What's Causing the Low Back to be so Painful?

(posted 7/9/2018)

There are a multitude of pain generators in the lower back: Muscles, joints, discs, nerves, or commonly, several of these factors combined.

In my opinion, one of the most commonly overlooked joint complexes in on-going lower back pain is the Sacroiliac Joint or SI Joint.

Why is this SI joint commonly overlooked? 

For starters, it typically does not have a positive finding on x-ray or MRI which are common diagnostic tools to investigate low back pain. 

Also, it can mimic referral pain of Sciatica or nerve pain.

Common symptoms may include pain at the base of the back into the top of the buttock area, usually one-sided but can be both, or can alternate.

It can refer a diffuse, achy type pain through the butt into the thigh, but typically stops by the knee, sometimes extending into the top of the calf.

The SI joint can also refer pain from the lower back around the hip and into the groin region. 

A lot of patients with SI joint pain have problems with sitting for periods and frequently have to switch positions while sitting.

Also, the sit to stand movement can feel very stiff and often may feel like the back won't straighten out. Sometimes it feels better once start walking for a bit, but too much standing and walking will tighten the lower back up across the belt line. 

If there is presence of any of these signs and symptoms, consideration of the SI joint complex as a primary pain generator should be made.

The good news is, the SI joint(s), as painful as they can become, typically respond very well to non-invasive treatments like care we provide in our office.

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Brandon Blood