Expert: Dr Ron Grassi,DC.,MS.,ACFEI. - 10/31/2009

Question
QUESTION: I went to a chiropractor 3 months ago due to sciatica pain I was experiencing in my right calf and ankle, he said it was due to my hip being out of place and performed adjustments on both hips, ever since then I have been experiencing alot of pain with sitting in my sacral and si joint areas and also stabbing pains in the front of my thighs. I have seen an orthopedic specialist and had pelvic xrays and a mri but they did not find anything wrong. What could be causing this pain? What type of doctor should I see? I have had two diagnosis si joint pain and bulging disk but they are just guessing at this.

ANSWER: Hi Eden: Have you had an EMG or Nerve Test yet.? Either  a Neurologist or Physiatrist do these. How is all your blood work.? any signs of inflammation.? With the pain you are experiencing you should ask for a Nuclear Bone Scan too. SI Joint pain IS NOT a Diagnosis. It is a symptom. And Bulging Disc WOULD NOT cause that kind of problem. After these tests, see a Rhumatologist. The reason the Adjustment hurt is likely due to the inflammation I suspect. How old are you and where do you live.  Keep me posted on your test results. Dr Ron Grassi,DC.,MS. Jupiter,Florida. www.DrGrassi.com

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QUESTION: Thanks for your response, I have not had a EMG or any nerve testing done. They did try an injection in one of my SI Joints but that did not help so after that they assummed it must not be a si problem but a disk problem. Do SI injections always work? I have not had any blood work either but I am a active healthy 41 year old. I have wondered if I have fybromyaliga though because I have tender spots all over my body but I have not been tested for it. I will make an appt with a neurologist. I am also going to request a lumbar mri.

ANSWER: Hi Eden: I thought you already had an MRI an it showed a Bulging Disc. An injection in an SI joint that does not relieve pain still does NOT MEAN that is not where the pain is coming from. That test is inconclusive. The Nerve test should give you that information. That is why I recommended a Rhumatologist. FIBROMYALGIA. That's what they do.  That is a Diagnosis of exclusion. In other words, if everything else is negative, that's basically all that's left. Don't forget the Nuclear Bone Scan. That rules out the worst.  This is a very low risk, sensitive, inexpensive test that's been around for 50 yrs. Why no blood work.? That is usually where everyone starts when trying to figure out a Diagnosis.  This is why I ask you where you live. Close to big city with teaching Medical Schools or Farmlamd.I know this is all frustrating but, hang in there. I'm here to help. Check out www.spineuniverse.com  www.spine-health.com  Too.  Thank's. Dr Ron.

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QUESTION: I live on the MD Eastern Shore and have been dealing with local doctors but of course there are good doctors in Baltimore. I had a MRI over 4 months ago that showed a bulging disk but they have not performed another one to see if it is worse, they did perform a pelvic mri and found nothing wrong sorry for the confusion. I have looked at spine-heath.com's website and have been doing exercises for my back and si joints both.

Answer
Without Trauma. It's unlikely your Disc got worse. Bulging Disc's are considered normal variants these days. Get an exercise ball. Strengthen the Multifidi and Psoas back muscles. Don't irritate the SI. Try Inversion Traction. Hanging upside down. You can pick one up cheap at a consignment store. Make sure your blood preasure is OK first. Baltimore. Good. Johns Hopkins. I love those Dungee Crabs there. Dr Ron. PS; Don't forget to ask for a Bone Scan. Insist.