Question
I have had pain in my left hip for 3 months.  It is in the front, side and buttocks.  I can push on the areas and either feel bruised or relieve the pain some.  The lower  back on the left is tired and sore.  This pain has begun to travel up the left side, shoulder blade and over to the right shoulder.  My Chiropractor says it is the SI Joint and has me lie on my side and bend left knee up with arms crossed and twists.  It is not getting better after 2 sessions - I had seen him for 3 months once a week and then not been in for 2 months. Had been given a "come in for rechecks when you feel necessary".  Should I have an xray done?  Could it be a bursa sac?  My right hip hurts as well, not a severe.

Thank you.

Answer
Dear Christine,

Your "hip" area pain can be from bursitis, myofascitis in the lower back or gluteal musculature, or an SI joint problem.  If all you are getting is side-posture joint manipulation, then there is no way to alleviate any possible bursitis or myofascitis.  Bursitis is easy to diagnose. There is often very localized tenderness to press on the hip bursa, and the bursa pain is usually quite prominent at night.  Laying on it in bed is also painful.  Myofascitis can cause similar symptoms, but bursitis is easy to differentiate because of a locally tender bursa, whereas myofascitis will have no bursa tenderness and will show more global, diffuse tenderness across a broad muscle region.  Both are amenable to therapeutic ultrasound.  Bursitis sometimes responds very well to the combination of ultrasound and deep soft tissue mobilization (especially Graston Technique).  When bursitis doesn't respond in a few sessions, then consultation with an orthopedist for cortisone injection is the best bet.  Your DC should be able to rule out bursitis and myofascitis.  If you cannot get a logical reason why your diagnosis is SI joint irritation, then you need to find a new doctor.  Also, most SI joint problems respond quickly to joint manipulation, unless there are myofascial lesions that are complicating it.  If so, then the DC must do soft tissue methods to clear the myofascial problems.  

'Hope this was helpful.

Dr. G