Question
hello, please can you help me. im suffering from constant pain in my back and have been since i gave birth 14 years ago. its the same pain and exactly same spot as were i got an epidural years ago. im always on tablets and now in hooked on tramdil tablets for pain.I have been told that maybe my cartigue got damaged when i got the epidural, i just want to feel no pain and live a normal life.I am only 36 years old. thank you lisa.

Answer
Lisa,
I am sorry to hear of your predicament. There is a few  that need to be ruled out out. First and foremost you may have an anterior pelvis. To determine if you do have an anterior pelvis you will need to have an AP Pelvis X ray of your pelvis and Lumbar spine while you are weight bearing ( Standing upright) Then you need to compare the two obturators. They both should appear patent (open) and of the same size. Also where the two pelvic bone meet at a jopint called the symphysis pubis should be in alignment and there should be a no breaks in the pelvic ring. This would be best assessed by a chiropractic radiologist. If this is the cause of your pain chiropractic adjustments should work nicely to alleviate most of your pelvic pain.

I have seen many cases where a patient has pain at the site of an epidural in my 29 year career. I Have not found any clear cut reason for this in the medical literature. I hypothesize that there is a possibility of scar tissue forming at the area of the epidural not allowing movement of the soft tissues around the area because the body heals with fibrous scar tissue that restricts this soft tissue movement which in turn can cause adhesions to the spinal nerves or even the recurrent meningeal nerve the innervates the lumbar facet(s) or Lumbar spinal joints.
This my be helped by manipulation under anesthesia. For more info on Manipulation under anesthesia or MUA go to www.drqdc.com and you can learn more.

You may actually have both of these in tandem and if you were to enter my services I would order a MRI as well as radiology (Xray) to determine which would be the best route to go. I would lean towards MUA.

I do not know if MUA is available where you live but we have a lot of people fly in to the US for this procedure. Also I do not think a medical radiologist would agree that an anterior pelvis even exists so if you have the X-rays done you will have to mail them to a board certified radiologist whoever is closest to you.

I hope this information sheds light on your medical decision making. Good luck with your condition.
Sincerely,
Dr John Q Quackenbush