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sacroiliac joint

BirdbackpainBBirdbackpain Posts: 39
edited 06/11/2012 - 8:46 AM in Lower Back Pain
I was hoping someone could explain this a little for me:

I am starting to believe that I have sacroiliac joint problems instead of a herniated disk causing my pain.

Daily my pain consists of dull to sharp pains radiating into my hips, down my glutes, down my thighs and in my groin area. Lower back is usually stiff.

Other symtoms; Tight hamstring in left leg, problems getting comfortable in bed while on back and on stomach.

Here is the question. The most pain free I have been since having bad backpain was after a month of manual adjustments from a chiropractor. Ever since I have been very active by running and light weights at least 4 times a week. A couple times in the last year I have stoped going due to a knee injury and being sick. Everytime I stop doing cardio the pain increased. would this mean that my sacroiliac joint is too tight and the running/eliptical loosens it up a bit?

MircoD of L4-S1 on 3/5/2014

MRI stating either re-herniation or post-op granulation tissue- 5/16

Re-herniation confirmed, ESI on 5/29


  • Were you diagnosed as having a herniated disk causing your pain?
  • Yes I was but was never happy with my diagnosis.

    The thing is from the beginning after I hurt myself getting a snowmachine unstuck I was told by a chiropractor that I had a twisted pelvis. He done adjustments over a month of time and I felt good for about 2 months.

    Went to a ortho doctor and had a MRI done. These are the findings:

    The spinal canal is lower normal in size. The foramina and lower normal to small in size developmentally. The conus medullaris appeared normal and terminated at a normal level at T12.

    T11-12 and t12-l1 appeared normal

    at l1-2 there is a mild disc bulging slightly narrowing the thecal sac and formina.

    l2-3 is unremarkable

    at l3-4 there is a minor posterolateral disc bulging slightly narrowing the foramina. The thecal sac is not impinged apon.

    at l4-5 there is a narrowing and disc bulging. There is a mild facet degenerative change and hypertrophy on the rights. There is mild narrowing of the thecal sac and moderate narrowing of the foramina.

    at l5-s1 there is mild disc bulging. a small posterolateral disk protrusion is present on the right measuring 2-3 mm. in thickness. The disk protrusion is impinging on the rights S1 nerve root. The thecal sac is not impinged apon. There is moderate narrowing of the intervertebral foramina bilaterally more marked on the right.

    The more I read though my pain seems to be more SI than herniated/bulged.
    MircoD of L4-S1 on 3/5/2014

    MRI stating either re-herniation or post-op granulation tissue- 5/16

    Re-herniation confirmed, ESI on 5/29
  • Why are you not happy with the diagnosis??? Just curious because the MRI report seems to follow the diagnosis you were given. I'm actually suprised that your chiro adjusted you.... So you currently run?? If you do I'm amazed.... Have you been to Pt and explained your symtoms and what makes it better worse? They might be able to answer some of your questions and help figure it out....Good luck!!
  • I feel as if that was the case I would be in more pain. I run, lift weights, and am totally active except when a injury arises. As soon as I slow down on my cardio the pain slowly gets worse and worse.

    (at least this has happened in the past)

    I also do not get the shooting sharp pain that comes with most herniated disk patients. Just a dull annoying ache.
    MircoD of L4-S1 on 3/5/2014

    MRI stating either re-herniation or post-op granulation tissue- 5/16

    Re-herniation confirmed, ESI on 5/29
  • No one can say whether your bulging discs are the cause of your pain except a qualified doctor. I have SI Joint Dysfunction that flares up rather frequently. It's very different from the pain I felt from my herniated discs but that only means that it was different. For my SI Joint pain, it starts to the right or left of center of my back around the belt line and radiates from there.

    If your concerned about the diagnosis, you could seek out a second opinion or suggest to your doctor that you think this may be a problem. You could have a multitude of issues contributing to the whole. Another source to discuss SI Joint pain with would be a Physical Therapist. My therapist several years ago was fantastic in helping me deal with this issue.

  • Bird, the answer to your question is yes it's possible.

    Have you read this thread?
  • Or it could be that both are true and causing pain, or that neither are the cause of your pain, or that the original physician is correct.

    When it is so difficult for a well educated and board certified physician to diagnose these things with an MRI in front of him, it's probably unwise to do so via internet or conjecture. Why not see another orthopedist for a second opinion and ask him what he thinks?

  • As the others have mentioned, no one here can assist in verifying or giving a possible diagnosis. I have a question or two. What are your long term and short term goals in regards to dealing with your pain? What steps have you taken towards those goals? How may we assist you here at Spine Health?


  • What are your long term and short term goals in regards to dealing with your pain?

    My goal is to be healthy.

    What steps have you taken towards those goals?

    Many chiropractor visits, Ortho doctor, pain specialist which included a ESI. Dedicating my life to be healthy(I.E: eating well, working out)

    Why not see another orthopedist for a second opinion and ask him what he thinks?

    I have already put out thousands of dollars and have seen no significant improvment. Already in debt, basically im a broke college kid.

    I think its funny only ONE person has answered the ONE question that I originaly posted. I figured that the people that have had the pains that I am feeling or have seen this in their journey. Where did I ask for a diagnosis? Once again here is the question.

    Everytime I stop doing cardio the pain increased. would this mean that my sacroiliac joint is too tight and the running/eliptical loosens it up a bit?
    MircoD of L4-S1 on 3/5/2014

    MRI stating either re-herniation or post-op granulation tissue- 5/16

    Re-herniation confirmed, ESI on 5/29
  • If Chiropratic adjustments help and exercise helps then you probably have a hypermobile SI joint.
    Bird, did you read through the link I posted above?

  • BirdBackPain said:
    would this mean that my sacroiliac joint is too tight and the running/eliptical loosens it up a bit?
    Please don't get upset with folks who are trying to find a way to help you out. By asking your one question, you are asking someone to give you an affirmation on what you have yourself determined to possibly be your problem.

    Is my arm broke if the bone is sticking out through the skin?

    Anyone who answers that whether it be yes or no or even a maybe, is making a diagnosis of the problem.
    Websters said:
    Diagnosis Identifying the nature or cause of some phenomenon
    The information that we can garner from an individual asking for help, allows others the opportunity to see if they can relate or if they've had a similar experience that they can relate with. With only 11 posts since Dec of 2009 (with 4 of them in this thread alone), most members have no idea what you have been through and what suggestions may or may not have already been given.

    Folks are just trying to help as best they can within the confines of the Standards Agreement that was established by the owners of this website.

  • Sorry, I am generally not a big believer in the "chiro vs. ortho wars" debate. It doesn't mean I don't think chiro is useful. I have been to many, they were somewhat helpful.

    But when they start saying that MDs are wrong about their diagnosis, I tend to get doubts- not because MDs are always right (they aren't), but because the data the chiros have to base their diagnosis on is generally pretty sketchy- some x-rays and a view of the person's back. The Ortho generally had the X-ray also plus MRI and more.

    So, basically, an ortho has access to all of the information a chiro has access to plus more. Now, some orthos get it wrong anyway.

    And, unfortunately, there just aren't a lot of cases of diagnosed SI dysfunction on the board. It's not that common. There's one who had a severe injury with surgery, but not just a misalignment. Most of us have gone the ortho route and found that we had problems in the spine. (I didn't have to look very hard for mine ;).

    As for the deep aching, I know exactly what you're talking about. I don't know what causes it, though, because I have multiple problems. I have herniations, bulges, plus I likely also have some SI issues as well along with that poor sad broken vertebrae. In my case, I wouldn't tend to think it's an SI issue, I'd tend to think it's an issue with the fracture. Do you have any annular tears or anything like that? Just a thought.

  • Great information, Tammy :) I forgot that you also had SI joint issues.

  • What Tammy has posted describes ligament laxity or a hypermobile SI joint. Exactly what I had. Yes manipulation, either by a PT or a Chiropractor, or by stretching can ease the pain but eventually the pain comes back. Manipulation is not the best treatment.

    The only way to permanently tighten up the SI joint or any joint, and end this hell, at least it was in my case, is to get Prolotherapy injections.
    Also, over time the joint will become arthritic because of excessive motion in the joint. Prolo will reduce the arthritic changes.

  • I have SI joint issues and hip tightness and leg pain along with back pain. I previously had a herniated disc at L5-S1 with nerve impinging on the L5 exiting nerve and annular tear but now have Degenerative disc disease but still have sciatica and go for nerve blocks in my SI joints and hip and epidural(caudal) going for my 5th injections Sept.2. It's the Pain Management Dr. I see to give the spinal and hip injections and never realized the hip tightness was the route which is where the sciatic nerve is. Anyway that's my experience only. Have you seen a Pain Management Dr. yet? Unfortunately the only cardio I can do is walking briskly and a few minutes with my stepper. Take care and hope you find a Dr. to help with your treatments. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Prolotherapy is the injection of a proliferant substance to stimulate the body's intrinsic ability to heal. It addresses the degeneration or incomplete healing of injured ligaments, tendons, and cartilage. There are two general situations for the use of prolotherapy. A traumatic injury, which incompletely resolves and a repetitive stress beyond the reparative process. Some barriers to complete healing are excessive or inappropriate use of anti-inflammatory medications, corticosteroids, poor diet/malnutrition, smoking, maladaptive behaviors (poor training technique, posture, etc.), and other existing diseases which stress the body (co-morbidities).

    Prolotherapy has been known by different names, but all have essentially the same intent. Sclerotherapy is an older term which was in use when the technique was thought to create scar in reducing symptoms. Now with the increased use and efficiency of diagnostic musculoskeletal ultrasound, the effect of tissue remolding to its normal architecture has been seen, thus there has been a movement to re-name it regenerative injection treatment (RIT).

    Depending on the definition, this type of treatment has been around since Hippocrates. In its current form, prolotherapy has been around since the 1930's. The "fathers" of prolotherapy were George Stuart Hackett, MD and Gustav A. Hemwall, MD who used it to heal and cure many resistant pain cases. Dr. Hackett's book was first published in 1956 and was most recently revised in 1991. More recently, there are a growing number of scientific articles being published with slowly increasing "mainstream" support. Unfortunately, this simple, safe, cost effective treatment is considered by some to be an alternative treatment when more expensive treatments (including surgery) have greater risk with the same or worse outcomes.

    Prolotherapy should be rendered by someone with expertise in the body's anatomy, kinetics, kinematics, and detailed understanding of the injection solutions and techniques. Many individuals mentor with an experienced provider while others go to courses or travel outside the United States on charity missions. Currently, it is not taught in any United States medical school or residency, but now in 2008 it has become part of medical training in Mexico. Despite the treatment being fairly simple, it is not as basic as finding a "tender point" and injecting dextrose (sugar). Like all things in medicine, the most vital part is identifying the correct diagnosis, understanding the pathology, and choosing the appropriate treatment for that problem. The rendering of the treatment is the "easy" part.

    Injury Background and Proposed Mechanism of Treatment Action

    There is a rich supply of nerves in the connective tissue about which people including physicians, often forget. They offer feedback to determine where one is in space and different types of pain. The weakest link is typically at the attachment, but can also occur in the zone where the tendon changes to muscle (musculotendinous junction). This is the region where the pathology commonly occurs either from acute stretch or chronic overuse. When an area is injured, the body reacts with "inflammation" to "clean" out the damaged tissue and bring in the elements for repair. Anti-inflammatories (Motrin, Aleve, steroids, etc.) interfere with this healing process if used incorrectly (they are also analgesics, which is why they reduce pain). Maturation for the healing response occurs after 3 weeks and can continue for 1-3 years to obtain similar strength to pre-injury. Healing is not complete when the pain resolves or we think we can do everything again. Studies have demonstrated that after 2 weeks there are no inflammatory cells so there is not continued inflammation, but if unresolved a degenerative process (tendinitis v. tendinosis). Electron micrographs and diagnostic ultrasound evaluation of tendons demonstrates this disrupted architecture. Weak areas displace environmental stresses throughout the body and cause overload to adjacent and remote regions. This is the reason why treatment takes longer the longer the problem has been present. Muscle "spasm" is not uncommon because it is trying to stabilize the injured portion of the body. Trigger point injections (injections or dry needling into tender muscle which refers pain somewhere else) are often given to "relax" muscle and decrease pain, but if they are repetitive it is usually a reaction to the underlying pathology, not the primary problem.

    Since there is poor blood supply to most of these areas, they are at greater risk for impaired healing. The classical proliferant is dextrose (i.e. sugar). This substance stimulates healing in at least two ways. First, it is more concentrated where injected as opposed to the surrounding injured tissue. This causes water to shift from the inside to outside of the cell; leading to bursting and causing a minor injury. The cell substances as well as the dextrose itself stimulates the healing cascade of cells to clear the damage and use new substances to re-build the area (macrophages, growth factors, etc.). Rehabilitation is very important once the healing has begun to prevent recurrence. If the precipitating cause can be identified and altered, this should also be addressed.

    Typical Conditions Treated


    Tennis and Golfer's Elbow

    Jumper's Knee

    Achilles "tendinitis"

    Hip and Shoulder "Bursitis"

    Osteoarthrosis or Cartilage Damage

    Any joints, but commonly the knee


    Various location, but commonly the neck and back

    Enthesopathies (where connective tissue attaches to bone)


    Plantar fasciitis

    -A Sports Medicine Group

  • Thanks to all for the help, I really appriciate it.

    I think my next step is going to be PT. It was recommended to me back in january but around feb/march I started to feel really good so I did not go thru with it.

    Thanks again...

    OZONE, I noticed while searching for prolo doctors in my area that OZONE and PROLO go together like bread and butter. Are you a paid rep or something?
    MircoD of L4-S1 on 3/5/2014

    MRI stating either re-herniation or post-op granulation tissue- 5/16

    Re-herniation confirmed, ESI on 5/29
  • Birdbackpain said:

    OZONE, I noticed while searching for prolo doctors in my area that OZONE and PROLO go together like bread and butter. Are you a paid rep or something?
    LOL, you are very observant. I joined this board in 2009 because I was interested in getting information on Ozone Therapy, I used Ozone as my username.
    I didn't find any info here but I did consult with a Integrative Doctor who uses Ozone to treat backpain.
    I decided not to have Ozone Therapy done because I wasn't convinced that it would work, it was expensive and the doctor did not impress me.
    I then chose Prolo and have no regrets about my decision.

    The Integrative Doctor that I had consulted also used Prolo so your right about the two going together. However, I haven't found that to be the case in Sports Medicine. In Sports Medicine the doctors who use Prolo often use Platelet Rich Plasma(PRP) too.
  • Welcome to Spine-Health! :)

    I was reading your posts and wanted to share some information with you. My symptoms resemble what Dave has posted, but I wanted to share some information I have collected since I was diagnosed with SI Joint Dysfunction.

    I first want to mention that my diagnosis was made through physical examinations from my two Physiatrists and also my two Physical Therapists. I have also had the diagnostic injection directly into the SI joint, which many consider the most "accurate" method of diagnosing SI Joint Dysfunction.

    Here is a portion of what I have gathered:

    "The SI joints connect the spine to the pelvis. The sacrum and the iliac bones (ileum) are held together by a collection of strong ligaments. There is relatively little motion at the SI joints. There are normally less than 4 degrees of rotation and 2 mm of translation at these joints. Most of the motion in the area of the pelvis occurs either at the hips or the lumbar spine. These joints do need to support the entire weight of the upper body when we are erect, which places a large amount of stress across them. This can lead to wearing of the cartilage of the SI joints and arthritis."

    "The most common symptom of SI joint dysfunction is pain. Patients often experience pain in the lower back or the back of the hips. Pain may also be present in the groin and thighs. In many cases it can be difficult to determine the exact source of the pain. Your physician can perform specific tests to help isolate the source of the pain. The pain is typically worse with standing and walking and improved when lying down. Inflammation and arthritis in the SI joint can also cause stiffness and a burning sensation in the pelvis."

    "Often the most accurate method of diagnosing SI joint dysfunction is by performing an injection that can numb the irritated area, thereby identifying the pain source. An anesthetic material (for example, lidocaine, novacaine) can be injected along with a steroid (cortisone) directly into the SI joint. This is usually performed with the aid of an x-ray machine to verify the injection is in the SI joint. The anesthetic and steroid can help relieve the pain from inflammation that is common with SI joint dysfunction. The duration of pain relief is variable, but this is very useful to determine that the SI joint is the source of the pain."

    "Physical therapy can be very helpful. Pain in the SI joint is often related to either too much motion or not enough motion in the joint. A physical therapist can teach various stretching or stabilizing exercises that can help reduce the pain. A sacroiliac belt is a device that wraps around the hips to help stabilize the SI joints, which can also help the SI joint pain."

    "Unfortunately SI joint dysfunction is not preventable in some people. For many, it is an unfortunate part of the normal aging process. However, the severity can be reduced through treatment with medication, injections, or physical therapy. Maintaining a healthy body weight and good conditioning can reduce the chances of developing SI joint dysfunction and other forms of arthritis. By reducing the loads on the joints, there is less chance for cartilage damage and subsequent arthritis."

    *** Source of the information I have quoted was gathered from Jason C. Eck, Medical Author and William C. Shier, Jr., MD, FACP, FACR. ***

    I really wish I had an answer for your question, regarding how your pain seems to increase when you stop doing your cardio excercises. I can kind of relate to that. For me, it's a necessity that I do my daily stretches and exercises for the "waist down" pains I have. It's really hard for me to distinguish which pain is coming from what source, as I have too much going on from the waist down. What I do know, is that it's very important for me to do my daily exercises and stretches, and also PT and aqua therapy. If I should have a set-back and skip any of those... boy oh boy... the pain is horrible in my hips, my thighs, my IT bands, my tailbone, the SI joints, etc.

    It would be great if you could be evaluated by a board certified spine doctor and/or a Physiatrist and a Physical Therapist. My Physiatrists and Physical Therapists really know how to hone in on problem areas and I tell you... they have been right on target with their diagnoses prior to my X-rays and other tests to confirm their diagnoses.

    I wish you the best and please... keep us informed. I am very interested to hear the stories of others who, unfortunately, battle with SI joint pain.

    Take good care,

  • I have SI joint pain and have been having a lot of pain since I fill down a hill, my pelvis rotates and that cause a lot of my problem they put it back and it rotates again. TP is very helpful for mine I also toke some Corticosteroids helps inflammation and help the pain
  • for SIJ dysfunction, this is the test I was given along with an injection of pain medication, to confirm the condition. I had one PT person also tell me that alot of us SIJ sufferers can't cross their legs over the knee. Do a Google on Faber test....then try to do the simple function...if you can't..your SI joints (one or both) are the problem. I have pain still but am able to manage it after a surgical fusion. SI joints are very underdiagnosed as problem pain sources.

  • just had my wife do the faber test. My right side in my groin area hurts like hell. Thanks for the info I plan on taking this either to my ortho that I have went to a couple times or my chiropractor that has dealt with me alot.
    MircoD of L4-S1 on 3/5/2014

    MRI stating either re-herniation or post-op granulation tissue- 5/16

    Re-herniation confirmed, ESI on 5/29
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