Question
Hi there,

I hope you can help. This is an ongoing issue for me. I have seen a few specialists some good and some not so good. What I need is peace of mind because I am prone to getting anxious about myself.
About a year ago I noticed something was wrong with my lower back. Like a stiffness. I can't quite remember only that it started to strain my hamstrings and I gradually was unable to walk straight. I started to walk kind of tilted like I had a limp. I managed with it. I could sleep at night but sometimes my hamstrings did hurt me when I tried to move over in my sleep.
In the summer I noticed while playing the piano, that when I sat with my arms unsupported in front, it gave me upper back aching. I would have to stop. The tinge was to the left below my shoulder blade.
I went to a sports physio and osteopath and they both mentioned something like a pelvic twist. I think that's the words they used. They told me it can happen easily and needs to be corrected. The osteo told me I needed masssage on my hamstrings and gluts to keep them from tightening. Otherwise he made some painful adjustments to my alignment. That was 2 months ago and I have still had a residual upper back ache. Funnily it is 'moving north' and is now mainly a stiffness in my shoulders, chest and neck.
At bedtime I have stiffened up quite a lot and I sometimes feel a little ache in my back between my shoulder blades when I turn arms out to the side, or when undressing.
What I would like to know is does this sound normal to you or does it ring alarm bells something different is wrong. I went to the doctor and he said it is highly unlikely I need mri or x-ray and that it sounds just muscular and they take time. Most people around me say this but at night it drives me nuts. I can sleep yes but initially with difficulty. I want to be free from all that tension!
Thanks so much for reading this long-winded question :)

Jamie

Answer
Dear Jamie,

I am sorry that you are having so much pain and discomfort.  I know that you feel that your question is long winded, but in reality, I have very little to go on. For example... how old are you? Are you male or female? What is your past medical history? What is your family medical history?

I am telling you this because you need to understand that anything that I tell you is of little or no value when compared to the opinion of a trusted and competent medical or chiropractic provider.

That being said, here are some thoughts that I have had after reading your email:

1) Sometimes, when pain is the lower back is associated with symptoms down the legs, it can indicate that the patient is experiencing nerve tissue irritation from disc degenerative changes, disc bulging or herniation, etc.  "pelvic twisting" is not a good diagnosis. It is simply a descriptive term for a postural position. Often the faulty posture is the result of some other underlying problems.

2) Stiffening up as the day moves along is sometimes the result of underlying arthritic degenerative changes in the spine. According to most MD's, spinal arthritis is normal and to be expected as we age. I personally feel that yes, we will gradually develop spinal arthritis, but that doesn't mean that we have to surrender to it. I take my spinal arthritic patients and teach them exercises to help them restore and retain motion, thus helping to reduce stiffness associated with the wear and tear of age.

3) There are some conditions that are not wear and tear conditions that can cause generalized spinal stiffening. Ankylosing spondylitis comes to mind as an example.  Although this is rare, it is a possible cause. Often this condition will first start to affect the sacroiliac joints (down near the base of the spine) and then spread through the spine over years.

Osteopathy is not a specialty.  Osteopaths are medically trained doctors, but they can specialize (in this country) as rheumatologists, internists, orthopedists, pediatricians, general practice, etc.  Your Osteopath might be any of these, or more.  If I were you, I would consider seeing an MD or DO Rheumatologist for an evaluation to determine if you are experiencing any of the strange arthritic types of diseases.  Once this is ruled out (odds are that you don't have this type of problem, and that instead you are suffering from spondylosis, or generalized spinal wear and tear)  I would align myself to a decent chiropractor who will do a good, complete history and examination.  

I hope that this gives you some ideas of what to do.

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