Lower Back Pain – The Biggest Overlooked Problem

Are you suffering from a back pain problem? Do you think that it might be a sacroiliac joint issue? This is a common problem that healthcare professionals frequently overlook, mainly because it’s such a unique joint to understand and check out and be able to assess and diagnose. And it unfortunately is a cause of a lot of back pain problems. It’s estimated that over half of all lower back pain problems have some sort of sacroiliac joint involvement.

Through this video today, I’m going to help you find out if you’ve got a sacroiliac joint problem, how to tell, I’m going to talk to you about treatment options that are out there, as well as what you can begin to do at home to begin to get some relief from a securely at joint problem.

Real quick, my name is Dr. David Middaugh. And I’m a specialist physical therapist at a company that I run called El Paso manual physical therapy, I’ve been helping people out with lower back pain problems. And I frequently find sacroiliac joint issues in these people and we fix them here in the clinic.

We’re pretty good at finding them and addressing problems related to them and keeping them healthy for the long term so that people aren’t having to deal with taking medications getting steroid injections, or having fusion surgeries and other related surgeries for back problems, specifically sacroiliac joint problems.

So let me tell you the number one way that you can find if you’ve got a sacroiliac joint problem. I’ve got the skeleton here because I’m going to show you just a little bit of basic anatomy so that you understand where the sacroiliac joints are. Now we’re looking at the back of the skeleton here. And here you can see the vertebrae, the bones of the spine, the bottom five are called the lumbar vertebrae, and then the tailbone right here, there’s two pieces to the tailbone. The sacrum is this big chunk. And then this little piece that moves here is the kocsis, we won’t worry about the kocsis. Just think of the sacrum right here.

The sacrum connects to these pelvis bones out of here, they have different names, we’ll call it the innominate for now, and where it connects to the sacred that the nominal word connects to the sacred. That’s called a sacroiliac joint. This bone is also called the iliac bone. So it has many names. But the joint line there is what gets involved so you can see it better on the front. There are the five bones and make up the lumbar vertebrae, the lumbar spine. And then right here is that crack for the sick relax joint. And if you look at it, it’s a huge joint is he enormous relative to the joints in the spine.

Now of course, you’ve got the discs, your joint discs are pretty big in the in the spine. But there isn’t that much movement in discs, where the most movement occurs, is in these little spaces right here. So the joints of the spine where the main movement happens isn’t actually that big Level to Level compared to an SI a sacroiliac joint problem right over here on the side. There’s a lot of movement that can occur there.

When I say a lot, there’s different directions of movement, but there’s just a little bit of wiggle relative to other joints. It’s not a very mobile joint is a move a whole lot normally, but it should have some wiggle. Now that the need to take a side note on this, because depending on what you already know about the sacroiliac joints, you might disagree with me. And that’s completely fine.

It’s a controversial topic securely, act joint some people in the medical field believe that they don’t move at all, it’s a fused joint. And then others believe that it does move because they can see it move or feel it move as well. If you’re having an sacroiliac joint problem, the way that you’ll be able to tell that it’s a secret electron problem is if you feel pain right there, it’s low. As you can see it’s part of the tailbone. So it’s kind of on the tailbone. And off to the side versus spine pain like in the lumbar spine, it’s a little higher and more central, not so much off to the side.

Oftentimes, what people say when they have a sacroiliac joint, we call it the point tests here in the clinic. Because what they do is point directly at the SI joint though, we’ll do this little turn around the set up in general and say hurts, right here, the pointing off to the side. Or maybe it’s the other side. And they’re telling us exactly which joining hurts. And then when we do as male therapist is we when we go and feel their joints, we confirm that we’re on the joint, and then we kind of poke it for them and compare set aside and they tell us Yep, you found it. That’s the spot that I pointed out earlier, when I showed you, it’s as clear as day that it’s a sacroiliac joint problem at that moment.

Now, finding the mobility unit is tricky. Finding how much the SI joint moves is tricky and it’s important for healthcare professionals to be able to do that so that they can know how to bring back motion that’s been lost and that usually is why the problem is happening there. That’s why the pain is happening there. And if the sacrum, the SI joint sacroiliac joint gets stuck in the sacrum itself can shift and move these bones can shift and move. And because this is the base for the rest of the spine moving up, if you have a shift in the base of the spine, then it can begin to affect other parts of the back.

So this this is why you see sacroiliac joint problems in combination. Often with lumbar issues, it’s kind of rare to see them just isolated one and not the other, they often affect each other and become interrelated. But I wanted to make a video today specifically on sacroiliac joint problems because there we’ve been asked by clients and friends on YouTube and people in the community here to talk about it because people that come into our clinic specifically to get treated oftentimes we talk about the sacroiliac joint. An

d me personally I’m so into it, I check it I just think in live and breathe it all the time that it’s like second nature to me. And I forget that not many health care professionals out there really don’t ever look at it really don’t ever check it. They never even mentioned the sacrum or sacroiliac joints. But you might be out there, kind of thinking maybe it’s not my lumbar spine, my low back, but it’s my low back. But it’s not quite my hips either. It’s kind of a pain in the butt behind but though not like the you know the meat of it kind of in this area right there.

That is likely a sacroiliac joint problem that you’re suffering with. And the common treatments for this that are done, if you can find a person that will pay attention to it. They’ll recommend physical therapy, which is good generally, you got to be careful with physical therapists, because not many of them really know how to assess and treat it. They’re all aware of it for the most part but figuring out the direction that a tailbone is shifted or the direction that a pelvis bone is shifted, or which joint is stuck or not stuck.

Joint can be too loose, that’s also a problem that can happen. And being able to tell that is it takes a specialist kind of understanding to tell that and then knowing how to treat it so that it is no longer stuck or that it’s stabilized and how to keep it like that for the long term. So that this isn’t a recurring thing. That definitely takes some expert help.

So be careful with which physical therapists you see make sure you ask questions beforehand. Kind of grill them I would I would look to because if you don’t get somebody who knows what they’re doing with the sacroiliac joint problems, specifically, chances are they’re going to run you through a series of normal lumbar exercises, lower back pain exercises that they might write everybody else through.

And it really truly takes a different perspective of X on exercises to stabilize and correct a problem down here in the sacroiliac joints relative to the lumbar spine. And you’ll save a lot of time if you get put with the right person and you go to the problem appropriately rather than treating a sacroiliac problem like a one bar problem.

Another thing that physicians might recommend if you see a physician about this is medications, of course oral medications. And that is good for allowing you to get through a tough time if you got to if you’re not sleeping enough or you have to work, and this is bothering you. Oftentimes this hurt with sitting. If you sit for too long the that one side will begin to bother you quite a bit.

Injections is another one. Getting steroid injections directly into the joint can be quite relieving. But it’s just a short-term solution. It’s not solving the problem for the long term once the effects of the medication the steroid injection. Once those effects wear off, then the pain typically returns if the joint is still stuck, or if it’s too loose as well. And in extreme cases, people do have surgery on the sacroiliac joint, they’ll get a fusion surgery, that’s what I’ve heard is most common.

It’s pretty rare to get those there aren’t many physicians, surgeons that I know that do that. What is more common to happen is people live with the sacroiliac joint problem unknowingly they don’t really understand they just think that it’s their back. But they haven’t seen somebody who was able to identify that it was a sick really a joint problem. And because it can shift the sacrum, it begins to change the way that the rest of the spine moves above.

And then disc herniations happen pinched nerves stenosis, arthritis, other things can begin to occur as a result of an SI joint problem. And that can create a situation where somebody might go to the doctor and they might recommend surgery because there’s a disc herniation or some compressed nerve. But really the root problem is that sacroiliac problem that never was fully addressed.

It is possible to prevent having those surgeries with the correct type of treatment to gain more motion in the joint that’s stuck or free up or gain more stability in the in the joint that is way too loose because that does happen less so but it does happen, you’re more likely to get a stuck joint and that can be freed up with certain hands on techniques, naturally, of course, and then exercises can help to create stability in the securely act joints so that it’s not becoming stuck again over and over repeatedly, I want to give you three things that you can begin to do at home to help a sacroiliac problem. If you think that you’ve got one.

Number one, strengthen the glutes and abdominal muscles. And let me just show you the skeleton why this is so important. whenever you’ve got a sacroiliac joint problem, remember the joint line, it’s right here, it’s between the sacred bone and the iliac, the innominate bones. What gives stability to these bones are the glutes, the gluteus maximus specifically, that that big glute muscle attaches along the rim of this bone as well as over the tailbone. So it crosses that joint. And if it’s adequately strong, and it’s strong enough, it can give stability to that joint on both sides.

Obviously, the other muscle that’s highly involved is the abdominal muscles on the front of the body, all those abdominal muscles attached to the rim of the bone right here and along the front of the bone right here. So they influence the position and the motion of the innominate bones here these pelvis bones. And they can create a normal amount of motion in the sacrum in the in the iliac joint back here. So between the butt muscles, the glute muscles and the abdominal muscles in the front, getting those stronger.

More than often, I’d say 99% of the time is what we’re doing here in the clinic, more often than not will read will allow you to keep the stability that you need in the SI joints to fix them for the long term so that nobody’s having to rely on medications, injections or surgery to fix this issue. A lot of people are doing exercises to free up motion back here and get rid of the sacroiliac joint problem. But some of the exercises that people do sometimes can be aggravating.

Another tip that I have for you. The second tip is to avoid exercises where one leg is going one way and the other is going opposite direction or different direction. Think like lunges for instance, when you do a lunge exercise, and one leg will go forward, the other leg goes backwards, because of the forces and pull on the bones of the pelvis, it can torque the joints that sacroiliac is quite a bit and feed into the problem.

So if you’re looking to create stability and get the muscles balanced around these joints, what you need to look at doing is exercises where both legs are doing the same thing at the same time. Kind of like squats or some similar motion. Now everybody has to walk obviously, and some people will go walk for improvement in the sacroiliac joint problem that is a good thing to do in certain situations.

But walking is an activity where one legs doing one thing and the other leg is doing the other thing. Of course it’s low intensity. So it’s a relative to like doing lunges or squats. So it may not bring on the problem right away. But if that’s your main form of exercise, that’s currently what you’re doing in an effort to free up the sacroiliac joint problem. It may be detrimental to you,. You need to rethink how you’re doing it.

Some version of a squat is typical, we’re doing another option, where you’re using your glute muscles is a bridge exercise, that one gets the glutes going pretty well. And if you do in such a way where you recruit your abdominal muscles, you get those abs to tighten up during the bridge exercise. That’s the best and we have videos on how to do that. If you go over to our YouTube channel, and you look under the lower back exercises, the lower back pain videos you’ll find plenty of different exercises and other videos to talk about lower back pain problems.

And as a side note to that we also have a program called the 28 Day Back Health And Wellness Boost Program. This program is a complete exercise program from A to Z takes you from where to start to where to finish and what to keep up long term to solve back pain problems. And now on the that program, I haven’t specifically mentioned sacroiliac joints a whole lot. And the reason being is because it’s not a commonly known topic.

If you found this video and you were googling or looking for sacredly acting problems, you’re one of the few you’ll know this isn’t something that’s commonly talked about, in even in healthcare circles tell you the truth in the public at large people that are not in the medical field, they really don’t know a whole lot about those joints. The medical professionals’ kind of are aware of that joint but don’t know much about treating it or problems with it.

So you’re getting some very specific you information here on this video. But on that 28 day back health and wellness boost program, which you can find all the details in the description here, we take you through bridge exercises and squat exercises, other glute exercises as well as abdominal exercises. And I know that that program, the 20 Day Back Health And Wellness Boost Program will create the stability that one needs back here to make sure that joint is right where it should be and that it’s moving.

Normally, they’re the same exercises that we take patients through here in the clinic. But it’s structured in such a way where you can modify the exercises to make them easier if you’re more irritable. If it hurts more right now, or harder if you feel better, and you need more of a challenge. To get that added strength to get that stability in the SI joints. Let’s get back to our list of things you can do at home.

Number three is don’t sit too long, make sure that you kind of stay active. Because the butt is right here, these bones right here in the tailbone as well. When you go to sit, you usually sit on these bones or these back here. And if you’re in a sitting position for way too long, you can begin to shove just one of these bones up a little too much more than the other one, or begin to show the tailbone in a direction that makes that sacroiliac joint get stuck again or to lose or become aggravated somehow. And so sitting too long is not a good thing.

The other compound effect of sitting too long is that when your legs are in a sitting position, so your hips are bent so that you can bend at your hips and put your butt in the chair of the seat wherever you’re at. It stretches out the glute muscles a little bit which stretch when you stretch a muscle out over a long period of time like ours like you might when you’re sitting it’s not a big stretch, we’re talking about a low level stretch, it actually is known by research to weaken a muscle.

You’re making your glutes weak the longer time that you sit. And here’s if you’re thinking I have a desktop, right? I drive for a living or if you’re having these thoughts and you’re thinking how can I get out if I really can’t, your best thing to do is to take timed breaks where you where you tell yourself every 20 minutes or every hour, whatever is appropriate for your work or your life.

Whatever you’re doing right now, get up move around so that you can get some action to these muscles back here. So you can activate them use them. So they can create the stability, stability that you need on the SI joints to securely act joints, but also so that you don’t constantly stretch them and get weaker and weaker and weaker over time.

One of the most common scenarios that we see for sacroiliac joint problems is it does tend to affect people that are older it can and frequently does affect younger people. But we see here in the clinic that it becomes more detrimental to people as they get older. Because if they’re not working out consistently and in a way that strengthens their butt muscles or gluteus maximus muscles, then they begin to lose the stability here. But when people are older, they typically spent a little more time sitting, if they haven’t been aware to work out their glute muscles, they’ll lose muscle mass back here and will actually get kind of a flat butt.

And I’ve spoken openly about this with the right patients, the ones that are I feel like won’t get offended if I tell them they have a flat butt. And then they’ll say stuff to me, like you know what I’ve noticed my butt’s kind of gotten thinner over the years, and it’s like, I don’t have anything back there anymore. And that’s a telltale sign that they’re going to just frequently lose stability in this joint, it’s going to want to get stuck.

And unless they get strength back and literally get more muscle back in that area, they’re going to have a hard time fixing that SI joint that’s really excellent for the long term. So getting more glute strength is huge. But you can combat it in the short term by just breaking up the sitting start to get up and move around a bit more.

Well hope this video was helpful for you. If you are watching this video, and you’re thinking, Oh my gosh, I need to get my sacroiliac joint checked out. I think that might be my problem or part of my problem. If it’s a lower back pain or hip pain problem, too. We’re happy to help and take a look at you and see if it’s right for you to come and see us.

The best way to get started on that is to go to the top of our website here and find the cost and availability button. And you can leave us your details there. You can also request a discovery visit what a discovery visit is. It’s a 20-minute consultation, a 20 minute visit where we’ll talk to you about your situation want to hear everything you have to say about your issue. And then we want to check it check it out.

So we’ll actually get on there and feel the joint feel the bones and diagnose the problem and then we’ll be able to tell you if we can help you or not. After that we can decide the next steps. If you wanted to hire us for treating the issue we can at that point. At the very least you’ll have the problem diagnose and you can move forward. knowing a little bit more about your issue. I hope that we can help you out I hope you can solve this issue. You can get back to doing the things that you love while avoiding medications, injections and surgery. Have a wonderful day