' area.  You speak of Lupus, you speak of Fibromyalgia.  Certainly these underlying conditions could be a cause or contributory to your complaint.  If it was just a mechanical muscular problem, that component could be more easily addressed. Given Lupus/ Fibro, this certainly complicates the picture, and REQUIRES increased commitment/ work on your part.

How are you handling these diagnoses?  Medications?, Diet and supplements?

These conditions probably at least contribute to the complaint that brought you here.  Are you close to ideal weight? Do you eat a proper diet?- NOT the SAD (standard american diet)diet.

Do you drink plenty of pure water, fresh raw organic foods, fruits vegetables: AVOID processed foods, preservatives, artificial additives.

Take targeted nutrition for the Lupus, these may help: Digestive enzymes and HCl, Glutamine and N-Acetyl Glucosamine, A, C, E, zinc and selenium, Omega 3 essential fatty acids, multi vit multi mineral supplement, probiotics, glucosamine and chondroitin sulfate; all of these could be of help for the lupus.

You mention fibromyalgia and the brain, this makes me think of a neurological chiropractic approach- read the book by Dr. Michael Johnson- "What Do You Do When the Medications Don’t Work?—A Non-Drug Treatment of Dizziness, Migraine Headaches, Fibromyalgia, and Other Chronic Conditions." see his website http://www.lifechangingcare.com
A different and effective approach towards fibro.

Hope this helps.  As always- only the treating professionals can make specific recommendations for any specific patient. The aforegoing is for information, education, discussion purposes only.

Thanks for the question, I do wish you Good Health- Naturally!


Victor Dolan, DC
http://www.DocDolan.net