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Old 12-29-2004, 01:32 PM   #1
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New On "Back" board, but not new to back problems HELP! (m)....

I don't know where to start, but I'll try to sum it up as short as I can. In 1984, I was about 13 years old and I was in the backseat of a car, and a car behind us struck us (they were drunk). I wore a neckbrace to the ER and had a slight case of whiplash. I had no problems for years until about 1986 or so, I started seeing a chiropractor for various problems arising with my back, neck and feet. Since, I have seen a chiro consistently, which is now about 18 years or so. I have had one child, I'm now 35 years old. I haven't a real diagnosis of anything yet, I've never had an MRI or CT Scan, but I think it's time I do. Most recently, I have been having major problems with myback and neck. Soreness, pain, etc. He did prescribe me orthotics which I have been wearing for about 2 months (I have a tilted pelvis), he's hoping this will help. He also gave me floor exercises, which have strengthened me a little, but still have pain in sacroiliac region bilaterally. I have been seeing him 1-2x a week. Here are the results of my MOST recent exam:

Posture:
High Occ on R
High Shoulder on R
High Pelvis on R
Levt convexity of lumbar spine
ankle pronation bilaterally
fallen arch bilaterally
hypokyphosis (mild) thoracic spine
Hypolordosis of (mild) the lumbar spine

Reflexes: Patellar, normal 2+, Achilles normal on R and grade 1.5 sluggish on L

Cervical Range of Motion - ALL NORMAL
Lumbar Range of Motion - ALL NORMAL
Extremity Range of Motion - NORMAL

Cervical orthopedic tests - ALL NEGATIVE
Lumbar Orthopedic Tests - Kemps test neg on L, kemps test + on the R with pain on the left SI (? - what does SI mean?)

Fadir's, milgrim's, L/R straight leg raise, Ely's, Yeoman's Kemps - NEGATIVE

**Abnormal muscle contraction was noted on the hip in extension bilaterally.

Muscle Palpatation:
Gluteus Maximus/Medius normal
Trapezius muscles revealed a myofascial trigger point tightness bilaterally
Lumbar erector muscles revealed hyperonicity on upper and lower and soreness in lower muscles
Hamstring muscles revealed tightness bilaterally
Medial joint line tender on the left
Plantar Fascia revealed soreness bilaterally

Motion Palpation:
Joint fixation on T6, T7, the right SI and the left SI.
Tenderness to palpation at T6, T7, L5 and the right and left SI.

Xrays: Xrays taken of Sandra dated 9/29/04 are a two view lumbar series. AP Lumbar film demonstrates a levorotatory curvature of the lumbar spine of 7 degress between T12 and L4. There is also facet tropism on the right at L4 and L5. There is a mild internal rotation of the left pelvis. There appears to be some mild degenerative changes noted at the inferior sacroiliac joints bilaterally. Lateral lumbar film demonstrates a slight hyperlordosis. There is no evidence of disc degeneration or spondylosis. There is a slight retrolithsesis of L4 on L5.

So...my doc thinks that with manipulative therapy and home exercises I can overcome this and if I can't within two months, he'll send me for an MRI. But my pain is not getting better and I think it's time for an MRI to tell ALL????!!! Don't you? I sure do!

I just want your opinion on what you think might be going on.

Thanks. - Sandra

Diagnosis: Pain in juoint involving other specified sites; Lumbago; Plantar fascial fibromatosis; Cervicalgia (neck pain); Congenital Talipes Valgus (I know what all these mean I think).
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Breast Cancer Survivor 12/09 -Stage 1-Grade 3- IDC. ER-/PR-/Her2+. Neck Surgery - ACDF C6/C7 11/08. Bladder Surgery-Burch Procedure 2/06. THE LAST FIVE YEARS HAVE BEEN NOT SO MUCH FUN!

 
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Old 12-29-2004, 01:48 PM   #2
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injured betty HB User
Re: New On "Back" board, but not new to back problems HELP! (m)....

[COLOR=Magenta]Lumbar Orthopedic Tests - Kemps test neg on L, kemps test + on the R with pain on the left SI (? - what does SI mean?)[/COLOR]

Sacro Illiac


The leg raise was negative for SI dysfunction which means that your SI ligaments are tight and your SI is not a problem.

It says that your SI is not loose, but you have tenderness there, your left, more than your right.

[COLOR=Magenta]There is a mild internal rotation of the left pelvis. [/COLOR]

This means that you need adjusting. It may just be that you don't sit straight and your pelvis muscles have learned to be in that position. Walking a lot usually eases this back as well as floor exercises that they will give you.

When your pelvis is twisted, it wears on your L4/L5 and L5/ S1.

[COLOR=Magenta]High Pelvis on R[/COLOR]

This would concur with the pelvis twist that you have going on.

[COLOR=Magenta]There appears to be some mild degenerative changes noted at the inferior sacroiliac joints bilaterally[/COLOR]

This is normal for your age.

[COLOR=Magenta]There is a slight retrolithsesis of L4 on L5.[/COLOR]

This would be because of the pelvis.

[COLOR=Magenta]So...my doc thinks that with manipulative therapy and home exercises I can overcome this and if I can't within two months, he'll send me for an MRI. But my pain is not getting better and I think it's time for an MRI to tell ALL????!!! Don't you? I sure do! [/COLOR]

First, I would seek out a Physiatrist. They specilize in the back and the SI joints. Then I would follow the exercises to a T and walk, walk, walk, and make sure that I sit evenly and do everything evenly.

This can be cured with PT. It looks like the pelvis problems are causing the back problems. Once the pelvis is tilted, it learns to stay there. You need to teach the muscles to go back where they belong. It is a long hard road, but it can be done. There is no surgery for it. It is all about muscles. It can be very frustrating.

I used to sit in my big old office chair with one leg up. It rotated my pelvis. I went to PT and they taught me how to keep my pelvis straight. It is a hassle, but it helps with the pain. I now do things out of habit, like no bending at the waist, I squat, I put my pants on while sitting, same with the shoes, and I stay away from stairs until the situation calms down.

Good luck and take care,

 
Old 12-29-2004, 02:03 PM   #3
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Re: New On "Back" board, but not new to back problems HELP! (m)....

I forgot to mention that I have recently had problems with incontinence. I was also tested for ankylosing spondilities and Rheumatoid and was negative for both. So, it must just be the pelvis causing me all these problems? WOW - today I went in for an adjustment and then he gave me shock therapy to my lower back and heat and massage and it still does not feel good. uggggh.
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Breast Cancer Survivor 12/09 -Stage 1-Grade 3- IDC. ER-/PR-/Her2+. Neck Surgery - ACDF C6/C7 11/08. Bladder Surgery-Burch Procedure 2/06. THE LAST FIVE YEARS HAVE BEEN NOT SO MUCH FUN!

 
Old 12-29-2004, 02:24 PM   #4
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Re: New On "Back" board, but not new to back problems HELP! (m)....

Sandra,

This is a problem that you have to be dilligent with. Once the pelvis rotates, you need to do your best to get it back where it belongs, unless, you were born that way. When I sent the last post, I forgot to mention that. It looks like your ligaments are tight and where they need to be, you passed the leg raise test. I was born with a twisted pelvis and then they tried to twist it to be even. The PT did the McKenzie Method on a table that stands up and he twisted my pelvis to where he thougt that it should be, not where my should be and it ended up sending me for pain shots. I could not walk. So, make sure that they look at you as a person, not as a set of bones and that they take into account that you passed the leg raise test. Don't let them move your pelvis too much if you are not normally completely straight. I am not sure how to explain this, but not everyone is born with a straight pelvis and they don't take this into account, they just go by the test book, unless you talk to them and tell them that you understand that there are exceptional cases and you want to check out all possibilities.

I hope that you find the comfort and ease of pain that you are seeking and that yours is simple to remedy

The heat and massage and the electro shock is too help loosen things up. They are working on your muscles. My DO doesn't agree with the shocking method but it works on most people.

Do you have access to a hot tub??? That works great.

Also, if you search around, you can find some great exercises/stretches to do at home. Another thing that helps is the cushion to put between your knees at night to keep your pelvis straight.


 
Old 12-29-2004, 05:05 PM   #5
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Re: New On "Back" board, but not new to back problems HELP! (m)....

Hi, and welcome to the boards. I think you need to see a neurosurgeon or an orthopedic spine specialist. You have been undergoing chiro care for 18 years....still going, things are worse...you need to have an MRI and be properly diagnosed. It is possible that the care you are receiving is not only not helpful, but harmful. I think chiropractic care can be very good for the right people at the right time, but I think your problems are beyone it. Why have you keep coming over years and not send you for a second opinion.? Could $$$$ be the answer? I am not trying to be offensive, but I fear I am. If so, I am truly sorry. I only want you to get the care you need before you reach a point where you are beyond help.

Good luck, please continue posting.

Carol
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Old 12-30-2004, 07:55 AM   #6
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Re: New On "Back" board, but not new to back problems HELP! (m)....

You are right! No, you were not offensive at all, in fact to the point, which is what I like. I am going to e-mail him right now and ask for a referral to his counterpart neuro person. I am sitting here at my desk (my job) in pain as we speak, moving in different spots continuously just to get comfortable. Ice and/or heat does not work and I have felt no relief from the shock/heat/massage I got yesterday. THANK YOU. Have a good day.

Sandra
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Breast Cancer Survivor 12/09 -Stage 1-Grade 3- IDC. ER-/PR-/Her2+. Neck Surgery - ACDF C6/C7 11/08. Bladder Surgery-Burch Procedure 2/06. THE LAST FIVE YEARS HAVE BEEN NOT SO MUCH FUN!

 
Old 01-18-2005, 09:57 AM   #7
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*MRI RESULTS* (New On "Back" board, but not new to back problems HELP! (m)....

Hey, I had my MRI last Wednesday after asking my CHIRO to move it up and not wait another two months. Here are the results summarized: This was done of the LUMBAR Spine and Sacroilic Joints only.

Alignment is normal. There is loss of disk signal and minimal loss of disk height at the L4-5 level with ventral extradural impression seen here. The other interspaces are well maintained. The formina appear widely patent on the sagittal views.

L3-4 - Axial images show normal caliber spinal canal, thecal sac, formina, and normal disk. Facets are midly hypertrophic here. (which means arthritic).

L4-5 - Axials show mild/moderate concentric disk bulging with a superimposed midline poterior disk protrusion, associated with some focal subannular signal; compatable with partial annular tear. This disk bulge does indent the central thecal sac slightly, but AP thecal diameter remains normal at 12 mm. The foramina are well patent here and no direct neural encroachment is confirmed. This could very well be a source of low back pain, but probably not radicular symptoms. Facets are mildly hypertrophic at this level (again, arthritic).

L5-S1 - Axials show normal spinal canal, thecal sac, foramina, and normal disk. Moderate hypertrophic facet arthropathyis present here (arthritic). This could also be a source of back pain.

Images of the sacroiliac joints show no clear erosive or cystic changes and no significant hyperostosis of the SI joints. There is a small lipoma in the right sacral ala.

1. Could this LIPOMA be causing all the pain in my right side hip, leg and ankle?

2. Arthritis?? I'm only 35 years old and this was only my lumbar spine? What about the rest of my spine, I'd bet it'll show the same!

3. He is referring me to a specialist in the spine. Do you think I'll need surgery?

Thanks!

Sandra
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Sandra-
Breast Cancer Survivor 12/09 -Stage 1-Grade 3- IDC. ER-/PR-/Her2+. Neck Surgery - ACDF C6/C7 11/08. Bladder Surgery-Burch Procedure 2/06. THE LAST FIVE YEARS HAVE BEEN NOT SO MUCH FUN!

 
Old 01-19-2005, 01:23 PM   #8
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Re: New On "Back" board, but not new to back problems HELP! (m)....

Hi there,

I was eleven when I was brutally attacked and kicked repeatedly in the pelvis and back while unconscious. I have amnesia from the attack and can only remember that ever after my mom would not let me lift anything heavy and my back would go out just walking down the hall.

Then when I reached age 33, I had a host of back problems which have just escalated and I am now partially disabled at 39.

For me, the doctor thinks that being kicked so hard probably did do damage to such a young back, probably to the muscle especially, but possibly ligaments. He now thinks my disk was ruptured back then, and has ruptured numerous times since.

The thing is, we then compensate, by holding our bodies differently, which leads to other problems. I have difficulties with my sacrum, which "slips" and one hip is chronically higher than the other.

I would tell the doctor that your first injury did occur at age 13, when your body was still developing. Try to remember from then on what happened with your back. Would it go out when you walked? was it hard to sit? Anything abnormal at all? Make note of these. Tell him this.

I do think that when you are so young and sustain an injury like that, you can then be chronically affected, even just by holding your body different from then on, resulting in other problems, especially if like you and I, we never saw a doctor for it.

I agree with the others here that physical therapy, exercise, stretches and strengthening are your best bet. But they have to be the correct ones. In fact, for us, they are CRITICAL. We simpy have to do them the rest of our lives to hold these back problems at bay. If you don't, you could end up like me with escalating back problems til you are disabled.

It's hard work, but it's worth it. SEE a back doctor and a physical therapist who can teach you the correct exercises.

Stretching and strengthening, taught by a PT, done every day, with regular walking, should help. But we have to KEEP doing it. I did mine for a year then stopped and BAM, disk ruptured.

If you feel you need an MRI, it won't hurt to have one, just to see if anything else is wrong. But I agree that surgery doesn't sound like it's for you - at this point - but posture, stretching and strengthening are.

a good phsyical therapist, hard to find, is worth their weight in gold.

Good luck to you. - ladybird

 
Old 01-19-2005, 06:49 PM   #9
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Re: New On "Back" board, but not new to back problems HELP! (m)....

Alot of back problems can come from mis-alignment of the lower body.
Orthotics work well, but cost way to much.
Archatomics-custom arch supports (on the web) has alot of good information regarding proper balance and support of the foot.
Every since I have been using mine, I have had a tremendous reduction in back problems.
Get well,
Mike

 
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