Question
I started  having lower right sided back pain (pinpointed around the si joint) about 5 weeks ago.  I work with children and have my own 24 year old to carry around (always on my left side).   I started seeing a chiropractor 3 weeks ago.  I had two adjustments just to my back.  It never really relieved the pain but I was able to function.  The third visit he did a hip adjustment on that right side.  Since that third adjustment I have had pain in my lower back as well as the side of the hip and into the groin/pelvic/lower right abdominal area.  At points the pain was so bad that I ended up in the er thinking it was ovary related.  I was cleared by my own obgyn saying he felt it was muscular skeletal in nature.  I went back to the chiropractor who informed me it would be "bothersome" until the adjustments finally took.  Does any of this sound right?  I have had constant pain with no relief not bad enough to keep me in bed but definitely making my job as well as being a mom difficult.  Should I be worried?  Thanks for any advice you can give as I'm finding the answers I'm getting from my doctors to not be helpful!

Answer
Thank you for your question. First, as a disclaimer, I cannot offer specific medical information regarding your case. This is for medical legal reasons, as I do not have the benefit of having either your records to review or the ability to examine you. Having said that, in general terms, the explanation that was offered to you to account for your increased pain after manipulation of your pelvis makes absolutely no sense to me whatsoever. Several clinical conditions can produce pain patterns similar to those that you have described. The first, and I guess to be the most likely, is referred pain from the sacroiliac joint. The second could be a potential disc herniation of the lumbar spine. If the disc herniation were involved, it would likely be the upper part of the lumbar spine, or possibly the very lower part of the thoracic spine. Additionally, referred pain patterns from myofascial trigger points of the lower back musculature, namely the quadratus lumborum muscle, may produce similar pain patterns. It is entirely possible to have one or more of these situations occurring simultaneously. Perhaps the most efficient means of diagnosis in this regard would be to consult your primary care physician regarding the possibility of being referred to an interventional pain management physician. If after examination it is determined that your sacroiliac joint is a likely culprit, the pain management physician might inject the sacroiliac joint with a steroid and anesthetic. If you experience significant pain relief following this injection then he sacroiliac joint is most likely the cause of the pain. If you experience no change of symptoms following an injection of the  sacroiliac joint, a disc herniation of the lumbar spine is most likely. An MRI would be required to validate that assumption. In the case of trigger points, seeing a practitioner who is truly skilled and knowledgeable in the evaluation and treatment of trigger points would be helpful. This practitioner may be a chiropractor, physical therapist, massage therapist, or a medical physician who has been trained in this regard. Most primary care physicians are woefully inadequate to accurately diagnose musculoskeletal disorders. Unfortunately, there may be a significant number of chiropractors who despite their claims of being spinal experts are so inadequate in their examination and diagnostic capabilitiesthat they may actually the unable to accurately assess the problem as well.  A potential warning sign of an inadequate chiropractor is usually a chiropractor who spends more time delivering various marketing ploys to a patient than in explaining what is actually wrong with the patient, devising a working treatment plan,, and adjusting the treatment plan if the results are not favorable. I hope this helps to answer your question. Best of luck.