Back Pain

What is the Sacroiliac Joint?

The sacroiliac (SI) joint is a large, weight-bearing joint located at the base of the spine, where the sacrum (the triangular bone at the bottom of the spine) meets the ilium (the upper part of the pelvis). There are two sacroiliac joints, one on each side of the sacrum. These joints play a crucial role in transferring weight and forces between the upper body and the legs, providing stability while allowing for a small degree of movement.

How Does the Sacroiliac Joint Cause Pain?

Sacroiliac joint pain arises when these joints become inflamed or dysfunctional. This can be due to several factors, including:

• Aging: As we age, the SI joints can degenerate and become more prone to inflammation and pain.
• Pregnancy and Postpartum: During pregnancy, hormonal changes cause ligaments to relax, increasing the mobility of the SI joints and leading to pain. Postpartum, the joints may remain unstable and painful as the body adjusts.
• Trauma: Injury or trauma to the lower back or pelvis can damage the SI joints.
• Inflammation: Conditions like ankylosing spondylitis can cause chronic inflammation in the SI joints.

Because the SI joint is a weight-bearing joint, it is subject to significant stress and strain, which can exacerbate any existing issues and lead to pain.

How Does Sacroiliac Joint Pain Typically Present?

Pain from the sacroiliac joint typically presents as:

• Localized Pain: Pain is usually felt in the lower back and buttocks, often on one side.
• Referred Pain: Pain can radiate down the legs, mimicking sciatic pain, and can be mistaken for sciatica.
• Worsened by Movement: Pain is often exacerbated by activities that involve weight-bearing, such as walking, standing, or climbing stairs.
• Stiffness: There may be noticeable stiffness in the lower back and hips, especially after periods of inactivity or upon waking.
• Tenderness: The affected area may be tender to the touch, particularly over the SI joint itself.

Prevalence and Causes

Sacroiliac joint pain is a significant contributor to lower back pain, accounting for approximately 20% of cases. The likelihood of experiencing SI joint pain increases with age due to the natural degeneration of the joint and the cumulative effects of weight-bearing activities over time. Additionally, hormonal changes and physical stress during pregnancy make SI joint pain fairly common among pregnant and postpartum women.

Understanding that the sacroiliac joint is a major weight-bearing joint is crucial for recognizing the impact of SI joint dysfunction. It is not just a matter of muscle strain; the joint itself can be a primary source of pain, with the muscles reacting to the joint problem. Effective diagnosis and treatment should focus on addressing the joint issue to alleviate pain and improve function.

What is Lumbar Disc Pain?

Lumbar disc pain originates from the intervertebral discs in the lower back. These discs act as cushions between the vertebrae, allowing for flexibility and shock absorption. Each disc has a tough outer layer called the annulus fibrosus and a gel-like inner core called the nucleus pulposus. When these discs become damaged, they can cause significant pain and discomfort.

Types of Lumbar Disc Problems

1. Lumbar Disc Fissures: Small tears or cracks in the outer layer of the disc, known as fissures, can occur due to aging, trauma, or repetitive stress. These fissures can cause pain and may lead to other disc problems if not addressed.
2. Lumbar Disc Bulges: A bulging disc occurs when the outer layer of the disc weakens, causing the inner core to bulge outward. This can put pressure on nearby nerves and lead to pain and discomfort, but the outer layer remains intact.
3. Lumbar Disc Herniation: Also known as a slipped or ruptured disc, this occurs when the inner core pushes through a tear in the outer layer. This herniation can compress spinal nerves, leading to pain, numbness, and weakness in the lower back and legs, often referred to as sciatica.
4. Lumbar Disc Sequestration: This is a more severe form of disc herniation where a fragment of the inner core breaks away and becomes lodged in the spinal canal. This can cause intense pain and neurological symptoms due to severe nerve compression.

How Does Lumbar Disc Pain Typically Present?

Pain from lumbar disc issues typically presents as:

• Localized Pain: Pain is usually felt in the lower back, particularly at the level of the affected disc.
• Referred Pain: Pain can radiate down the legs, often following the path of the sciatic nerve, leading to sciatica.
• Worsened by Changing Positions: Pain is often made worse with certain activities such as bending, lifting, and getting out of a chair.
• Numbness and Weakness: In cases of nerve compression, there may be numbness, tingling, or weakness in the legs and feet.
• Difficulty with Mobility: Severe pain can lead to difficulty with walking, standing, or other daily activities.

Prevalence and Management

Lumbar disc problems are a common cause of back pain, accounting for approximately 40% of cases. They are also a frequent cause of sciatica, where the pain radiates down the leg due to nerve compression. Despite the potential severity of these conditions, most lumbar disc issues do not require surgery and can be effectively managed with conservative treatments. At Riverbend Chiropractic & Wellness, we offer a range of non-surgical therapies to help manage lumbar disc pain, including:

• Chiropractic Adjustments: To realign the spine and relieve pressure on the affected discs and nerves.
• Massage Therapy: To reduce muscle tension and improve blood flow to the affected area.
• Physical Therapy: To strengthen the muscles supporting the spine and improve flexibility and posture.
• Pain Management: Techniques such as heat/ice therapy, electrical stimulation, and other modalities to reduce pain and inflammation.

By addressing the underlying issues and providing comprehensive care, we aim to alleviate pain and improve the quality of life for those suffering from lumbar disc problems.