my case-

[whatishappening]

Thank you Linda. My whole body (pelvis and up) was rotated in that xray. So what I am concerned about is if I try to derotate, then the verberea will rotated relative to each other and the lateral curve will show. I am planning to get xrays at a chiro's office showing me derotated to see what happens to the spine- but I have to wait a bit- just spend another $100 last night on IMS..

Hurting myself by trying to derotate is my concern but I see no choice because of the radiculopathy. But I honestly don't know what I am doing so that is why I am looking for qualified help. Thanx, you and this forum have been amazing- at least now I understanding more.

Thanx jrnrc- I don't know if the whole experience is as appaling for everyone else in Canada. A couple of my PT's have had knees surgeries quite easily. 2 of my older clients have had knee replacements. I mean lots of people who are in pain get help- so I just don't know what the deal is with me. Maybe they think I'm crazy for talking about being rotated so they are just blowing me off. But you are right. And the thing is that when it comes to the spine it seems to me that the only type of doctors that are really trained are orthopods. BUT, they don't want to send you to an orthopod unless you are ready for surgery. I guess. So there is a gaping hole between pain and surgery wherein there is no qualified help. Thanx

[skevimc]

It's difficult to tell how much your pelvis is rotated because the x-rays don't show the full pelvis. You mentioned that you might get another x-ray at the chiro. If you do, see if they'll open up the window to get the full pelvis. Then it would be possible to tell how rotated the pelvis is.

To me, the right pedicles look at bit more prominent than the left. This would be consistent with a small rotation and with the spinous processes. It would also appear that you have quite a bit of lumbar lordosis (looks close to 90° measured by the top of L1 and the bottom of L5. Normal would be in the 30-50° range I think.) and, if I am seeing correctly, anterior pelvic tilt. (This would greatly increase your lordosis). As I was looking at the lateral x-rays, I think I can see your illiac crests and acetabulum(s) (hip sockets). That can give the impression of how much rotation you have in the pelvis. It looks like some rotation but a bunch of lateral tilt to me. Have they ever talked to you about a leg length discrepancy? I'm not sure I'm seeing things correctly though because the height difference I'm seeing of the hip sockets on the lateral view is not as pronounced on the frontal view. However, I also just noticed that your ischial tuberosities (butt bones) have a lot of height asymmetry on the frontal view. So it's clear that you're standing with two separate postures for the two x-rays. Were these taken at the same time? If so... "Bad radiologist... bad bad bad... go to your room"

I'd want to see you in a true neutral spine and see what happens to your x-rays then. But ultimately you couldn't do that until you could figure out what you'd need to move in order to get a neutral posture. To me, it looks like the lordosis is causing the spinous processes to stack tighter together and so they rotate slightly to help everything fit in place. If they take an x-ray with your hips aligned, I'd imagine it might look like you have a lumbar scoliosis. In the frontal view, your hips are aligned and that is causing your pelvis to tilt. I'd want to know if this is because of tightness or because of the legs.

Or at least that's my non-clinician input.

[jrnyc]

hi "whatishappening"
my sister has lived in Montreal (and now lives in Verdun, outside of Montreal) for 35 years
she swears she has no problems getting care...she said emergency care is instant....other
things she has to wait for...that is the part i wouldn't like...i guess we just get used to
seeing doctors in the States whenever we need/want to....though i see several doctors who do not take insurance or do not take my insurance, and i pay them cash....not easy for
someone who is not wealthy....

i hope you can find the care you need...
i was wondering if you get any relief from massage...IF the problem is coming from your
muscles, maybe that would help...?
there is also the possibility that some kind of injections would help with your pain....
i get mine from a pain management doctor....do you have those in Canada? i guess you must...
what does it take to get referred to one? tell your GP that NO, you cannot live with the pain!
he doesn't deserve to be a doctor with a comment like that...disgusting...i wonder if would say that to
his wife or daughter...?!!

jess

[LindaRacine]

Taking on an unnatural posture during X-rays won't tell you anything in terms of scoliosis. For scoliosis X-rays, your fit should be flat on the ground, your toes lined up, and your knees should be unbent.

[whatishappening]

Thank you VERY much for your replies Linda, Jess and skevimc.


The first person I saw- a very experienced pedoratrist (podiatrist), sat in a chair and looked at my hips at eye level. He said I had a 1/2 inch leg length discrepancy. He also noticed that 1 AsiS is furthur back than the other. Since then, my leg lengths have been pretty quickly checked by 5 physiotherapists, 1 massage therapist and 1 chiropractor and they all said the leg lengths are equal. But only one mentioned the pelvic rotation and the massage therapist and chiropractor both denied that my pelvis is rotated.

When standing for the xray, both my legs were straight- I was standing up straight- like I would if I was in the miliary or something, with stomach pulled in etc. I am able to derotate by even furthur sucking in my abs as hard as I possibly can and pressing strongly down on the floor with both feet. But that posture is impossible to maintain, so I stood the way I would stand if say, "At Attenion", in the army (I was in the Militia when young). My feet were in line. I have been obsessed with this posture for the last year so I know that is how I was standing.


The person who took the xrays was a radiology technician- not a radiologist. The lumbar and thoracic / ap & lateral veiws xrays were taken at the same time- ie within 5 minutes of each other but with separate shots.


For the next xrays I will derotate (unnatural for me) and ask that my whole pelvis be included. I hope the rotation is not being caused by radiculopathy or vice versa.

Thank you very much!





Jess:

I am from Montreal! My aunt lived in Verdun. The best doctor I ever had was when I lived there- but that was 20 years ago and the whole system has changed since then. At least, I noticed a big difference when I moved to BC. But I really haven't gone to many doctors out here- I have always had great health which is why now, when I finally need the system, I am just so dissappointed.

Yes emergency care is great I guess- if I needed a bypass I would get one within weeks. And the irony of this situation, is that my heart is great because I have been able to keep fit and happy. Now with this condition- whatever it is, they don't treat that, I have stopped exercising, getting depressed, gained weight (15 pounds) and in the long run they will have to treat me for a heart condition which will be so much more expensive that 10 minutes with a spine doctor now..


My GP is a female. And yes, I was thinking of asking her "what would you do in my position?" I doubt very much she would just sit back and let it happen. I am planning to get a new one. But a man I work with is experiencing bad sciatica and I don't think he has even gone to a doctor. A female painter I sometimes work with- well, she woke up one morning and couldn't move her leg- all day. And her, I don't think she went to a doctor either. And I went to a chiropractor's sales presentation (1.5 hrs long) and he showed us all one of the ladies xrays for demonstratation purposes and her xrays showed quite bad scoliosis- like, why is that woman finding that out in a high pressure chiropractic group sales demo? anyway....

I had a massage a couple of months ago. $100. I can't say it helped. I have just finshed 3 rounds of IntraMuscular Stimulation- they stick needles into your muscles, including the spinal muscles. It is very painful. I don't think it really helped but maybe it did.


I don't know about injections or drugs. I am taking lots of aspirin (about 6/day) plus about 4-5 Glucosmine plus 1 can of salmon plus 1 antidepressant. I will go on drugs/injections if and when I have to. I was hoping to find out what's wrong. This way, I can also notice or try to draw patterns on what movements cause the pain- it is actually helping me alot. I don't want to just ignore the pain with shots and then continue on doing damage. But ofcouse if the pain gets bad enough I will have no choice.

ttyl & thank you very much

[skevimc]

For the next xrays I will derotate (unnatural for me) and ask that my whole pelvis be included. I hope the rotation is not being caused by radiculopathy or vice versa.

Thank you very much!

No, don't derotate. Don't do anything except try to make sure the postures are the same. When I was saying I wanted to see you in a true neutral, that was more the researcher talking, i.e. let's see if correcting the pelvic girdle alters the spinal issues. For diagnostic purposes, you want a true to life shot. But the full pelvis would definitely be better.

1/2 inch leg length discrepancy isn't as big as I would have thought given the differences on the x-ray. I wonder if the angle of the x-ray beam is exaggerating or reducing some of your twists and turns.

[Karen Ocker]

my thoughts

Have you ever had an MRI to see if you have any hidden vertebral abnormalities-like spina bifida occulta?
Like Linda it looks like you have kyphosis--- and, to me, profound lordosis on the lateral views.
Before my revision surgeries I did Pilates. It really reduced any pain I had. Once I learned the movements I could do it at home. One only does the movements that do not hurt.

I don't believe chiros are adequate for your case since it hasn't worked so far. There is a reason for your pain.

Another thought would be syringomelia.

[jrnyc]

i asked about injections because they can be quite helpful for soft
tissue pain...
i get botox shots to stop the muscles from going into spasms....i was thinking that IF
muscles are contributing to your problem, shots might help you...but that is for a doctor
to evaluate...and it doesn't sound like you have access to doctors who might be helpful...
i am grateful to every pain doctor who has ever treated me...until/unless i have the
surgery, i deal with the pain with shots, oral meds, and sometimes just toughing it out....
i also have stopped exercising...before i herniated discs, i could manage my scoli, and
went to the gym 3-4 times a week, for cardio and weights....now i cannot exercise at all
...too much pain....
i really wish you could go see a pain management doctor...even while trying to figure outthe problem, it might at least get you out from under the pain...it is so hard to think
straight when in pain!

please be careful with a lot of aspirin every day...
you know what it can do to your stomach...
i wrecked my stomach from oral antibiotics and from aspirin (Lyme disease)

hope you feel better...but please be careful what you do to get an Xray...you could be in
increased pain afterwards!

jess

[LindaRacine]

Have you ever had an MRI to see if you have any hidden vertebral abnormalities-like spina bifida occulta?
Like Linda it looks like you have kyphosis--- and, to me, profound lordosis on the lateral views.
Before my revision surgeries I did Pilates. It really reduced any pain I had. Once I learned the movements I could do it at home. One only does the movements that do not hurt.

I don't believe chiros are adequate for your case since it hasn't worked so far. There is a reason for your pain.

Another thought would be syringomelia.

I agree that there appears to be hyper lordosis. Perhaps the facets are painful. If that's the case, a facet block could be diagnostic.

--Linda

[whatishappening]

Thank you everyone for replying. I really am very grateful.

skevimc
Thank you for pointing out that the spine rotates to provide room for the vertebrea when hyperlordotic. I think that may be key for me. I will hold off on the xray for a few days at least anyway.

Re Hyperlordosis:
I have been to 5 physiotherapists, 1 massage therapist, 2 chiropractors (though one said nothing) and 1 sports medicine doctor for an evaluation. One physiotherpaist said I was hyperlordotic but no one else said anything. I just dug up the papers from the Sports Medicine Doctor and it says neutral lordodis but it also says 20.5 cm on Schober's test- which means I am on the border of having limited forward flexion in the lumbar.

I think the lordosis changes- that it contracts quite a bit - I guess goes into spasm, and then that makes the pelvic rotation even worse. And I know that rotation (opening my left hip) turns on the radiculopthy, which also makes my back contract into the hyperlordosis. And ofcourse sometimes when I walk normally, my left hip will open up too much (only natural) and it will turn it on. I also think straight hyperextension makes the lumbar contract too because my doctor mentioned McKenzies at one point and that make me much worse.

So that would explain why lots of people haven't seen the hyperlordosis. Bcecause it comes and goes. But it is getting worse (duration at least), I know that for sure.


Re the Kyphosis- I just looked up the Sports medicine Doctors notes and it says my thoracic spine extension is less than 5 degrees and normal is 5-15 degrees. That is news to me because she didn't mention it. I know that I have a pad of fat up there. It is larger now because I just gained 15 pounds. She also wrote that I have moderate forward chin.

I am just looking at the notes now and it says Left thoracic is slightly higher than right and left shoulder is mild-moderately elevated.
There is more stuff on this paper that I haven't seen. It says zero curvature seen and she rubbed my disks up and down my back and nothing hurt.

Linda, The ct scan showed facet joint arthritis and bulging disks. so yes, factet joint artritis could be it. And it is spasming me into a position that makes it worse. I will ask about that block, thank you. I just don't get how that can be causing my whole body to rotate and contract.

Plus, my left leg- and even shoulder- just feel more loose or flacid than my right. And I keep tripping (like a slight toe stubbing) on my left leg.

Jess-
I am so sorry you can't exercise anymore. Exercising- particularly aerobic exercise is one of things I really love and I have cut back to only once a week. I am sorry you are in pain., This "pain" in general is so new to me, and it really sucks.

Karen- yes, well what got me in major trouble was in Jan a PT prescibed the pilates pelvic bridges. And I now know that my left hip was sagging down while doing these ( the Sports medicine doctors noted it) and so that basically twisted my spine and turned on the radulaopthy really bad. The worst for me was in March/April. It is slowly getting better but I also have frequent setbacks. I am still taking one pilates class a week and doing some at home. Actually I am so upset over what happened to me doing those pilates exercises that I no longer trust myself so just yesterday I intsalled a mirror on the underside of a bar table and I am doing the exercises under the table. Sounds sort of narcissistic but it isn't. I am really surprized at what I see.

I haven't had an MRI. Waiting times here are 18 months but the neurologist chose a CT scan instead. It showed bulding disks and facte joint arthritis and forminal narrowing- but all "mild". I am not on the wait list for an MRI. I would like an MRI to know where the problem is. That facet joint block sounds good.

I do feel there is a genetic component to this because I almost fainted when I saw my brother a month ago- how one scapula is sticking out one one shoulder is higher. Also my nieces, their shoulders are very rounded foreward- more so than other teenagesr I see. And I was already suspecting something bad prior to seeing him, so seeing him has not led me to imagine things, it was quite the opposte, I never expected to see him like that. He is complaining of shoulder and upper back pain- no lower back pain.

thank you very much

[dailystrength]

Egoscue method

[QUOTE=whatishappening;124164]Hi Dailystrength, thank you for the suggestion, I would love to take something like that - I just checked though and it is not offered here.. Too bad.

Here is the Egoscue website for anyone else interested. I have finished my training and it really has been good. http://www.egoscue.com/

[whatishappening]

[QUOTE=dailystrength;126669]

Hi Dailystrength, thank you for the suggestion, I would love to take something like that - I just checked though and it is not offered here.. Too bad.

Here is the Egoscue website for anyone else interested. I have finished my training and it really has been good. http://www.egoscue.com/

Thanx dailystrength. I just watched that video on their web site.: so it seems there is a common theme I am seeing about pelvic alignment. I have seen and have been practicing variations of that tower exercise they show. Here are a couple of other sources:

1) a more dynamic version:
http://www.wrightbalance.com/p/core-research

2)an exercise from "Posture Alignment- the Missing Link in Health and Fitness" has the same exercise as in the Egoscue video except that the subject must keep their own foot square (not easy to do). They stress the importance of this and also say to stay in the pose for 3 minutes.

My huge question though is what if the scoliosis (or torsioned spine) includes a rotated pelvis-then, by trying to square the pelvis with these exercises, the relationship between the spine and sacrum stays fixed so that the whole torso (and its musculature) must rotate to match the squared pelvis.

This is most certainly what has been happening to me as I attempt to sqaure the pelvis with these exercises. And I really fear I am doing the wrong thing. I am most certianly feeling huge bizarre things in my back- is it improving or getting worse?

See I think if a person's genetic (or structure/unfixable) scoliosis includes a torsioned pelvis, I think these exercises may be bad?????? How to know the difference?

oh and PS, I had my followup with the neurologist- she said the numbing and stingling and burning I have been feeling is not associated with nerve compression but more of a myofasical problem. That makes sense to me because as I am trying to "derotate" my fascia will be pulled into the new position.

[dailystrength]

I haven't looked at your site yet, and the square footing, but just to address the questions-- my trainer says to not try to rotate or correct my rotation (it is very tempting to try to do when I stand or lie down.) She said the excercises will train the muscles so just let that do the work. When I had tingling down my left arm while doing static back, she said it wasn't harmful but to ease up and increase the time slowly. Now I can do that exercise with no problem and it is very soothing at the end of a day. So be gentle - my feeling is there is a lot going on back there and undoing rotation will take time and patience, as it's been many years of bad posture habits. Best to you and I will be sure and look at the site. Right now my jaw has been acting up - I must hold a lot of the tension there! I grind at night and have broken and lost teeth from it! Now I am faithful to wear the nightguard! My Egoscue trainer gave me some exercises that are helpful for TMJ also.

[whatishappening]

Thank you So much for repsonding Dailystrength- I really appreciate it. I am sorry about your jaw. I am so grateful you seem to undersatnd my problem. Now that I have derotated a bit, the line down the front of my abs is no longer vertical. Scarey stuff. I think you are right- I should just ease off. You are SO right- it is SO tempting to derotate! I wish there was a Egoscue trainer here- or anyone who understands. Thanx again and wear that mouthguard!