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Strained Muscle or Hernia?
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Questions in the Chiropractic Care Forum are being answered by Dr. Adam Tanase, a board-certified Doctor of Chiropractic. Topics covered include Muscle Pain, Nerve Pain, Movement Disorders, Subluxation, Upper Cervical Care, Pain Management, Health Care Alternatives, and Wellness Care.

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Strained Muscle or Hernia?

I recently visted a chiropractor who actually ended up over-adjusting my hip.  After repetitive visits over the past 3 weeks it seems to be back in place.  I am still sore throuhgout the area due to the muscles and bones being worked with so much.  However, I have had an odd swelling in the lower right side of my abdomen since this has happend.  Could this just be a severely strained muscle due to the muscles overcompensating for the hip being "out"?  Or could it be worse and be a hernia?

Other notes:
-Whenever I ice the area the swelling does decrease
-The area feels like it is tugging?
-Gets worse when sitting all day
-Swelling decreases during sleep
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514494_tn?1376514748
Thank you for your question. A bulge beneath the skin in your abdomen is a typical sign of a hernia. However, a physical exam is needed to determine if a hernia is actually present.

Hernia pain generally becomes more intense throughout the day, and can worsen after standing for a long time.

If it truly is a hernia, and the bulge disappears when you lay down flat, or press on it, it isn’t an emergency case (although it could still benefit from medical attention). If, however, it does not flatten out when you press on it or lay down, this could be the form of hernia referred to as “strangulated," and is considered an emergency case.

A few questions for you… I’m not certain of your age or sex, but have you recently been pregnant? (Recent pregnancy can weaken the abdominal wall, increasing the possibility of a hernia, as well as cause stubborn hip pain)  

Does the area hurt when you cough, sneeze, lift or perform physical activities?

Have you participated in any other physically demanding activities that may cause the two problems to be distinct and unrelated?

Have you mentioned this pain to your GP or the chiropractor who addressed the hip issue?

What type of treatments/techniques did the chiropractor perform on you?

Certain chiropractic techniques are more aggressive than others. It’s possible that the increased motion applied during the manipulations stretched and pulled on contracted muscles that weren’t too happy about moving… if that's the case, the hip area could definitely be tender/sore for a few days after.

If you’re not fond of the type of adjusting you received, realize that there are many different chiropractic techniques. You may benefit from another technique. A great online resource for researching some very gentle forms of chiropractic can be found online at www.UpCspine.com.

If the pain/swelling you’re experiencing lasts for more than 10 days, it’s time to go back to the doctor – whether that’s a chiropractor or GP – to evaluate the condition more closely.

I hope this information was beneficial to you.

Warm wishes,
ART
5 Comments
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Avatar_n_tn
Thank you for responding so quickly!  

Some answers to your questions:  

Age: 24
Sex: Female
Normal Build (in case weight plays a factor?)

I have never been pregnant and currently have no chance of being pregnant for obvious reasons.  The symptoms have only shown up since the chiropractor treatment on 4/28/08.  

I have also no participated in anything strenusous for as long as I can remember.  Especially as of recent, ever since my hip hurt, I have basically just taken it verrrry easy by resting alot in fear of something else popping out.  

I have mentioned the pain to the chiropractor numerous times and he blows it off as a bladder related issue or a "pissed off  muscle".  I have not seen a GP yet since I don't have insurance (I just graduated from grad school and my new employer's benefits start on 6/1/08).  --which is why I figured I'd use this resource until I could see a GP.  

I have been a patient of this chiropractor since about March 2006, and he recommended that I would come in every semester for a "typical adjustment".  Every other session I have seen him, I've never had a problem.  So it was just a typical crack the neck, spine, hips, and leave.  He went to the Palmer Chiropractic school, if that makes any difference.  I've seen him about 4 times since he knocked my hip out...I am fairly confident that the bones are all happy now, its just some of the surrounding muscles that are tender/sore/etc.

This pain/swelling has been apparent since 05/06/08 when I went to his father (they have a joint practice) and during that time the pain/swelling has varied due to receiving a few more treatments during this time frame as well.  So should the 10 day time period still apply?  

Also I thought I should note that I do have irritable bowel syndrome and was wondering if that could be significantly flared up and cause swelling due to the numerous adjustments and stress of wondering what's going on?

Thanks again,
Tiffany
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514494_tn?1376514748
Tiffany,

I'm glad I could help. Adjustments won't exacerbate your IBS, but IBS often flares up due to stress.

In addition to this, you could have been accumulating quite a bit of stress as you finished up grad school and began looking for a job (or anticipating the start of your new job) - so that should be factored in as well.

Some chiropractors have a lot of experience with gastrointestinal problems, including IBS. You might consider consulting one near you who can provide dietary recommendations.

Warm wishes,
ART
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Avatar_n_tn
So would you say that the IBS is more likely to "flare up" than having a hernia, considering the circumstances?
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514494_tn?1376514748
Tiffany,

Given the circumstances, it's fair to suggest an IBS flare up.

Warm wishes,
AT
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