Question
Due to excessive bending and cleaning, my back muscles became overly tense, knotted, and when I would bend down, I had a hard time straightening back up.  So, I backed off and took it much easier for a couple of weeks.  My back was relaxing, but still weak.  After I dropped my kids off at their Pre-K on Monday, Feb. 14th, I coughed and almost collapsed in pain...it felt as if my whole pelvic area shifted..I couldn't hardly stand up, and it wasn't any better to sit; even laying down was painful and I could feel my muscles tightening and spasming.  I could not lift my left leg to sit inside the car w/o using the help of my hands, and when I walked, it was with a great deal of pain and irregular movements. Since then, each day brings a little less pain, however it seems to be centralized in my sacrem and hips.  My left hip is thrust out to the left and feels rotated to the right (so, it's sticking out and rotated inward).  I cannot stand normal at all--it is completely obvious that I am "bent" or "crooked".  Sitting makes my condition worse, since I can't hardly walk after I've been sitting for very long. laying down helps relax my muscles so that I can move around, but once I am on my feet, my muscles tense up again and intensifies the pain.  I have seen a chiropractor three times in the last week and each time, he manually twists me to adjust the L-5 region.  while this is really super painful, I can actually walk better afterward for a few hours, but then it's right back to the way it was before I went in.  I am a very active, athletic person, but have always had a weak lower back.  I am not in church today simply b/c I cannot sit (and care for my 2 little ones in this pain).  I am concerned about how twisted my pelvic area is, and the intense pain it is creating...and, can this be fixed?  I feel like someone needs to "shove" my left hip-side back over to the right and then pop me back into place.  Any insight is gratefully appreciated!!

Answer
Dear Jody,

It sounds like you are in a lot of pain, and I am so sorry for you!  First off, lets take a look at this posture or twist that you are experiencing.  This is called Antalgia. It is the natural reaction of your body to the injury that you sustained when you hurt yourself. The body is trying to position itself so as to take pressure off of damaged tissues and/or nerves.  It is something that you cannot control, yet it will improve as your pain and inflammation decreases.  The main thing to understand is that Antalgia (your shift of your hips and pelvis) is NOT the cause of your pain and is not your injury.  It is a SIGN that you have injured yourself.

This link helps you to understand some of the causes of lower back pain. http://eastmesachiropractor.com/index.php?p=97738

I am concerned for you because many of the symptoms that you describe indicate that you might have injured a lumbar disc (increased pain with sitting, pain spreading into the upper legs, etc)

This is NOT the end of the world! If you did injure a disc in the lower back, it can and will heal, but you have to give it plenty of time.  Discs will require months to years for healing. That means that you need to be careful not to RE-injure yourself through bending and lifting or other strenuous activities. If it is a damaged disc, it can be injure even more if you are not careful.

You should talk to your chiropractor about the possibility of a disc injury, and ask him/her what his treatment plans and goals are, and then follow them.

If you were in my office, I would make sure that you were not experiencing any loss of muscle strength in the lower extremities. I would check for your reflexes and make sure that they are strong and equal in the knees and at the ankles. I would test you for sensation losses in the legs.  I would also put you through several orthopedic tests, such as the leg raising test or the milgrams test.  These would all help me to better diagnose the condition.  

X-rays will not tell you much, since they do not show the discs.

If the symptoms progressed or got worse, I would consider an MRI of the lumbar spine.

I hope that this gives you some ideas of what might be wrong and how to take care of it. Give yourself some time. I have confidence, based on what you have told me, that you will recover. Be patient!

Good Luck

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