Question: I am wondering about the right way to treat pain in the sacroiliac joint from squats and dead-lifts?

I am wondering about the right way to treat pain in the sacroiliac joint from squats and dead lifts... I am nursing a pretty inflamed sacroiliac joint and experiencing some serious sciatic pain down the back of my leg due to it. All the muscles in my butt on both sides (glute medius, piriformis, etc) are in lockdown and it’s taking forever to heal up. Between the chiropractic, massage and acupuncture I am getting mixed feedback and confused as to how to get through it. One says total rest and the other says stretching and light exercise. Which one is best?

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Doctor’s Response: The first step is to verify that your pain is coming from the sacroiliac joint.

The first thing I would recommend is that you verify that your pain is coming from the sacroiliac joint. If your pain is coming from the lumbosacral spine, and not the sacroiliac joint, then the treatment is not only different, but the prognosis of the treatment is different. For instance, you have a lot of muscles that surround the lumbar spine, which can serve to bio-mechanically brace the spine during appropriate squats and dead-lifting. If your pain is really coming from the sacroiliac joint, then these muscles are of no effect. Squats and dead-lifting usually aggravate the sacroiliac joint, if the pain is coming purely from the sacroiliac joint. It sounds like you have done all the preliminary conservative measures to control this pain, so you are now to the point where you do need a diagnosis. The gold standard for diagnosis is injecting the joint or joints with a Novocain-type substance and a steroid-type substance to verify that the pain is coming from those joints, and to try to provide some relief.

I would very much recommend you see a physiatrist that is a doctor of physical medicine and rehabilitation, who can not only give you an accurate diagnosis of whether your pain is coming from the sacroiliac joint, but this professional can also provide some conservative measures plus injections to help relieve this pain. It is only after failing treatment from such a professional that a fusion would be considered.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.