Question
In 2002 I had a L5/S1 discectomy after struggling with sciatica for almost a year. My pain was immediately relieved and I had no back issues until 2 years ago. In October 2009 I felt pain in my SI joint which caused lower back and groin pain as well as sciatica type symptoms. I had about 8 chiropractic treatments which eliminated 60% of the pain. About six months later all the pain disappeared. Then in November this year I felt pain in my SI joint again with pain in buttock and thigh. After 3 chiropractic sessions, the pain has gotten much worse. Getting in and out of the car, putting on socks and shoes are a problem issues. Sitting is not a problem but when I get up from a seated position, I feel quite severe pain in my buttock and thigh. Walking also causes pain in my buttock. The pain does not extend below my knee but there is a patch at the back of my leg just above my ankle that aches when I walk. I have seen 2 chiropractors who both confirmed that my SI joint is "stuck". They both confirmed that there is no muscle weakness in the affected leg. I have had another 4 chiropractic sessions and have experienced no relief. In all 7 chiropractic sessions, the only adjustment that have been done to me involved the chiropractor抯 hand over the sacroiliac joint and pressure is applied while the my  upper shoulder is tractioned backward and the knee is tractioned towards the floor. I have been advised by the chiropractors to do stretching which involves pulling the affected leg to the chest and turning it inwards towards the left shoulder which is quite tight and painful at times to do.

I am worried that I have received no reduction in pain, the SI joint is still 搒tuck?(as per my last visit 15/12/2011) and I still feel pain in the SI joint after 7 chiropractic sessions.

What is strange to me is that if I am in a standing position for longer than an hour, I find that my back muscles surrounding the si joint all around to the front of the waist tenses up and all my pain disappears while in this standing position. What does this mean? Are the ligaments loose? Would I be a good candidate for a SI belt?


Any advice and encouragement will be greatly appreciated
I am a fit 36 year old male of normal weight who goes to gym at least 3 times a week. I enjoy the treadmill and circuits but have stopped due to the pain in my thigh.

Answer
Hello David,


    You may want to have a MRI of the low back again, after surgery the joints above or below can be affected due the change in biomechanics (this may happen within 5yrs post surgery).  So a MRI will show exactly what is going on, then a proper treatment plan can be established.  When you are standing, you may be experiencing guarding (muscles tighten up to support the spine which helps relieve pressure on the joint or nerve thus a reduction in pain).  Use ice and no heat, you may want to continue low impact exercises such as the recumbent bike.

Have a great day,
Dr. Brendon O'Brien D.C.