Expert: Dr. Victor Dolan, DC, DACBSP - 9/20/2009

Question
I have pain that usually starts from sitting in certain positions, standing for long periods of time and sitting on the toilet, even for a short time.  It will start on the sides of both hips with pain in the front of the hips and front hip bones  as well.  The pain will also move to the backs of my legs at times with mostly tingling, not numbmess.  It is progessively getting worse and I seem to have it daily now.  It can take quite some time to go away when trying to lay down and rest it.  I would appreciate any thoughts on how to proceed.  I thought it could be sciatica at one time, but now sure the symptoms are quite right for that.  I have no pain with coughing.   Thank you!

Answer
Hello Katie,

I am sorry to hear of your progressively worsening hip pain.

You do not mention your age, any trauma, previous history.  You seem somewhat familiar with back pain, back problems being the root cause of sciatica; you seem familiar with one of the signs of back pain and sciatica being connected- pain upon coughing/ sneezing/ taking a bowel movement ('straining at the stool') which is a dejerine or valsalva type maneuver.

If my answer does not help you, help enough, seem incomplete; do not hesitate to RE-contact me here at AllExperts.com = http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Depending upon your age, depending upon prior history, the CAUSE of your pain/ problem may be as far away as your feet (not likely, maybe you need orthotics?, but not likely), possibly the knees (still not very likely, but have you ever injured your knees?- perhaps your gait is altered therefore affecting your hips/ back/ neck?), If you are a little older,,,, perhaps this could be your hips--- now this is more likely then feet or knees, but usually hip problems are NOT bilateral (both sides at the same time); and finally- perhaps it is your pelvis/ SI joints/ lumbosacral spine.  

As a very long shot, your problem could even be of vascular origin, do you have any other symptoms in the lower extremity?  Coldness, coolness, swelling, cramping, varicose veins?- on this long shot a lower extremity doppler test may be necessary, a pelvic ultrasound to view the vessels.

Certainly I recommend an evaluation of your progressively worsening problem, preferably by your local Doctor of Chiropractic.  If you wish, perhaps you want to see a sports injury specialist chiropractor, orthopedic chiropractor, rehab chiro.  Yes chiropractic doctors have specialties just like medical doctors; see: http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf

Whatever you do , you do want to get to the cause of your problems, not just treat symptoms and allow the underlying problem to grow worse.  Do not just take medications to cover up the problem, mask the symptoms.  I have an information handout sheet that I utilize in my Staten Island Chiropractic office, and my hip pain patients would also get a copy of this about drugs and pain:




PAIN

Pain is a 'red light on the dashboard'.

Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?

Pain, pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?

Pain,
do you cover up the pain by taking a painkiller?
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?

NOTICE ON PAIN RELIEVERS:

Label changes ORDERED by FDA; the FDA announced proposed label changes for
OTC over-the-counter pain relievers to include the potential for stomach
bleeding and liver damage (FDA news 206- 207; 12-9-06) ;

The American Heart Association issued a scientific statement recommending
medical doctors change the way they prescribe OTC pain relievers from a first
choice to an alternate of recommending non-pharmacologic treatment (AHA
statement 2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other
NSAIDS is that it will inhibit cartilage repair and accelerate cartilage
destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people
take NSAIDS for the pain of Arthritis, not realizing these drugs may make
the underlying condition worse. These medications cover up the pain,
and cause the problem to worsen.


Pain can often be the result of the Vertebral Subluxation Complex.

Vertebral Subluxation ( 'VSC' , 'subluxation' )
Vertebral Subluxation is actually a quite common condition. Doctors of
Chiropractic look for pathological conditions which may require referral to
other specialties, and also look for ‘Subluxation’. Other disciplines
look for pathology, but overlook the importance of alignment and movement in
the spine which affects our nervous system (the master control system- ALL
health disciplines learn this). VSC- 'Subluxation' - can be the cause
of many symptoms and conditions.



Only a Doctor of Chiropractic will evaluate and treat for VSC, as
well as other pathology.



The course of VSC is highly variable. Some patients with VSC literally
cannot walk, yet other patients with similar test findings may be able to run
marathons or lift heavy weights. Some patients immediately develop symptoms
related to the VSC, some patients take years to develop symptoms. Some
people suffer for only a few days with pain and symptoms, some people suffer
for months. Some people recover in days, some take months or years, depending
upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system
(the master system which controls and coordinates all function within the
body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones
lose their normal movement patterns and position. When subluxated, joints are
in a stressed, vulnerable, compromised condition. Subluxation may cause
Arthritis, Disk Herniation, or aggravate such conditions.
Vertebral Subluxation cannot be corrected through chemicals
(medicine), stretching, yoga, vitamins or physical therapy alone.
Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a
mechanical correction- - - a manipulation, best performed
with the chiropractic adjustment.

Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American
Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain
Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of
Chiropractic in a Hospital in New York State (DHSI); As Seen in
PREVENTION Magazine
+++++++++++++++++++++++++++++++++++++++++++


Get to the cause of your pain/ complaints with an examination by a licensed health professional.


"....I have pain that usually starts from sitting in certain positions, standing for long periods of time and sitting on the toilet, even for a short time. ....", prolonged postures, repetitive movements usually signal a musculo-skeletal involvement.  For you this could be hips, pelvis, SI joints, lumbosacral musculoskeletal segments.  Your Doctor of Chiropractic could evaluate if your hips are in proper alignment, pelvis, L-Sac spine are in need of adjustment.
Again, certainly- an Xray would be a part of the evaluation.


"....It will start on the sides of both hips with pain in the front of the hips and front hip bones  as well.....", this area of pain- the hips, sides of legs, front of legs could be indicative of a 'pinched nerve' (vertebral subluxation) up higher in your lumbar spine- perhaps as high as L1, L2, L3, perhaps you can ask your doctor about 'Meralgia paresthetica'- your chiropractor certainly knows that condition!  Have you gained weight recently?, are you heavy across the middle- the waistline?


"....The pain will also move to the backs of my legs at times with mostly tingling, not numbmess....."- tingling still usually = nerve, sometimes = vascular.


"....It is progessively getting worse and I seem to have it daily now....."- getting worse?, get it examined.


"....It can take quite some time to go away when trying to lay down and rest it....", cannot rest it forever---- see above- get it examined!


"....I thought it could be sciatica at one time, but now sure the symptoms are quite right for that...."- it may not be 'Sciatica', but it could be another, different 'pinched nerve'.


Sciatica is just one of many types of pinched nerves.  My Staten Island Sciatic pinched nerve patients get this information:



“Sciatica”   

( Also Known As-   neuritis,  neuralgia,  sciatic-radiculitis   )
(pain down the leg, with or without
back pain)

   Sciatica can be caused by many different things.  Big, BAD, catastrophic things like a tumor or a cancer can cause
Sciatica (only a proper exam by a licensed doctor, like your Doctor of Chiropractic, or your family Doctor of Medicine, can evaluate
your signs and symptoms, and perhaps refer for testing).  

Big, bad things like a Herniated Disc, sciatica, possible fracture or dislocation
can cause Sciatica (again, best evaluated by your DC or MD, and perhaps referral).  Bad things, like  - Sprains, Strains, contusion,
or Vertebral Subluxation Complex (all very efficiently diagnosed and treated by your Doctor Of Chiropractic.  

Sciatica can come
from a motor vehicle accident, sport injury, slip, trip, fall, arthritis, lifting improperly, or even bad posture in standing, sitting or
sleeping.  

All of these things often have a Lumbar (Low Back) Vertebral Subluxation involved. Sometimes  we  can  wake  up  with  
‘sciatica’,  .... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a ‘sciatica’.  Frequently-  the true   
c a u s e   of  the ‘sciatica’,  = pain in the lower back, buttock(s), thigh, calf and/or foot (even to toes);  is a misalignment,  a  ‘kink’
in the neck- more properly termed a Vertebral Subluxation. “”Sciatica””  is only  1/2  a diagnosis  ..

..   what is   causing   the sciatica?
              
Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)

The vertebral subluxation complex is often the underlying cause of sciatica and many healthcare problems.  A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


This   (subluxation)  is a serious condition identified by its five parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
    Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         

Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          
Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.


Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomate, American Chiropractic Board of Sport Physicians; Diplomate, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  


+++++++++++++++++++++++++++++++++++++++++


I know I have given a lot of information.

I hope this all helps.



If you need further information, do not hesitate to RE-contact me here at
AllExperts.com
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm



Thank you for your question,
I wish you luck in returning to good health.



your Staten Island Chiropractor expert,




Dr. Victor Dolan, DC, DACBSP
Email newsletter: . . . . . http://drvictordolan.chiroweb.com



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