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In The News

Julie Watkins, St. Luke's Hospital

Do I really have low back pain?

According to recent reports, low back pain is the fifth most common reason for all physician visits in the United States. It is estimated that 15 to 30 percent of patients diagnosed with low back pain actually have sacroiliac (SI) joint dysfunction.

SI joint pain is often overlooked, and it may take weeks or even months before patients receive a correct diagnosis. Women are especially at risk for developing SI joint pain due to female hormones.

The SI joint is composed of the sacrum (tailbone) and ilium (large pelvic bone) and is held together with a tough band of ligaments. Injury to these ligaments leads to excessive movement or even arthritis and can result in pain.

Symptoms of SI joint pain may mimic low back pain and can be hard to distinguish from other types of low back pain, which makes a diagnosis very difficult.

Other symptoms may include pain in the hips, buttocks, thighs or groin, pain with prolonged sitting or standing or pain climbing stairs or when going from sitting to standing.

Typically, 20 percent of pregnant women experience SI joint pain due to the production of the hormone relaxin. As production of this hormone increases, it causes softening of the ligaments to allow for childbirth, increasing movement in the area of the SI joint. More movement, along with the added stress of carrying a growing baby, can result in pain. The more pregnancies a woman has, the higher her chances of developing an SI joint problem.

Fortunately, patients have a wide variety of conservative treatment options for this type of pain. These may include bracing, physical therapy, medication (such as anti-inflammatories) and interventional pain management. Surgery is rarely ever considered or performed for this condition.

If you experience symptoms similar to those described for SI joint dysfunction and they do not resolve on their own within four weeks, contact your physician for an examination.

Julie Watkins is a physical therapist with Brain & Spine Therapy Services, part of the Brain & Spine Center at St. Luke's Hospital. To take a free back pain risk assessment, visit the HealthAware Risk Assessments page.

This article was published in the St. Louis Post-Dispatch on November 14, 2013.

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