Expert: Dr. Nekessa Remy - 10/30/2009

Question
QUESTION: In July I went to a chiropractor for the first time because I was experiencing sciatica in my right calf and ankle, after examining me he said that my right hip was out of place and performed adjustments on both of my hips. Ever since I have been experiencing a lot of pain in my sacrum and si joint area also stabbing pains in my upper front thighs,the pain is aggravated by sitting. I went to an orthopedic specialist and can not get a firm diagnosis they think it's either a herniated disk or si joint problem, could chiropractic adjustments cause this? It has been 3 months and the pain is not getting any better, I have had a pelvic mri but they didn't find anything wrong, any idea what could cause this type of pain? I am in physical therapy now but am not finding any relief.

ANSWER: Hi Eden
I am not sure what type of adjustment was done to your hip therefore I can't definetivley determine whether or not the adjustment aggravated your pain. I am certain that the adjustment can not cause a herniation in your disc. Your sciatic symptoms may not becoming from your hip however, it could be coming from your lumbar spine or from a muscular entrapment. A herniated disc can cause pain in the regions you reported including the anterior thigh and SI region. The herniation may be causing pressure on the nerves which make up the sciatic nerve.  If that is the case a lumbar MRI would be able to diagnose it. In terms of treatment, I would recommend traction therapy, this can be done manually by a chiropractor or some physiotherapist. I would also look into McKenzie Rehabilitation, it a technique used specifically for disc related conditions. It involves graduated extension exercises which are designed to aid the reabsorption of the herniated disc, thus reducing pressure on the nerves and the symptoms you are experiencing. There is a lot of research on this new method, I would speak with a health care provider about implementing this in your current treatment regime

Hope this helps



---------- FOLLOW-UP ----------

QUESTION: Thank you for your response, I am going to request a lumbar mri at my next doctor visit. I am receiving physical therapy and traction but the traction has been making me very sore so I have stopped it. Do you recommend inversion? My husband has a teeter inversion table I could use if that will help? Also do my symptoms sound like it could be a SI joint problem instead of a disc problem?

Answer
SI problems are not typically associated with sciatic type symptoms. However a chiropractor should be able to differentiate between a disc or SI problem through a series of orthopedic tests.  I would advise perhaps seeing another chiropractor. As for inversion, I would not advise inversion therapy unless in was under the care of a health care professional. Research has not shown inversion to be a definite effective treatment for lower back pain, although it may provide you with some temporary relief by minimizing some pressure on the disc.