Question
hello Dr. Boss :)
i have had chronic pain down my left leg for almost a yr now ... however, my CT scan and x-rays show nothing of significance (sciatica was ruled out d/t this) ... i was told by my GP that it may be due to an "alignment" problem, where too much pressure is put on my left leg, and that possibly chiropractic care would suit me best ... my question is: does this sound like it may have some merit, and is it worth looking in to? (i know this service is not intended for diagnoses- i am just hoping to find out if chiro is something to consider!)  thanks so much, erin

Answer
Erin,

Thank you for your question.  I think that you are doing the right thing by exploring everything you can to find out what would be best to do.

Your GP is pleasantly and surprisingly correct in this situation.  I say that because my history with the average GP is that they will often "pooh" off leg pain symptoms in the absence of any CT diagnostic findings.  I commend him and advise you to continue to us him or her and they are obviously "on the ball".  

In the absence of lumbar disc involvement which has been ruled out by the tests, the next most likely suspect is a pelvic imbalance.  This is a problem in which the pelvic bones, right and left, are either tilted or torqued.  This will cause irritation of the sacroiliac joints, the joints that connect the pelvic bones to the sacrum and spine.  It can also lead to irritation of the sciatic nerve where it exits the muscles of the buttock.  CT scan will not show any problem in this case.  The sciatic nerve will not be "pinched", it will just be irritated by the misalignment of the pelvic bone and from tightening of the muscles of the buttock.  The result is usually very low location of lower back pain, pain and tightness in the buttock and leg pain.

To properly evaluate this, you will need an xray of the lower back and pelvis in a standing position.  I am assuming that the xrays you had taken were in a lying down position on a table.  This will often not show the tilt or torque in the pelvis.  

Regardless, the treatment of choice is chiropractic.  You will need the joint manipulated to ensure they will begin to move properly and be re-aligned.  Therapy is helpful in loosening muscle tightness and spasm.  Finally, a heel lift may be needed in your shoe.  In the presence of a pelvic tilt, a heel lift may be needed to act as a "lift" for the side that is lower.  This will lift the pelvis and help the manipulation hold.  The irritation is taken off of the joint and other structures and the problem is solved.

I recommend that you take your GP's advise and find a good chiropractor in your area to take care of this problem. In my office, I usually will see this type of condition about 6 to 12 visits.  Let me know if you have any further questions.  Good luck

Dr. Boss