Question
QUESTION: I went to a chiropractor for a neck adjustment and after the adjustment I was leaving the room when the doctor asked me if anything else he could do for me.  I said, well now that you mentioned it, I do have a small sore spot near the bottom of my back on the right side, about the side of a silver dollar.  He said, well lay down here and let me examine you.  I layed down on his table and after about 20 seconds of examinating he said let me give you a back adjustment.  He then gave me instructions to lay on my left side, cross my arms across my chest, he then took my right leg and put his belly against my shin.  He then reached around my neck and then leaned forward against my leg in 3 quick lunges (thrust) and gave me what he called a side posture adjustment.   It was like he was trying to make my knee touch my chin. During those 3 quick thrust I experienced extreme pain in my knee, hip and quad muscle. It was very painful but only lasted only a short time, maybe 3 seconds total.  As I got off the table I noticed the contents of my pants pocket fall from the top of my quad muscle to the side of my leg.  As I walked out of the office my leg just didn't feel right. I didnt think much about it at the time, but I think those items in my pants pocket ( keys, pocket knife, chance purse) was lodged between my belly and quad muscle during the treatment, because the next morning I couldn't walk at all.  I couldn't straighten my leg out.  My knee, hip, quad, and groin was extremly sore, the pain was like a hot knife being stabbed into my leg.  I had to go to my family doctor where he perscribed muscle relaxers, anti- inflammatory pills, and told me that the a blood vessel near the bone probably burst during the side posture adjustment. I had to be pushed around in a wheel chair for a couple of weeks then crutches for a month, then theraphy. My question is?  Did he perform the side posture adjustment correctly and if so does it supposed to hurt so bad?
thanks  Bobby Radford

ANSWER: Bobby,

First, I don't know why the DC didn't check your lower back a bit more than 20 seconds before doing anything, unless your back was examined previously.   You would have done better to clear all your pockets prior to the joint manipulation, or spoken up that you were being poked by the stuff in your pocket.   If you really broke a blood vessel, why would your MD prescribe anti-inflammatory?   If there was no spasm, why a muscle relaxor?  This doesn't seem to make sense.  The side posture maneuver varies a bit from one DC to another, and the way it's performed can vary depending on how the DC wants to address the joint system.  If you had that much pain, requiring a wheel chair for weeks, why didn't you get an MRI of your thigh to see if something was ruptured?  That would prove or disprove the speculations about what happened.  If you did have a rupture, then the NSAID meds can interfere with the healing.  I've had lots of patients forget to clear their pockets and roll onto things.  It's usually an immediate sense of discomfort that causes everyone to stop and take the stuff out of the pocket.  Your situation seems rather peculiar.  I'd like to see an MRI result.   

'Regards,

Dr. G

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

QUESTION: Thank you for the answering my question.  I did make one mistake, it was not anti-infammatory, it was pain pills and muscle relaxers.  I agree that I would have done better if I had cleared my pockets before the procedure.  And I would have if I knew what was about to take place.  The DC never explained what he was going to do, he just gave me directions and I followed them.  Seems to me "HE" should have checked stuff like that, himself! During the procedure I tried to express my discomfort to the procedure at the time but It only lasted about 3 seconds and he was pushing the air out of my lungs during those 3 thrust he gave me and I couldn't say anything until it was over. After he stood up and got "off me", the pain subsided and it wasnt until the next morning that I couldn't walk. The procedure happened about 6pm.  The DC only examined my back for a period of less that 30 seconds, and he had not examined my back before. It was my first trip to  him.  The very next morning My entire right leg was
sore around the hip, groin, quad muscle, and knee.  I wasn't untill about 4 weeks later as the hip and knee pain started to subside that I notice the quad muscle was still sore as ever.  That is when my MD made the comment that he subspected that a blood vessel had burst.  He did order a Cat Scan, but I was fired from my job because I couldn't walk and lost my insurance and couldn't aford it. But my question is still, did the DC perform the side posture adjustment correctly, or did he go too far?  Or use too much pressure.  Thank you!

Answer
Bobby,

The DC should have done some examination on your lower back to be sure that there was no problem.  If you gave him no information on our back, then he should have asked you about any problems and checked it out.  If you had reported no prior medical history of underlying issues, e.g. previous injury to the back or hips, etc., and he had good reason to believe you had no issues, then the odds of a basic side posture manipulation causing a problem is quite remote.  From what you said, it was the stuff in the pockets that was the problem, and that he thrust on your thigh and pelvis in a side posture position three times when you had pain on the first time.  It was careless.   The side posture adjustment was not done incorrectly, since there is no such thing as incorrectly.   It's a manual procedure that can be performed in a variety of ways.  I cannot understand why you had a CT scan and not an MRI.   

'Regards,

Dr. G