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. Standing does not cause pain. 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". 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) after 7 chiropractic sessions. 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
David,

Forget about the stuck SI joint.    It is not the problem, but a finding on you that very likely will always be there, and the SI joint adjustment just happens to cause whatever painful anatomy you've got going on in your lower back to get pushed around such that your pain changes.   If you had a surgery, then there is going to be scar tissue and altered lumbar joint mechanics, as well as the potential for a disc above the area to become more vulnerable to cracking, tearing, bulging or focally protruding.   Also, at the L5-S1 level, if there was only a microdiscectomy and not a full fusion, there remains the possibility that the remaining L5 disc can be the culprit for localized and referred pain simply by becoming damaged and oozing inflammatory chemicals throughout the day (this is called "chemical radiculitis").    Hugging your knee and other similar exercises are fruitless and have been shown to not change back pain conditions.   Stretching your hamstrings, e.g. with a leg out straight, also will just tug at an irritated nerve root or nerve sheath and cause the hamstring to reflexively go tight again.   This, too, has never fixed  back conditions.    From a manual treatment perspective, you should try flexion-distraction or a similar "decompressive" procedure (see my web site for a video of this).    You also should try to get some Graston Technique to work out any scar tissue in the lumbosacral joint margin, and even better if the provider can include trunk range of motion along with Graston Technique (see: FAKTR.com).     Lastly, try a few sessions of active myofascial release, or the trademarked "ART" procedure, targeting the lumbosacral zone and into the buttock and hamstring (this is the course your nerves go as they tunnel through muscles after exiting your spine).     You need to tell your chiropractors to stop looking at the stuck SI.   If the lightbulb is out, stop whacking the bulb and consider looking at the socket, wire or switch...      At the gym, avoid exercises that load up your lumbar spine:  squats, supine leg press machines where your feet are not lined up under your butt, really heavy standing calf raises (machines) where the pads are on your shoulders, and abdominal crunches - especially abdominal crunches.    Lastly, you may be a candidate for an epidural steroid injection or a lumbar facet joint block procedure.  This would be done by an interventional pain management specialist.    

I hope this was helpful.

Dr.  G