Question
QUESTION: Hi John
I have been dealing with constant low back pain for a little more than a year now. After being sick of having medications thrown at me, and no solution on how to fix the pain for good, i decided to start going to see specialists on my own. No one has been able to give me a straight answer on what my issue is - possibly things I was born with but I had a hard time believing that, as I am 28 yrs old and have NEVER had any back pain in my entire life, and this just started one day as an annoyance and over a month span it got to the point where i was always in tears.

Just recently started going to a highly regarded Chiropractor in my area about 2 weeks ago. She reviewed my MRI, did a physical exam and determined that my left SI joint was out of place. This sounded like a possibility as my SI joint has been mentioned in the past from my PCP and Pain Mgmt Dr, they just couldnt see what was wrong with it in the MRI, they just knew it didnt look right. I have gone for 2 adjustments so far, going for my 3rd today. I am also going to Physical Therapy- i usually do PT the opposite days that I do chiro with a day or two inbetween.

What i am curious about is that I have had increased discomfort since starting to get the adjustments. Nothing severe where I need to run to the ER or a Dr., but I am in more pain now that I was before staring chiro. It almost feels likes its more the muscles around the joint since the pain is more a throb/burning opposed to the usual sharp pain. I wanted to find out if this is normal for someone who is having a joint manipulated and put back into place, esp if its been out of place for over a year. I have also been told that a lot of my muscles in my back/hip (hipflexor, pfiomris)are really really tight now and have been having them exercised/stretched/massaged/trigger point release. Could it be the combo of getting the adjustments and doing PT?

My pain management dr isnt a fan of chiropractic care, so I fear that she will tell me to quit if I tell her its making my back flare up. I would like to be able to tell her that i rec'd an unbiased opinion, not from my own chiro, who said I need to stick with it for awhile longer before I notice any results.

Thank you so much for your time!

ANSWER: Jess,

The flare up you speak of is quite common with the first few adjustments. Please discuss this flare up with your chiropractor and ask if there is any nutritional regime he/she recommends for inflammation. I suggest using ice and compression in the following manner. Fill a gallon plastic baggy with ice being careful not to fill it too much or two little. Now you will lay on the ice on a carpeted area in your home. You should situate the ice so it covers the entire area in question and there should only be one to possibly two layers of paper toweling between your bare skin and the ice pack. The compression is supplied by your body weight. It should feel very cold but not "pinchy cold". You should ice 20 minutes-take 15 minute break- re ice for 20 minutes. (20 on/15 off/20 on)Do this daily until you have normal function again.

I also suggest discontinuing PT for the time being as you could be getting to much Physical Medicine at the area of concern, namely your low back and specifically your SI joint. Please let your chiropractor know what you are doing at the PTs office. Also if you continue to flare up your chiropractor will be better equipped to make changes in their protocols for your recovery.

As far as your pain management doc not liking Chiropractors; is he from the dark ages? Fire him and get a new one! Medicine does not have all the answers and neither does chiropractic. The best is to utilize medicine and or Chiropractic for the better good of the patient. Bye the way would you continue to treat with a Chiropractor who said I don't like pain management docs..it's just downright ridiculous!!

Good Luck with your health issues! I hope this has been helpful
John Q Quackenbush
Phoenix Chiropractor
www.drqdc.com

---------- FOLLOW-UP ----------

QUESTION: Thanks so much Dr Quackenbush, your advice was helpful. Is there a chance that if im getting a flare up after having 3 adjustments already, that there could be something else causing issues besides my SI joint? I do know that I have a LOT of muscular issues around my hips/glutes/pelvis/thighs - everything is really really tight, and supposedly adding to my pain. I went for a deep tissue massage today at my DC's office and it really hurt during it, but at this point my back doesnt hurt like it did earlier today.

I am also seeing a Craniosacral Fascial Therapist, and I went for my first major Craniosacral Fascrial treatment today, and she seems to think that my hips were "jammed" - not sure how to talk medically - and it was causing my sacrum to be stuck and it wasnt moving at all - she also mentioned my fascia muscle was really really tight. She did some work and was able to free my sacrum so that it now has movement, and my hips were moving better too. Could these things be the underlying issue?

I have just heard so many different things about the cause of my pain - the medical dr's ive seen dont really have an answer, they have seemed to be guessing since my MRI's didnt show anything serious, just some things that I may have been born with. My last one was deemed "normal".

I am following your advice of getting a new pain dr - he has been great in terms of helping my pain, but doesnt really care about how i feel about the medications and how negatively they have been affecting me, and has offered me no suggestions or anything that I could do to help my back. Its been a year of dealing with him and the only thing thats changed is im on stronger meds than I was a year ago, but nothing has been done to try to fix my back. Thats why i finally went out on my own and found all these other people to help me.

Answer
Jess,
Glad you are doing somewhat better. I still opine that 3 visits is just a drop in the bucket at this point continue with your DC. I also think you are attacking your problem with too many health care practitioners.Make sure each doc knows what the other is doing as they could be complimenting each others care or they could be slowing the others results. Discuss this with them openly management of your case is crucial and you need to have one of docs in charge and at large...if you get my drift. These docs need to know everything about you and your body and what you are doing with it as far as health care. It seems you are moving in the right direction keep up the good work but tell all to everyone of your health care providers. It is in your best interest.

in the mean time check out my facebook fan page and please join up and tell your friends tooo!
http://www.facebook.com/pages/Phoenix-AZ/Phoenix-Anthem-Chiropractor-John-Q-Quac

Thanx

Dr John Quackenbush