Answers to Questions about Chiropractic:
Who Should I See about a Misalignment That
Is Causing My Right Hip to Stick Out?

Samuel Homola, D.C.

Question

I had back surgery three years ago for a herniated L4-5 disc. The results were not good. and I still had pain down my right leg. One year later, in the same miserable state, I went back to an orthopedic surgeon. With barely a two-minute evaluation and a copy of my MRI, he said I needed a second surgery to put a rod in my back. I wanted no part of another surgery and left feeling very discouraged. A friend of mine gave me a copy of the book Treat Your Own Back by Robin McKenzie, a physical therapist. I read it and felt that it saved my life. I followed the exercises, got rid of the pain, and started a rigid exercise program when I got back on my feet.

At the gym two weeks ago, I threw my back out while raising a seat on one of the machines. A severe pain in my lower back buckled my knees. The next day, the pain was so bad I couldn't turn my head, wiggle a toe, or raise a leg without a catching pain in my lower back. I tried to do the McKenzie exercises but couldn't do much for about 48 hours but lie on my back and use a heating pad.

My body is so out of alignment. My right hip is sticking way out. I have never gone to a chiropractor before because, quite frankly, I was always afraid they would crack something that would leave me paralyzed. But I am not keen on the medical profession, either, because they are so quick to recommend surgery. If I could turn the clock back, I would not have had the first surgery, knowing how the McKenzie exercises helped me.

This time, I don't have pain going down my leg. It's all in my lower back. Over the past two weeks, I have been able to implement the McKenzie exercises and I am on my feet, walking daily (but very slowly), and doing ice/heat treatments.

I went to a chiropractor two weeks ago and he did everything I am reading on your site about warning signs. He immediately did the full spine x-ray from my neck to my buttocks. He gave me the whole line about subluxations and said I needed six to twelve months of chiropractic treatment and then maintenance care for the rest of my life. He wanted me to pay for the treatment up front for a discount and then deal with the insurance company myself. Needless to say, I said no thank you and left.

My dilemma is this: Although I move a little more each day, my body is visibly out of alignment. I get on my feet after I do an ice/heat treatment and a set of McKenzie exercises. But I can only stay up for about two hours, and sitting is painful.

I know I need treatment but I don't know who to proceed with. My insurance will cover 40 visits with a network physical therapist or 12 visits with a network chiropractor. I just want to get aligned properly and be able to resume my active lifestyle. My right hip is still sticking out.

Three years ago, a physical therapist gave me a lift for my left shoe, saying that my left leg was shorter. Last week, the chiropractor told me I needed a lift for my right shoe since the x-ray showed that my right hip was lower than my left. I am so confused and I don't know who to proceed with. I am also concerned that I might be doing more damage trying to walk while I am out of alignment. I read an article that said exercising when not properly aligned is like driving a car that needs a front-end alignment. You can drive it, but eventually things will wear improperly and break. I don't want that to happen.

Answer

It may take several weeks to recover from the type of injury you describe. So be patient and don't panic. You might have an unstable segment with degenerative changes that have occurred as a result of disc herniation or surgical removal of disc cartilage. This would make you more susceptible to joint injury caused by an awkward or wrong move. You,ll have to be very careful to avoid improper postures in the gym.

The "body misalignment" you describe is probably the result of reflex or protective muscle spasm that is pulling you to one side, making one hip more prominent than the other. This distortion will disappear when the injury heals and the spasm subsides.

It's not likely that a shoe lift to correct unequal leg length will be helpful. An effort to alter your shoes might make matters worse.

You are in no danger trying to exercise or move around, but you should not do too much and you should not do anything that causes pain. Gradually increase your activities as your condition improves.

If you develop leg pain or do not continue to improve, or if your pain and spasm (distortion) have not subsided after about four weeks, see a physiatrist (a physical medicine specialist) or an orthopedist who specializes in the care of back pain and get a diagnosis based on a new set of x-rays. You cannot rely upon a diagnosis of "subluxations" located on a full-spine x-ray. If you have segmental instability due to degenerative changes and not a new disc protrusion, chances are you symptoms will subside with time and a little over-the-counter pain medication along with physical therapy or self-help.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on June 23, 2002.