Low back and SI Joint Pain

by Jamie
(USA)

While I was in physical therapy, end of last year, my therapist told me that she thought my coccyx and sacrum were straightening out making my lower back straigthen out, hips unaligned. What does that mean? What is that called?

A pain management tech told me that I also have facet syndrome, I guess I asked him the right question because everyone else has been telling me that my xray's and mri scan from last year of my lumbar spine are normal,(still waiting on my results from a recent mri of my lumbar spine and pelvis).
I have been in physical therapy and failed numerous times, and I've seen a chiropractor in AK who told me to, "Just cancel all the appts made and not go back." Since adjustments only helped for less then a day. I will be getting RA testing in the next few days.
But other then being told I have facet syndrome, per se failing: P/T, chiropratic care, and massage therapy, I am not getting any real answers.
I do know that I have a lumberized S1, shooting pains down legs, sometimes numbness and "falling asleep" in my legs (more then right side then the left), sudden sharp intense pain in my right SI joint/hip area that causes me to fall while standing, sometimes if the pain is really bad I can't walk unless assisted (after the pain level has decreased), if I stand my right shoulder is lower then my left and my hips are not aligned, when I sit I can feel I am sitting on my tailbone. I am in pain managment, orthopedic care (recently), and seeing my PCM regularly. Reading before, I was in physical therapy. Had phsyical therapy off and on since 1999. And seen a chiropractor last year. So I am getting help, just not answers or a diagnosis (...yet).

Hello Jamie,
Thank you for your question. There is I'm afraid no easy answer.
Sacral anomalies can be the devil, and often in such cases various different chiropractic treatments need to be tested. One person reacts well to manipulation on one side only, another not at all to manipulation. One to Thompson drops, another to activator treatment, or perhaps McManus traction. Each case has to be treated on its merits. So, what's needed is a thinking chiropractor, and a patient patient. I treated just such a case this morning. The lady in question is vastly better than when she first consulted me a year ago, but a small wrong movement, stepped backwards over a box, has set it off again.

What always helps is a set of gentle back exercises, sensibly done. With a facet syndrome there may be pain with a pelvic tilt, on extension, so it needs to be gently and carefully done.

The fact that chiropractic has helped for a day is encouraging, but obviously more needs to be done. A lift in your shoe, on the short leg side may be vital and sometimes can be the solution to years of pain. Type "leg length inequality" into the search this site facillity at C-H.

At the end of the day, if no treatment helps, then you have to think of helping yourself. Go for a walk every day, perhaps start swimming regularly, lose weight if that's necessary, do the back exercises very faithfully (see "lower back exercises" at C-H), avoid things that you know aggravate your back... try and avoid chronic medication.

Perhaps try a different chiropractor who uses different techniques. I wish I could be more helpful but clearly yours is a tough case. The kind of challenge I enjoy, but you don't live on my doorstep!

I'm afraid I haven't a clue what straightening out of your coccyx and sacrum means. Gobble-dy-gook.

Good luck, and keep in contact.

Dr B

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Jun 24, 2011
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by: Jamie

Thank you for replying, I actually got a call today from my Doctor. I have degenerative disc disease and facet disease both from my L4 to my S1. Still waiting on my report from my Xrays I had done yesterday and my RA test results. I am relieved that I am finally getting answers, but not so happy about what answers I am getting. I feel like I am too young to be getting this type of arthritis (27). But Degenerative arthritis runs in my family on both sides. I am most definately going to try to get more exersize and movement in my daily life. Thank you for your help.
~~jamie~~

Reading throught the casefiles at C-H you'll soon realise that most of our patients have arthritis. That doesn't mean that have untreatable and intractable pain. Far from it.

Punch "chicken bones" into the search this site facillity at C-H. Eat from fatty fish too, or take omega-3. Good luck.

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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