Question
"Hello, on March 24, 2009 I was in labor and having my daughter 6 weeks
early, I had an epidural since 5 pm the evening before ( 3-23-09) due to my
right kidney hydronephrosis, I had 7 nephrostomy tube since december 7th
08, they all kept clogging with calcium stones, well the 7th one was clogged
and they could not remove the tube, I was in so much pain so they gave me
an Epidural Pump and a Fentanyl pain pump, needledd to say I was pretty
outta it, the next morning they decided to indure me, they were rollingme
from side to side sitting me up and they laid me back down and went to roll
me onto my left side, now I was very close to he left side of the bed( w no rail
up) the nurse went to roll me over and my left leg (dead weight, i had no
control over it, not to mention I gained a lot of weight being on bedrest and
water weight), well my left leg fell off of the bed pulling my leg down very
hard, well she put it back up on the bed... A little while later she had to roll
me over again, she cld another nurse to come help, she asked the other nurse
to watch my left leg since I had no control over it, well she didnt pay attention
and this time it dropped even harder, y ankle hit the ground hard and my hip
bent out ver hard, I felt this hard yanking sensation thru my whole body, no
pain due to the epidural , well anyways, I had the baby not to long after. They
turned off the epidural and I slowly started to feel some pressure in my low
back(which neither have ever hurt before at all) and a strong burning
sensation in my left leg which kept intensifying... It hurt worse than my Neph
tube in my kidney and my delivery pain So they kept me on my pain pump... I
told my Dr he ordered a lt Hip xray and a venous doppler the next day. They
were normal, he said that my hip could have possibly dislocated but was put
back in place when my legs were put into the sturrups to deliver, not sure
though.. I couldnt walt on it, it would pop out of place if I put any pressure on
it and the pain was tremndous in my leg and low back... I was in the hospital
for a week until I could walk and I got my tube out.. 7 weeks later (now) I am
still having a hard time walking and especially getting up and down, my hip
even gives out and I will fall.. I saw my Ob dr for my Post appt and he made
me go see my Primary Dr right away, my PCP then ordered an MRI I just got it
done yesterday and the results say...
Left hip- High T2 signal is present within the posterior aspect of the vastus
lateralis muscle where it abuts the inferior margin of the greater trochanteric
of the left hip indicating the presence of interstitial edema or hemorrage
likely realted to a muscle tear. Impression says Left Vastus Lateralis Muscle
tear.

MRI Lumbar spine-L3-4, L4-5, L5-S1 all say Small Broad based posterior
annular disc bulge, Bilaterl posterior facet joint arthrosis, no foraminal or
central canal stenosis.
Immpression-1. Mild mulitfactorial degenerative disc and joint disease at L3-
4,L4-5,L5-S1 without evidence of canal or forminal stenosis
2. Mild degenerative disc disease at remaining lumbar disc levels...
Im so sorry for the book..  My PCP want sme to go to Physical Therapy which I
have been before nad know it is only a temporay fix..:-(
I am still in a tremendous amount of pain, only 27 w 3 children and am
desperate to get better, My leg keeps giving out, it hurts so bad to get up and
sit down in a seated position, if I lay down my back feels like its going to
explode, my left hip feels like it is on fire and in knots ans the both spasm
like crazy... Can you help me understand what all of this means for my future
and how can I get all better so I can play with my kids and clean the house
without hurting, I feel like an 80 year old woman.....  Again sorry for the Book,
Im just desperate for some help... I am still on Percocet 10/325 which helps
but not completely, pretty sad huh and I hate taking it so I go without it most
days and take Ib Profen which doesnt touch it...Ahhhh

I hope to hear from you soon, PLease help

Thank you so much,
Melissa Martin

Answer
Dear Melissa,

I agree that the tear was most likely the result of the hospital issues, especially in light of the edema visualized on the MRI report in the vastus lateralis musculature.  Ultrasound would be a great choice to initially start to mobilize the edema around the greater trochanter along with guided stretching exercises to help with proper scar formation...a physical therapist is definitely qualified to perform this.  Deep tissue work such as Graston, A.R.T., and S.A.S.T.M., are great techniques as well...generally performed by sports injury trained chiropractic physicians and some massage therapists.  You can research these techniques at length on the internet and find qualified practitioners through their certified practitioner databases.

However, I would also suggest that you research the technology of class IV laser therapy.  Class IV is important because lasers of lower levels do not penetrate as deep and generate very little heat in the tissue.  These lasers are affective to reduce pain by lowering inflammation, and by actually directly addressing pain transmission...it can be very effective even in patients who have not had good results or who are in chronic pain.  K-laser is a good choice, because it can do both of the above, but you will need to be treated twice on every visits because you will need 2 separate wavelengths of laser energy to accomplish the reduction.  However, there is another laser (Cutting edge lasers) www.CElasers.com which can do both wavelengths at the same time...this is definitely worth exploring in detail.  Chiropractic physicians use these frequently and most predominantly more than other health care practitioners.

The MRI results are not alarming, but can be contributing to the pain levels you are experiencing. Any time you have degenerative joint/disc disease or bulges this can result in pain, however, I have frequently seen worse MRI result in patients who aren't having pain levels, and the findings were visualized due to another reason for the study.  Degeneration and bulges are not always associated with pain and dysfunction.  Facet generated pain (spinal joints) would be worse with bending backwards and may be either right, left or bilateral in nature, but should be alleviated with forward bending.  Chiropractic physicians are also very good at eliminating this pain by normalizing joint motion...if you haven't already figured this out, I would recommend that you find a good chiropractic physician to help with this.  Preferably one trained in one of the above soft tissue techniques and one who has a Cutting Edge class IV laser.

Good luck Melissa, I hope this helps your understanding ans lead to a speedy recovery.  Don't give up!!

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net