Question
Hi Victor, for nearly 3 months now i have been getting a constant pain in my lower back at the upper bum crack and also slightly on both sides of the bum cheeks. every time i get up from sitting i am in agony and it takes me a little while to get up then i have to stretch it off because my upper bum goes very stiff. i have been to the doctor and he was not very helpful. I havent fell recently and have been trying to not sit for long periods more than 10 mins. Please could you tell me the problem and how to reslove it. Thanks alot.

Answer
Low Back Pain, coccyx pain, herniated disc, pinched nerve

Hello Aadam,

Sorry to hear of the pain in your butt.

First, we have to locate the pain more accurately.  "Lower Back Pain", depending upon who you talk to, could be flank pain (possibly kidney pain), spine pain in the middle of the low back (sprain /strain, herniated disc, even an aortic aneurysm), hip pain (some people point to their hip(s) and say- my low back hurts), LumboSacral pain (low back, a little inferior to the beltline), SacroIliac joint pain (close to the hips), Sacral pain (kind of at the top of the crease between the buttocks) or Coccygeal pain (often deep in the crease between the buttocks).  Locating the pain is important,,,, people often use the same words, yet mean different locations.

You have been to the "doctor",  what type of doctor?, what type of tests?  .....Xrays performed?  anything else?

Now, working from the bottom upwards:
The Coccyx is the very bottom of our spine, very small, well protected by our buttock muscles and its inward curve. Not often injured, but a common mechanism of injury would be a slip or fall where we land hard on our buttocks in a sitting type position.  We can fracture, dislocate or subluxate our coccyx.  Lower back problems, suspected coccyx problems should be imaged- meaning take an Xray, and then perhaps even an MRI or CT scan.  

If the Coccyx is fractured, it takes a couple of months for a fracture to heal.  If it is Dislocated or subluxated, a manipulation may be indicated.  Some Doctors of Chiropractic may be able to provide the procedure necessary.  This Staten Island Chiropractor does not perform any 'internal' osseous manipulations.  An internal manipulation would mean the practitioner utilizes a finger cot, finds the coccyx internally and gives a pull or thrust into the correct position.  This would only take seconds.  The need for this type of maneuver is rare, but sometimes necessary; but this area of the body is socially sensitive.  In my Staten Island Chiropractic office , I do not perform internal maneuvers- I do not palpate (examine) the coccyx,  inguinal or femoral hernias- I refer for other specialists to examine and treat.  Unfortunately in today's litigious society certain body parts are not evaluated or treated by some doctors, even if effective evaluation, diagnosis, treatment can be performed by that practitioner.

Coccyx work can also be accomplished through external tissue pull work as well.  If the Xray and/ or Doctor's exam finds it to be a coccygeal problem amenable to Chiropractic treatment, I would recommend listening to your neighbors, getting the name of a good Doctor of Chiropractic in your location and visiting that doctor.

Higher up, your low back pain could be due to Hip problems, SacroIliac conditions, LumboSacral subluxations, or even a herniated disc.  Differential diagnosis must be made by your Doctor of Chiropractic.  I have a couple of handouts I utilize in my Staten Island Chiropractic Office that may be helpful to you:
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Lower  Back  Pain  (LBP):          Low  Back  Pain  can be caused by many different things.  Big, BAD, catastrophic things like a tumor or a cancer can cause low back pain (only a proper exam by a licensed doctor, like your Doctor of Chiropractic, or your family Doctor of Medicine, can evaluate your signs and symptoms, and perhaps refer for testing).  Big, bad things like a Herniated Disc, sciatica, possible fracture or dislocation can cause LBP (again, best evaluated by your DC or MD, and perhaps referral).  Bad things, like  - Sprains, Strains, contusion, or Vertebral Subluxation Complex (all very efficiently diagnosed and treated by your Doctor Of Chiropractic.  LBP can come from a motor vehicle accident, sport injury, slip, trip, fall, arthritis, lifting improperly, or even bad posture in standing, sitting or sleeping.  All of these things often have a Lumbar (Low Back) Vertebral Subluxation involved.

              Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

This is a serious condition identified by its five parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical-  problem requires a mechanical   correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.
++++++++++++++++++++++++++++++++++++++++++++

Disk   Herniation

Herniated  disk  is  actually  a  quite  common  condition.   However,  the course of the condition is highly variable.   Some patients with a herniated disk literally cannot walk, yet other patients with similar MRI findings may be able to run marathons or lift heavy weights.   Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow:  Ice the area when painful-  10/ 15minutes on, 30/ 45 minutes off;  avoid certain postures and movements;  bend the knees when coughing or sneezing;  bend the knees when lifting anything;  do not extend legs straight out when sitting, laying down, lifting, or driving.   Avoiding certain movements and postures will prevent aggravation of the condition.   Practicing good postures and movement patterns will help the condition heal and be less painful.
Disk  Herniation  is often caused by, or often  concurrent with the Vertebral Subluxation Complex.

         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
    Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.   
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.
++++++++++++++++++++++++++++++++++++++++++++++++++++

I hope this helps.  This Staten Island Chiropractor wishes you good luck, and Good Health Naturally !

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com    (email newsletter)
http://www.GoodHealthNaturally.info
http://www.DocDolan.net