Question
For about 6 months I have had a hip that aches a little, particularly when lying down in bed. It is not a joint problem, because it does not hurt when I walk or go biking. There is sometimes a slight ache in my thigh and calf. Makes me think of a "pinched nerve." I did lift something heavy just before this started. There is no pain in my back. Can a pulled muscle cause this symptom and can it take a long time to heal?

Answer
Dear Don,

This question was found in the "question pool", so I picked it up and I will give you a competent answer.

First of all, never say never. You can not say that this is not a joint problem because it doesn't hurt when you walk or bike.  Often arthritic joints feel a whole lot better when they are being moved and used, and then feel terrible at rest...

Second of all, you describe this pain as being in the thigh and calf.  Yes, a pulled hamstring could cause this type of pain... but wouldn't this also make you think that walking, running, or cycling might make it worse?  Just like I believe that the hip joint could be involved, I have to keep muscle strain as part of your differential diagnosis.

Third... I know absolutely nothing about you, so ANY answer is pure speculation... but you say in your statement that you lifted something heavy and that the symptoms began after that lifting episode.  When a heavy object is lifted, we put significant strain on the intervertebral discs of the lumbar spine... in other words, we are at risk for tearing and damaging the pads of cartilage between the bones of the back.  When a disc is damaged, (and usually they are damaged over and over and over again for years before any pain/discomfort/disability appears) at times it will begin to bulge out or herniate. If this is combined with any other arthritic or degenerative changes in the lower back, nerve irritation, or "nerve pinching" can happen.

In short, based on limited data, I would have to go with number three.  The only way to know what is happening is to subject yourself to a good examination. Your first stop should be at a competent chiropractic office. Ask for a good orthopedic and neurological examination. When the chiropractor is done, ask for a differential diagnosis... in other words, a short list of possibilities. Ask him/her how he/she is going to rule in or rule out the diagnosis.  If the chiropractor doesn't do much of an exam and simply tells you that you have a bone out of place and it is pinching on a nerve, it is time to politely excuse yourself and find another.  There are plenty of good, caring chiropractors out there that will do a good clinical job.

If this is a pulled muscle, then it can be helped with simple physiotherapy and exercise. If this is a disc problem with nerve irritation, it might require adjustments, traction, therapy, exercises, etc... and even MD involvement for pain management if needed.

I hope that this gives you some ideas of what you can do to get some help Don. 6 months is a long time to have the symptoms. It is time to be checked out!

Good luck Don, and I hope that you feel much better soon!

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