Question
Hello,
I am a 26 year old female. When I was 21, I was injured in a car accident. I was in so much pain the next day that I went to a chiropractor, and x-rays showed a small curve in my spine that wasn't there before. I received treatment for a month or so, and was on my way, but pain continued. Since then, I have been experiencing near-constant muscle spasms, knee swelling, back pain, etc. In 2009 I started experiencing extreme swelling in my right knee. I went to the ER because I couldn't walk, they did nothing. They sent me to the ortho, who said it was "patellofemoral", which I was diagnosed with at 13 and never experienced any significant pain and certainly no swelling from. Finally, I went to another chiropractor and new x-rays showed my spine being even more curved, and my right hip being out at least an inch out of place. Treatments to put my hip back in place relieved swelling in my knee and my pain lessened, but they stopped working after a while. The doctor has tried several methods of putting it back in and nothing stays. I am in constant pain. I'm a petite woman, I'm not carrying extra weight. I do try to work out to strengthen my core but everything I do messes up my hip and causes my knee to swell. I am in pain every day, and the pain in my hip shoots down to my knee and into my foot, and I often have numbness in the most swollen part of my knee. I do not have insurance and cannot afford to go to the chiropractor so often. Is there anything I can do to keep my hip in place? What, exactly, is the best explanation for why it's doing what it's doing? I was told by a doctor and a rheumatologist that I appear to be in the beginning stages of RA. Could that have anything to do with it? Any information would be very much appreciated. Thank you.

Answer
Hi Ally,

'Sorry you're having such difficulties.  I know it's frustrating, especially at only 26 years of age.   There are a few things I need to better understand in order to help you.    When you say "hip" do you mean the true ball and socket joint of the hip, or do you mean the pelvic or sacroiliac joint.    Many people use the term "hip" and they point to their lower back, SI joint, buttock, or groin.      If you mean that the "ball" of the ball and socket joint of the hip is loose and migrates forward, then that's what I'd like to know.   This joint system is called the femoroacetabular joint (FAJ).   There is a big difference between FAJ instability causing hip and knee pain, and knee pain from localized knee joint problems like irritation of the your knee cap (patella) as it rubs against the leg (femur).    Also, hip, buttock, thigh pains are common referral zones when there is a lower back problem such as a disc tear or herniation.   X-ray is useless, so tell these dumbbass doctors to stop taking x-rays to look at your spine.    MRI is the rule, and it should be used to rule out a disc problem in the spine, or a tear of the cartilage or ligaments that encapsulate the FAJ.    X-ray is only needed to rule out a fracture or dislocation, and as such is only used if your history and examination warrant it, e.g. you fell off your roof and can't walk...     Blood tests will tell you if you have rheumatoid arthritis (RA), and often there is a family history of this disease or similar autoimmune arthritic diseases, e.g. ankylosing spondylitis (AS) in a parent or close relative.   Also, is your knee truly swollen?   Like it gets big and puffy?   Or, does it just feel swollen but is no different in size than the left knee?     Has anyone suggested MRI?   Do you have your chiropractor's original report that shows the exam findings, assessment/diagnosis, and type of treatment applied or a treatment plan?      If they are saying a "bone is out of place in your back" and that's the basis of your treatment, run like hell out of that office!   This is an outdated and flawed paradigm, and you'd know you were getting this type of treatment if the DC put your x-rays up and drew lines across the vertebra and said stuff like, "this bone here is a little off...  you need to treat 3x/week to line it back up..."   Run like hell...       Give me some more info, Ally, and I'll be happy to help out more.

Dr. G'