Question
i work with someone who insists she has two twisted vertebrae (she says lumbar though when asked which ones she does not know), also a dislocated pelvis. She works 40 hours a week and rarely complains of pain. My question is if these "problems" are real, would she be able to walk around and actual work this much. She says the only time these issues bother her is sitting long periods of time. Also, she fails day after day to produce a doctors note.

Answer
Dear Mander,

First of all, people are very poor at describing their medical conditions to others. Think of it this way. The doctor is trying to explain his diagnosis in understandable terms to the patient (who only understands part of it), who then turns to you or somebody else and attempts to describe his/her condition in terms that she understands, hoping that you will understand.

So, that being said, It is impossible to determine what exactly your co-worker is complaining of.

That being said, a true "dislocation" is a severe disruption of the joint integrity. A dislocated pelvis, to me, by pure definition, means that she has suffered a severe rupture of the sacroiliac joint or joints... usually this is associated with a pelvic fracture as well. Considering that she is walking, it is very unlikely that she has this severe of a condition.

What she might, however, be describing is that she is suffering from a "subluxation" of the pelvis or SI joints. This is more of a fixation or mild joint dysfunction of the pelvic joints. This type of patient is very much able to stand and walk. They often experience pain with movements or with certain positions.

Now, as far as "twisted vertebra" of the spine. Some people do have rotational distortions of the vertebral segments. Often these are associated with a type of scoliosis, or lateral deviation or distortion of the spine. Usually, this is something that develops during adolescence, lasts a lifetime, and can cause, due to abnormal mechanical function, significant pain in the lower back. It can also exist for years in a non-symptomatic state.

Again, if your friend has been seeing a chiropractor, I would almost bet that the chiropractor is trying to help her to understand that she is experiencing some joint dysfunctions/fixations of the lower back, and likely not any type of dislocation, which again, would be a devastating injury, possibly resulting in a paralysis of the lower extremities.

Now, getting through all the rhetoric, what she very well might have is mild disc injuries in the lower back region. (this type of problem often causes pain with sitting, and is better with standing.) She might also be experiencing facet joint problems, muscle spasms, etc. She has probably gone to a chiropractor, and the chiropractor has probably told her that she has fixations/subluxations of the pelvis/SI joints and subluxations of the lumbar spine.

I have not seen the patient nor her x-rays. I have not seen her file. It just sounds like she is having a difficult time explaining to you what her doctor has tried to explain to her.  This (lack of ability to properly communicate) is a very very VERY common problem.

If you are her employer or supervisor, you need to be very careful here. You cannot condone nor condemn her for her inability to describe her health condition. You might be treading on some thin ice. She is entitled to medical confidentiality protected by law.

This is my opinion only, and does not replace a complete examination or consultation. Work/injury related issues should be addressed by physicians, and through correct human resources channels with care to protect rights.

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