Expert: Gerald Anzalone, D.C. - 4/26/2010

Question
I have a question with my lower back and hip. I am 31 years old, and have had problems since I was 18. i went to a Chiropractor for a couple years from the age of 18-19. When I sleep, walk, sit, stand, I have massive pain sometimes in my lower back. I have to turn my body to 'pop' it, so the pain goes away. I have done this for years and now I think I really messed up my lower back/hip. The last time I went to the Chiropractor, he told me that my hip was turned! He even made a comment. "How in the world do you even walk? or with stand the pain?" I didn't say much and never went back. I thought it would "go away".
 Now when I am walking, if I put my hands on the back lower part of my back on my hip area, I can feel where my hip on my left is "sticking out" you can not feel it on my right side. Now my left leg feels like it is "getting caught" and I have to sit Indian style on the floor or lay on the bed, and push the inner side of my leg out, so it will "pop". Then it feels better. Sometimes when I stand and move it will pop, or if I am getting out of my car it will pop and then feel better. My Husband freaks out when this happens! It is so loud it sounds like a bone snapped in half! What is the cause of my hip to turn? He also said that I have no cartilage or something in the last three disks of my back. My Mother has a bad back, did I get this from her? I did fall on the stairs at age of 18 holding a dresser, and ever since then I have had problems. Is hasn't happened for 6 years (knock on wood) that my back will totally "go out" and my legs turn in, and I can not stand or walk. I have to go to the Hospital and they give me a shot of pain med. It then will go away in 4-5 days. If I don't get a shot then it will linger around for a month or so. I was pregnant last time it "went out" and could not get the pain shot, it was horrible! I was in pain for a month! I couldn't sit, lay, walk, nothing! please help me on what I should do? Is something really wrong? Will my hip just move back in place over time? I am thinking not hence it was about 13 years ago he  told me this was happening.

Answer
From your description, it sounds like the problem is a dysfunctional sacro-iliac joint, but you need to see an appropriately qualified practitioner for a precise diagnosis.

For general information purposes, please see this link for detailed description of sacro-iliac joint pain evaluation and treatment:

http://www.eorthopod.com/content/sacroiliac-joint-dysfunction

According to a 2004 article in the Journal of the American Academy of Orthopedic Surgeons:

"The sacroiliac joint is a source of pain in the lower back and buttocks in approximately 15% of the population. Diagnosing sacroiliac joint–mediated pain is difficult because the presenting complaints are similar to those of other causes of back pain. Patients with sacroiliac joint–mediated pain rarely report pain above L5; most localize their pain to the area around the posterior superior iliac spine. Radiographic and laboratory tests primarily help exclude other sources of low back pain. Magnetic resonance imaging, computed tomography, and bone scans of the sacroiliac joint cannot reliably determine whether the joint is the source of the pain. Controlled analgesic injections of the sacroiliac joint are the most important tool in the diagnosis. Treatment modalities include medications, physical therapy, bracing, manual therapy, injections, radiofrequency denervation, and arthrodesis; however, no published prospective data compare the efficacy of these modalities."

I would first recommend evaluation by a chiropractor; if you are deemed a candidate for manual therapy/manipulation, I would try that approach first. Other treatment options include physical therapy.

I would also recommend seeing your primary care physician to determine if oral pain medications and anti-inflammatory medications are necessary.

Finally, I would recommend seeing a pain management physician if the above therapies fail; steroid injections in the S.I. joint may be helpful, if the S.I. joint is indeed the problem.

I hope this helps to answer your question.