Question
QUESTION: i injured myself in a fall at work and have done lots of pt which hasn't helped much i had a sprained si joint which wasn't noticed for 2 months when it got stuck out of place they did 4 leg pulls b4 it stayed in place and a 5th time which popped 2 of my vertebrate i have problems with bending though and fells like it still goes out at times i was told it goes out because of my vertebrate being out of place and have been told my vertebrate is twisting when i bend down and when i come up i feel the pain as it catches going back into place is there anything i can do to fix this problem i did recently havesurgery on my hip which also had pain to and i had a tendon that went to my back stuck in my hip i was told they cut it to stretch it but still have problems

ANSWER: Dear Rob,

There is not enough information here for me to give you much help, but I will do my best.  First of all, the SI joint, as far as it being a movable joint and the source of dysfunction and pain, is very controversial. I recall as a young student looking at the SI joints of cadavers, complete with all ligaments in tact.  I was impressed at how solid it was. I believe that MAYBE it rocks back and forth, but it doesn't slip out of place, at least in my mind.  Others have different opinions about the SI joint.

In your dialog, you do not describe any symptoms, just the believed diagnosis of a sprained SI joint.

I am going to assume that the diagnosis is accurate... this is a HUGE assumption.  If indeed you did injure your SI joint, and considering the fact that there are very strong ligaments associated with the joint, it is going to take you many months for the ligaments to fully heal. I would allow at least 6 months to a year.  There is NO amount of "leg pulling" that is going to take time off of this clock.

My personal experience is that most of the time when spinal injuries occur, the joints and tissues affected are the intervertebral disks and the facet joints and ligaments.  These are much more frail and subject to injury.  

If you are experiencing pain extending into the legs, numbness and tingling, weakness in the legs, increased pain with coughing, sneezing, bending, and lifting, I would pressure your doctor to perform an MRI of the lumbar spine to rule out disk and facet joint issues.

As far as a "tendon" being cut from you hip to your back... I can only speculate what this was, and I have to wonder why in the world this would be done?  Tendons attach muscle to bone. There is an essential muscle called the Psoas that runs from the lower back, through the pelvis, and attaches, via tendon, to the upper femur, or "hip".  Why would a surgeon cut this tendon?  If they did, there is no turning back from this.  What is done is done.  That is why I ALWAYS tell patients that surgery should be the absolute LAST thing that is done, after EVERYTHING ELSE has been exhausted... and only then after careful consideration and contemplation of the potential outcomes.

It sounds to me like you need more diagnostic answers.  Ask your doctor if he/she thinks that a disc is involved. Ask them why/why not.  Ask them how they can know for SURE.  Ask them if they think something is broken. Ask them why/why not. Ask them how they know for sure.  You might have to press them to get real answers and additional testing.

Don't give up Rob.

I hope that this at least gives you some ideas.

Keith Biggs, DC
http://www.eastmesachiropractor.com

---------- FOLLOW-UP ----------

QUESTION: i have had a mri that showed a bulged disc a bone scan and x-rays nothing showed something broken as far as the tendon being cut i thought i was going to get the cartilage in my hip fixed i had a pop in my hip though and this was caused by the tendon that was in the joint which they cut to stretch i have even had an injection in the very bottom facet that helped tremendosly with the pain but didnt fix the problem and it has been 16 months since ive been havin problems i have had pain down both of my legs also and the longer im on my feet the more problems i have

Answer
Dear Rob,

Probably non an SI sprain. Your leg pains are more likely related to the disc bulging problem. The fact that you had some relief, temporarily, with a facet injection indicates that you likely have facet degenerative changes as well.

It sounds to me like and epidural might be your next thing to try.

With this additional data, I have to assume that you have degenerative arthritis in your lower back, aggravated by the fall.  

The truth of the matter is that with degenerative arthritis of the lower back, you are likely to experience long term troubles. You need to start shifting your mind set from "curing" or permanently fixing the problem to finding things that help to manage the problem.

These are the things that can help you to manage your problem:

1)Chiropractic manipulation
2)PT/rehabilitation
3)epidural injections/Medications
4)Facet injections
5)Neuroablation
6)Acupuncture
7)Massage
8)Spinal surgery to decompress the nerve tissue

Please understand that NONE of these will make you grow a brand new back. Not even surgery. It is essential to learn to MANAGE your condition.  Use any of the above, or any combination of the above, to manage your condition.  Some of these procedures/treatments will work better than others, depending on your diagnosis. The more accurate the diagnosis, the more educated your treatment plan can be.

Good luck

Keith Biggs, DC