Sacroiliac Joint Dysfunction

by Maria

s1 dermatome

s1 dermatome

Pain in right lower back developed gradually after 2 to 3 years of pulling loaded wheelchairs from ground up into van up narrow ramps then lowering them at end of day to ground. Used right leg as brace to lift them and landed on right leg as chair weight pulled body forward when lowering.

When I trip or slightly jar the right side of my body my symptoms return (shortening of right leg/contraction, pain in outer right foot and right shin, altered breathing, head tightness, groin and inner leg pain) however is quickly controlled by my chiropractor who does the leg drop plus trigger point.

I believe this condition has caused significant arthritis also to the right hip and lumbar area. I have been doing the SIJ exercise on your site despite the hip issues and it is giving much relief. However the head heaviness/tightness is still prevalent, which I think may be connected to this issue also. Can you suggest something for the head tightening. Thanks.

Hello Maria,
Do three little tests for me please:
* Lying on your back pull the knee to your chest and then to the opposite shoulder, compare with other leg. What do you feel?

* Bend forwards and then backwards and then to the side. Is the naughty leg much tighter, more painful than the other leg?

* Go to C-H and do the Slump Test for Sciatica and let me know what the result is.

* A fourth. Stand on your toes on the good leg, raise the heel. Is the naughty lower leg as strong?

Let me know.

Dr B

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Dec 16, 2012
Cortisone injection?
by: Maria

Thanks - my chiropractor does keep things on an even keel. Must mention that I had a cortisone injection into SIJ and was free of pain and waking with bad heads for almost three months but have heard not so good to have too many of them.
Thank you for the informative tips on your page.
Just one thing - are there any exercises I should not be doing. My chiropractor does not mention doing any exercises just walking.

Dec 15, 2012
SIJ problem?
by: Maria

1. Unable to pull right knee to chest tight and sore - not able to cross centre line with right knee. Lower portion of right leg knee to foot angles inwards.

2, When bending forward backward and sideward naughty leg is much tighter and more painful.

3.Slump test - unable to raise right leg more than 45degrees not a lot of pain just tight with no give. Barely able to lift from accelerator to brake when driving.

4. When raising heel on left leg pain down outside of right leg not very strong.

Hello Maria,
This means that there are different things going on, perhaps interrelated, but together causing your disability. Let's look at them one by one.

1. There is fairly clearly something going on in your hip. It could be arthritis, or one of the pre-arthritic conditions like Femero Acetabular Impingement sydrome or hip dysplasia. Only an X-ray of the pelvis and a careful and thorough examination of your hip will make the diagnosis.

2. These are signs of significant nerve impingement in your lower back. That could be a grumbling slipped disc, or facet degeneration, or other. Again, X-rays and careful examination.

3. A positive Slump points to a pinched nerve in the back, confirming 2 above.

4. I'm not sure about this one. What is important is that you can raise your R heel off the ground. It's possible that you have a "crossed sciatic sign".

All in all... get started on regular back exercises every morning before getting out of bed, and start the hunt for a thorough and experienced chiropractor in your neck of the woods. These are problems that I treat on a daily basis. Mostly they respond well to chiropractic, though sometimes a good surgeon is essential.

Good luck, let us know how you get on.

Dr B

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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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