Question
I'm a 24 year old female and have had pain in my buttocks, hip and around the SI joint for almost four months. I saw a doctor after the first week of symptoms who prescribed a ten day course of anti-inflammatories. After this course I had only slight discomfort deep in the buttocks but the pain returned full force about 2 weeks later. I then got x-rays which were normal and saw a sports science physician about 4 weeks later who diagnosed me with sacral-iliac and piriformis pain and said that one could be causing the other. He also prescribed rest and anti-inflammatories and sent me to a physiotherapist. The physio did deep tissue massage and used some kind of electronic device on the muscles and advised stretching. After therapy I felt pain free but still couldn't cope with high impact exercise, the pain returned after a few weeks. While visiting family I went to a new physio who used dry needle therapy and she advised I go to someone in my home town who specializes in rehabilitation. This is who I'm seeing now, he thinks I'm hypermobile and told me I didn't need to stretch so much and gave me a number of core exercises to do. He also strapped the sacro-iliac joint which seems to help. I felt great after the first few sessions with him but experienced acute pain again after two weeks for no reason I can pinpoint.

I can't understand why the pain keeps recurring after it seems to be getting better. I'm wondering if there is something crucial that could be missing from the diagnosis. I haven't mentioned that I get frequent urinary tract infections and I've heard these can cause infection in the SI joint. Is this a possibility or would the specialists I've seen have been easily able to out-rule this? Are there any other reasons why I could be taking so long to heal?  

Answer
Frequent UTI's wouldn't necessarily lead to infection in the SI joint; however, any internal problem can manifest as back pain.  If you haven't seen a chiropractor, you may want to.  Physiotherapists will exercise you and exercise you, but, if there is a misalignment problem that wasn't seen (MD's, when reading xrays are not looking at the mechanics), then exercising the "bad" will not help. You can feel better, then worsen again.  It sounds as if this is the case.