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Chronic back pain - Sacroiliac joint


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Old 03-07-2016, 09:20 AM   #1
OrangeAugust
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Chronic back pain - Sacroiliac joint

Hello, I've had chronic back pain for a number of years and I recently talked to an acquaintance of mine who is a physical therapist. He asked me some questions about where the pain is and what kind of movement cause the most pain. He suspected it was the sacroiliac joint on my right side. He did a quick physical evaluation (mostly checking the flexibility of different muscles in my legs). One leg was much tighter than the other, so he suggested some stretching exercises to do at home. That seemed to help, but a couple of months later I had a problem with it after shoveling snow. Thankfully the pain only lasted a couple of days. Then last week I was sick for a day and felt bad enough that I just laid on the couch all day. At the end of the day, my lower back was pretty sore. Two days later, my back hurt so bad I had the same problems- walking, standing, sitting- lots of pain... the only relief was lying down on my back or side. After a few days now since the pain has died down, it is no longer radiating through my entire lower back, I just feel it concentrated just to the right of my spine. Anyway, why is it so chronic where it seems like anything I do can set it off? I can get temporary relief with rest and some leg stretches, but it worries me that as time goes on, the recurrence of it is much more often. Any ideas/advice/experience/tips? Thanks in advance!

Edit: In case it matters, I'm 34 years old and have been having problems since I was in my late 20s. One doctor suggested it was because I have flat feet.

Last edited by OrangeAugust; 03-07-2016 at 09:30 AM.

 
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Old 03-07-2016, 06:23 PM   #2
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Re: Chronic back pain- Sacroiliac joint

Good posture and structural alignment in general has an effect on various spinal conditions and can be a cause of many of them. Our posture begins with our feet. It is the foundation for how the spine aligns. If the base is defective, it effects the ankles, knees, hips, pelvis, shoulders and how the head is carried...just like a series of building blocks. When one is out of kilter, it throws off alignment of everything above it.

Your flat feet could be contributing to your problems, which may indeed get worse as you age. Have you noticed how you stand and sit? Do you favor one side? Do you stand with more weight on one leg, with the other leg turned to the side...the way models pose? Do you cross one leg over the other? After decades of always crossing one leg over the other, it can begin to take a toll!

It may be that your SI joints are too tight or too loose. Either one can create issues!

I would suggest that before the problem becomes chronic, take action. Get orthotics for your shoes and always wear them in supportive, flat shoes. Go to a PT or have your friend show you appropriate exercises to strengthen the muscles of your back and core. Learn to sleep on your back with something under the knees, or on your side with a small pillow between the knees. You want to support the natural curves of the spine. Learn to limit the time you spend sitting. Get up every 30-60 minutes and walk around for a few minutes. If you work at a desk, get an ergonomic chair and set up your work space to be as ergonomic as possible to protect your back.

When you have tasks that you know will cause lower back pain, like shoveling, raking, running a vacuum, avoid if possible! Otherwise break up into short work periods with breaks in between when the discs can rest.

 
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Old 03-08-2016, 08:56 AM   #3
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Re: Chronic back pain - Sacroiliac joint

Thanks a lot.
I had gone to a podiatrist about a year and a half ago because of ankle pain that appeared without a cause. He said my feet are very flat and he made custom orthotics for me. I wore them for about 6 months, and then it was summer and I wanted to wear flip-flops, so I got out of the habit of wearing them. Through speaking with people on here, and research online, there were a lot of people who said that orthotics would do more harm than good to my feet. So I stopped using them. But occasionally I wonder which is the lesser of 2 evils- not wearing them and continuing with my ankle, back, and knee problems, or wearing them and possibly suffer damage to my feet. Anyway, I haven't worn them for about a year, but I began to use them again today. The muscles in my lower legs feel tired while I'm wearing them, but I will get used to them, I guess.
I recently rearranged my workspace at work because I developed tendinitis in my wrist. So I'm paying more attention to the position I keep my hands and arms in all day, which has caused me to change my posture somewhat. So hopefully that will help my back, too.
When it comes to physical movements that aggravate it, I hate asking people for help. Like, I've really aggravated my back while shoveling this winter, and also last fall when I was cleaning up my yard (a lot of twisting motion with raking and using a leaf blower). I guess I just don't like to face the reality that there are certain things I need help with. I have this thought in my head that people will just think I'm whining when I say I need help with manual labor. Anyway, I guess that's something mental I need to get over and get more help with yard work this upcoming season.
Anyway, sorry that got so long. Thanks for your tips and advice.

 
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Old 03-08-2016, 09:53 AM   #4
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Re: Chronic back pain - Sacroiliac joint

Hi have you had any xrays or MRIS done yet to pinpoint the problem? I would think this would be the 1st step in trying to treat the isdue. Yes, wearing your ortho disc (short intervals at 1st) is a great idea but I'd want to know what's going on, what the pain generator is.

I'd see a pain mgt specialist who could ask for these test and is very versed in the muscular skeletal system. They can also pinpoint the pain problem suggest PT if necessary and maybe suggest injections. There is one they can do in the SI joint that is very successful called a radio frequency ablation dead in the nerve causing the pain. Pain mgt specialist have extra training in performing injections and use flourescope to guide them.

Cathy

 
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Old 03-08-2016, 03:59 PM   #5
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Re: Chronic back pain - Sacroiliac joint

Oh, it hadn't occurred to me that if you have been in pain this many years you had not seen a spine specialist for an accurate evaluation. That would be a good first step.

I would just comment that all orthotics are not equal. I was first sent to a podiatrist and ended up with orthotics that I wore initially, but gradually stopped wearing. Years later I developed spine issues, sciatic pain and other issues. When one compensates for pain, it eventually takes its toll.

In addition to all the medical specialists I went to, my orthopedic spine surgeon suggested I see a practioner that
Performs a form of bodywork that works with postural and structural alignment. At the first appointment, he had me stand, assessed my posture (which I always thought was pretty good!) and told me my feet were throwing the rest of my alignment off. They are somewhat flat and slightly pronated, which causes the legs to slightly rotate inward, which causes the pelvis to tip, which affects the Sacoiliac joints, etc. Again, orthotics were recommended and a pedorthist was recommended. I will never go to anyone else again for orthotics! There was such a difference. The bodywork guy is trained in acupuncture and Chinese medicine and I gradually learned from him how all this is so interrelated.. It is a shame how western medicine is so segmented. Up until recently spine surgeons wouldn't consider the SI joints as a source of lower back pain. They will treat the back and neck but aren't too interested in what might have caused the issues to begin with.

If your orthotics are properly fitted, they should help your structural alignment and posture. They should not damage your feet and you shouldn't have to choose between better feet or better back!

The idea is to strengthen the back and core so your spine will be supported properly. This should make it possible to do those chores, if down carefully and thoughtfully, and a bit at a time.

 
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Old 03-08-2016, 10:38 PM   #6
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Re: Chronic back pain - Sacroiliac joint

I had another thought. Check into the psoas muscle. It is the only muscle that connects the upper body to the lower body. We worry about building abs but most have never heard of this muscle. People who sit a lot are especially susceptible to weak psoas muscles. Sitting puts the body in a relaxed hip flexion position, with the full weight of the torso bearing down and the lower extremities inactive. This can slow blood flow, nerve response, etc, which can lead to lower back pain, sciatic type pain, poor posture etc.

When the psoas is tight it can have an effect on the SI joints, hip sockets, and glutes. You can read about it online to see if you think this may be at least part of your problem.

 
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