When Lower Back Pain is Not an Issue of the Spine

See your doctor with a complaint of lower back pain and their first inclination will likely be to look at your spine. Doing so is a good starting point. However, what if your doctor examines your spine and finds nothing wrong? What if the doctor rules out sciatica?

Whether or not your doctor knows enough to look at the sacroiliac joint, it could very well be the cause of your pain. Failing to look at it after finding no spinal problems or sciatica could leave the doctor with no other choice but to label your pain non-specific. Out comes the prescription pad and away you go to the pharmacy.

More About the Sacroiliac Joint

The sacroiliac joint connects the lower spine to the hips. It is one of the largest joints in the body. It is also one of the most stressed joints due to carrying so much weight and being responsible for the body’s ability to pivot from side to side. The joint even helps transfer loads as a person moves, stands up, sits down, etc.

All of this is to say that sacroiliac joint disease is a common cause of idiopathic back pain. Where a GP or primary care doctor might describe a patient’s lower back pain as having no known cause, a pain medicine specialist will take a good look out the sacroiliac joint in the absence of a spinal issue or sciatica.

More About the Condition

Sacroiliac joint disease is more of a condition than an actual disease. It can be brought on by a wide variety of factors. More often than not, it is the result of some sort of injury or trauma. Things that can trigger sacroiliac joint disease include:

  • prolonged heavy lifting
  • prolonged sitting
  • sports injuries
  • car accidents
  • standing, walking, or jogging on hard surfaces.

Whatever the cause, the condition is the result of some sort of injury to the joint. It can be exacerbated by anything else that directly affects the sacroiliac joint. This includes pregnancy and childbirth, osteoarthritis, and scoliosis.

Symptoms and Treatment Options

Patients dealing with sacroiliac joint disease can experience a variety of symptoms. The most common is lower back pain felt on only one side of the back. Another common symptom is sciatica. If a doctor suspects the condition based on patient complaints, one way to test for it is to manipulate the back to see if doing so changes anything.

Because the joint itself is so difficult to get to, manipulating the back should not provide any sort of relief. This is a signal to the doctor to move on to diagnostic tests that might include MRI, CAT scan, X-ray, etc. A positive diagnosis generally results in a highly conservative treatment to start with. Patients are advised to rest as much as possible. They are advised to avoid strenuous activity that could cause additional inflammation.

Sacroiliac Joint Injections

At Lone Star Pain Medicine in Weatherford, TX (, sacroiliac joint injections are presented as an option when more conservative treatment doesn’t offer enough pain relief. The injections combine and anesthetic and steroids to offer both immediate and long-term relief.

Pain medicine doctors will often turn to fluoroscopy as a tool to improve the efficacy of sacroiliac joint injections. Fluoroscopy helps by allowing doctors to see exactly where the medication is being injected. Choosing the right injection site is critical to achieving pain relief.

Lower back pain is often a spinal issue. But when the spine is checked and no issues are found, the sacroiliac joint is worth looking at.

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