Low back pain will affect 90% of individuals at some point in life. It is pretty much inevitable (like taxes) that it will occur, and fortunately most of the time it resolves uneventfully.
About 5 to 10% of low back pain becomes chronic in nature. When a person is experiencing chronic low back pain, how often is an area outside the low back the source of that pain?
Several studies have looked at this question, and the answer is approximately 25% of the time. In one out of every four individuals dealing with chronic low back pain, either the hip or the sacroiliac joint is the actual source of the pain. To be fair, it may be a situation where both the low back and hip for SI joint are causing the pain in combination.
In the work up for low back pain, there are very good ways of delineating where the pain is coming from. Unfortunately, studies have also shown that slightly over 10% of the time sources of pain cannot be figured out. X-rays of a person’s hip joint can show whether moderate to severe arthritis is present. The doctor can see joint narrowing, bone spurs, and other evidence of arthritis on the films. Along with this, physical examination can tell whether the person has tenderness over the hip joint, pain with range of motion of the hip, and also whether or not there is pain outside the hip joint or down the side of the thigh.
It may be that an injection of numbing medicine into the hip joint will become necessary to see how much pain relief is achieved in the hip and low back. If an individual becomes pain-free after this diagnostic treatment, the answer is fairly obvious. The reason a hip problem can cause low back pain is if significant arthritis is present a person may be overcompensating when they walk and back pain may result.
The sacroiliac joint is located below the low back on both the right and left side of where the pelvis meets up with the sacrum. These joints contain cartilage just like others throughout the body and maintain a small amount of motion at 2 to 4 mm in each direction. When arthritis occurs and cartilage is lost, inflammation may ensue and a person experiences pain that waxes and wanes.
There are multiple ways of telling if the SI joint pain is the source of the low back discomfort. Physical examination with provocative maneuvers can help reproduce the pain.
The best way to tell if a person’s SI joint pain is causing the back pain is to perform a diagnostic injection of numbing medicine into and around the joint. If the back pain is substantially relieved, then the SI joint may be the generator of the pain. Diagnostic injections may work simply for a few days, or it may help for months.
The bottom line with studies looking at where low back pain is coming from show that in one fourth of individuals, the pain is coming from somewhere else. This should be kept in mind if low back pain specific treatments are being performed and inadequate relief is being achieved. It may be that additional treatment efforts should be focused on the hip or the SI joint to truly help relieve the persons low back discomfort.
If you are having back, hip, or SI joint area pain and live in Arizona, then the Board Certified, Fellowship trained pain doctors at Arizona Pain Specialists can help you. At these pain clinics in Arizona, the AZ pain doctors are diligent about locating the source of the pain and reducing or eliminating it.
The pain clinics in Phoenix and surrounding areas accept most major health insurance along with Medicare, Medicaid, AHCCCS, Personal Injury, Worker’s Compensation and self pay.
You do not have to live in pain as your status quo. Call Arizona Pain to schedule at a location near you today – (602) 507-6550.