Question
40 yr old woman in good health....started 2 weeks ago with hip pain on my
right, sometimes shooting down my leg... Now the hip pain is gone but I
have severe lower back pain. I also have some neck pain with dizziness.  
I have seen a chiropractor who says this is a good sign that the
inflammation is moving.  Anyway...at what point should i get concerned?
Could it be something serious? I'm getting scared!

Answer
Dear Lynda,

Sorry to hear that you are having pain. Pain is never fun. Glad to hear that you are seeing a chiropractor.

First of all, the description of "hip" is very difficult for me. Do you mean that you were feeling down in the buttocks region, in the groin, or in the side of the upper leg/pelvis area.  When a patient complains of "hip pain", this means something different to everyone.

I am going to assume, for now, that the "hip pain" that you were referring to was in the lower part of the low back, right side, in the buttocks or just above it. If I am wrong, let me know, OK?

I am guessing this because it sounds like you are or were suffering from sciatic nerve pain, radiating into the leg on the right.  It is also possible, however, that your "leg pain" could be a muscular pain referral. How far down the leg does the pain spread?  Have you ever had anything like this is the past?

As a patient improves, sometimes the pain will "centralize". This means that the pain will regress to its primary irritant. In this case, it sounds like your chiropractor believes that your hip and lower back and leg pain is the result of issues in the lower back. This could definitely be the case.

As far as "when should I be worried", here are a couple of thoughts:

1) If your chiropractor did not do a good examination on the initial visit, complete with reflex testing, muscle testing, range of motion testing, and orthopedic tests, you should be worried right away.
2) If your Chiro did a good initial exam, and you know this doctor well from past experience, it is likely that you still need to give this some time.  Injuries can take weeks to months to heal.
3) If the radiating leg pain started after the initial treatments, then perhaps it is time to ask the chiropractor to try a different technique. If he/she is unable or unwilling, it is time to find another one.
4) Danger signs are loss of bladder or bowel control, loss of strength in the leg.
5) My experience tells me that the most common cause of significant back pain with pain extending into the leg is that it can be the result of a disc injury in the lower back. Discs require months to years to heal...
6) If you are worried, go with your gut feeling, and get another opinion. If the leg symptoms continue, an MRI would be indicated to see what is irritating the nerves that are exiting the lower back region.
7) Even if there is a disc problem, these can heal and become stable. Do not run to a surgeon unless you have some of the danger signs seen in #4 above.
8) As far as dizziness. If you are getting dizzy after the chiropractor adjusts your neck, My opinion is that you should not have aggressive/popping techniques performed in the neck. Your chiropractor should watch you for possible central/cranial nerve signs and only perform light force cervical spine therapies.  If you feel nausea, dizziness, half of the body tingling or falling asleep and severe head pain after neck adjustments, you should seek emergency care.

Every case is different, and since you are NOT sitting right here in front of me, I have to defer to the experts that are evaluating you and treating you right now. Open up a dialog regarding what the Chiropractor thinks your diagnosis might be. Ask him if he thinks that there might be a disc problem. Ask him how "inflammation travels". Ask him if he has a plan if the current treatment plan fails.

I hope that this helps you. Good luck in finding answers and the care that you need.

Dr. Keith Biggs, DC
http://www.eastmesachiropractor.com
http://biggschiropractic.blogspot.com
http://therapeuticfoods.blogspot.com