February 2005 I was in the gym doing an assisted squat on a smith machine and hurt my back, it was not the first time. I have hurt my back several times in the past, the first time I remember hurting it was when I was about 15 years old and I was working at a grocery store. I am not sure what happened, but I must of leaned the wrong way to lift something, the next 2 days I could not move. It healed on it’s own and I was okay within a week. Another time I hurt my back was snowboarding at Sunshine Mountain in Alberta, this time about 23 years old. I was going down the hill and slightly moved one way and I felt my lower back. It was fine that day, later the next day I was in severe pain. I went to my first chiropractor, Dr. Fox in Calgary, he was wonderful, he got me back on my feet in no time at all (a couple weeks) with muscle therapy, adjustments and stretching, that was probably about 2-3 years ago now.
Last February I went to the physiotherapist (or called physical therapist in the USA) until about mid or the end of April the same year. When I stopped seeing him I felt I had my full range of motion back. July 2005 my back started hurting again, but due to no incident this time. It would just feel stiff and uncomfortable when I got up in the morning. It now has progressed over time, now I cannot stand for over a couple minutes and lying flat causes me extreme discomfort. I went to a chiropractor in Vancouver a couple of times (only went a couple times because I moved to the California) and saw no great improvement. I moved in USA in November with my now husband and did not treat my back, lack of medical insurance, and worry that we were not covered, and expense. Lloyd felt it would be much too expensive to go and we could not afford it so I did not. I tried to continue stretching, but it did not seem to help, nonetheless I continued. Now sleeping also causes me discomfort and I wake up due to the pain after about 6 hours. Finally in March I went to the doctor and found out I was covered if referred for a few visits. She referred me to the chiropractor, who I went to see for about 7 visits in about 4 weeks time. I did not feel any better when I finished, she did mainly adjustments. I went back to the doctor and was referred to a physical therapist, who I went to see for 8 visits in 4 or 5 weeks, again feeling no real improvement at the end of treatment. The physical therapist did stretching, muscle work/massage. Seeing little to no improvement she recommended that I return to my doctor to see what was next.
I went to the doctor this afternoon (my regular doctor is away so I saw a different one, but still very pleasant lady). She has now recommended me to a physiatrist. She said… a physiatrist is in between a physical therapist and a orthopedist. An orthopedist would mainly be able to recommend surgery, and if I needed it would perform it, but if not would not be able to do much for me. She said for a person my age we want to avoid surgery at all costs and a physiatrist would be able to do some injections to decrease the inflammation in the area bothering me. She did examine me and said that it did not appear to be in my spin, so I was not to worry about spinal problems, but it seems to be in the joints next to my tail bone, the sacroiliac joints. She thought it could be Sacroiliitis, an inflammation of these joints (which is what my doctor in Vancouver thought it possibly might be in October but recommended a new bed, stretching and yoga).
Injections sound scary to me! I am wondering if I have gotten to the point and need this type of treatment or maybe I just need more physical therapy time? I am returning to Canada in September for some coursework, which I made my doctor aware of, she said I would at least be able to see the physiatrist once maybe twice before I leave. I asked if I should have an MRI or Xray done, and she gave me an order for one just in case it was something else and said they would call me once they received the results.
In the USA there is a limit to how much physical therapy and chiropractic you receive. Being on an HMO plan, I am entitled to 6-8 visits maximum. I cannot help but wonder if I continued to go to the physical therapist for another month would I get better? When I was injured last February, it at least took 15 or more visits (2-3 months worth!) before I left okay. However, if I was in Canada I do not think I would ever get to a physiatrist, and if I was finally recommended to one, which would be after at least 6 months of physical therapy that was going nowhere, I would then be put on a wait list for 6 months minimum to a couple years to see a physiatrist. So is the USA to quick to jump to a conclusion and should I be continuing to see the physical therapist, or is it indeed time to step it up to a physiatrist and Canada is too lax?
I am going to go through with it and see the physiatrist while I am in the USA, maybe this is indeed the treatment I need? But I am not going to be quick to get the injections if the physiatrist suggests them, being scared of needles and apprehensive about such an invasive therapy. Returning to Canada in September I will again have no extended medical for chiropractic treatments, which run at minimum $35 a visit. Lloyd being thrifty will probably want me to wait to see if we can get some kind of coverage before seeing anyone. My girlfriend Ali has seen a chiropractor in Victoria who did wonders for her, but wondering if mine is too far gone, or perhaps we she has a different problem with her back. I hope to try Ali’s chiropractor when we return if I still am in pain, if we can afford it of course. I am at the point where I think I am doomed to live with his pain for the rest of my life, and also think I am too young to have back pain, how did this happen?
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Julia, don’t give up! You are *not* going to have back pain forever. It’s great that you are seeing a physiatrist. It’s a great speciatly — they are not quick to recommend drastic, invasive procedures. It was a physiatrist that first helped me. Even the injections that they sometimes recommend are simple, out-patient procedures.
Back pain can take such a long time to heal that it feels permanent. But even at my advanced age, I have healed quite a bit. My upper back problem (neck), which has always been bad, gives me very little pain these days. And the lower back problem, which was acute when it happened but not as bad as the neck, is now totally healed. Most of my improvement was from doing the stretches religiously, even when I was frustrated by slow or apparent lack of progress, and by doing strengthening exercises with *very* light weights and stretchy bands.
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“Lloyd being thirty will probably want me to wait to see if we can get some kind of coverage before seeing anyone.”
Thirty or thifty? Don’t playa hate
You seem resigned to this pain being permanent and requiring invasive treatment.
I think it you believe in physiotherapy and your body, that will work.
Yoga can actually be hard on the back. It is important to get some good material or hook up with a good professional with whatever treatment you choose.
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Coleslaw: lol, thanks Dyl, I did mean “thrifty” (I changed it). You and your brother always seem to notice my typos/spelling mistakes, hehe. I have tried chiropractic and physiotherapy in the past, believed in it, and it has worked. I feel the same about it now however, feel that I have subborn muscles that take a little longer to heal (which the US system does not allow for). I am going to continue to seek treatment until it gets better. I have had acunpunture before, and think that may be an alternative too. Thank you for your advice and spell checking. p.s. Did you mean “if” instead of “it” in your 4th paragraph?
Vera: thank you for your encouragement. It gave me hope to read your experiences with back and neck pain, that I too could be healed one day! I hope that day is not too far in the future for me. I look forward to being able to exercise like I used to. Before I was injured in Feb’05, I had a goal of doing a triathlon, maybe I will be able to eventually realize that goal if my back heals (it is okay too if I do not, it would just be nice to feel that fit again).
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An interesting study from San Diego shows that special exercise can help to treat sacroiliac joint pain of the lower back.
Move your hands from the top of your pelvis at your sides around to your back where you will feel a bump just to the side of your spine. That’s the sacroiliac joint where your pelvic bones attach to your spine. If it hurts to touch that spot and when you bend forward or backward, you probably have sacroiliitis. This research shows that people with sacroiliitis have an overactive gluteus muscle in the buttocks below that painful joint and an overactive latissimus dorsi muscle in the back above the sacroiliac joint on the other side. Special rotary exercises that strengthen the latissimus dorsi on the other side and leg press exercises that strengthen the gluteus muscle on the same side were effective in controlling back pain in the sacroiliac joint.
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Thanks Dyl, that is helpful. I am already doing those exercises, and was debating stopping some weights, I am now focusing on keeping my core/abs tight so I do not put any added stress on my back. It may be I have not been doing them long enough, or may be I have not strengthened those muscles enough to take some of the load off my sacroiliac joint to reduce the pain.
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Pingback from Benefits of exercise « Julessilver on April 6, 2007 at 5:42 pm
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desperate to find some info out there about sacroiliitis, and came across your blog. i feel hopeful that i will get better after reading some of the comments made. i’m gonna try the suggestions of coleslaw with the streghthening exercises. if it’s any help, i find that with more and more stretching, i can see some improvement of my sacroiliitis. my abs are toned, and so is my back, however, until i injured myself 3mos ago, i rarely if ever stretched. try stretching, i think it will help you as it has helped me. gb
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SIJ dysfunction is very common disorder. SIJ pain is just one symptom of many it can cause. And usually the pain is on the healthy side. You don’t believe? When you get an upslip of ilium it moves up compared to sacrum and usually rotates too. That lifts hip bone too and the rest of the leg has to follow. When standing and walking you have to get that leg touching the ground so you have to twist your pelvis so that the leg at upslipped side can reach the ground. That way your sacrum is leading to the upslipped side. But your upper body has to lean to the other side to keep the body in balance.
So as far as 80% of your body mass can be carryed by the other side SIJ with every step you take. So eventually muscles and ligamenst get tired and cause cramps and pain, sometimes even inflammation. And also on that side the nerves are more compressed bacause the scoliotic curve of lumbar causes more pressure on that side. It is not always like this but most cases are. Many other subluxations of pelvis can happen too and they can cause different posture and functional changes.
And medical sudies tell back pains are in 70-80% of the cases on the longer leg side. They just think that length difference is anatomical. Even if you look from X-rays there can be length difference because pelwis is twisted and iliums are not equally positioned so other femur is closer on z-axis than other, but on 2-dimensional picture you don’t see the z-axis. You see only 2D prjection of 3D world and that can shorten other leg easilly 1-2cm depending of the picture angle.
Some say SIJD is mostly women’s disorder. They are right, but many men have it too. About 80% of people have it causing them many different Muscular Skeletal Disorders. For women it is easier to happen because their pelvis is buld to give up easier. So smaller trauma can cause them upsplips, subluxations etc. And after giving birth those problems arevery common…
Most common SIJD case is upslip: Other ilium has moved out of it’s natural range and got stuck because of a trauma, fall, slip, or other accident. usually it is also rotated forward (anteriorly). When stuck it has no schock elimination and all those forces from down to up go to spine and causes countinuous stress there: wear and tear of spine and discs.
When pelvis is not functioning symmetrically it stresses the spine. There you get scoliosis, extended lordosis, wear and tear in discs and vertebra. Also altered pelvic ring posture causes piriformis tightening, ischias, leg weaknes, muscle imbalance, back muscles tightening, bad body posture, neck problems, shoulder problems,.. And to legs not only hip problems but also knee, ankle, achilles and many others too because it changes the way you walk.
But because the pain usually comes after yers of walking with SIJD that is difficult to diagnose. The trauma that caused it is so far in history. And it is not only a disorder for adults but also for children too. To children it causes ie. idiopathic scoliosis. See those pictures they use describing scoliosis: 9 out of 10 have pelvic bones malaligned. They say scoliosis causes that. But if your pelvis is not levelled the spine can not be straight. Can it? It was corrected from me at the age 35 by pushing it back by one old doctor. I had had mild scoliosis, short left leg and unleveled pelvis for all my life. Not any more!
And when they diagnose that rotation scoliosis, it means your other ilium is more forward than other (upslip and anteriorly rotated). It causes that twisting force to lumbar spine. And up in shoulder level you willingly fight against it trying to compensate that twist…
And when you have both SIJS upsipped you will get very exteded lordosis and you walk like Donald Duck …This was a short message about SIJD and I am just an exSIJD patient who has interviewed hundreds of other similar patients and few experts who really knew how to help by correcting the problem.
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Trying to get ahold of the Expatient to see who he saw to help him. Please contact me
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I have read many of your articlels in various other places throughout the year. And have actually seen many people linked to the websites you attached. Please contact me
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I am also curious who he saw. I believe I have SIJD, and I have been at a loss about how to treat it. I have bee suffering with it for about 4 years now. If anyone knows possible treatments, would you mind passing the info along.
thank you so much -
How to contact you?
Or did you already contact me? -
Hello Jules,
Your article really caught my attention because I have had a somewhat similar experience.
In 2002, I also injured my lower back by doing power squats with far too much weight (and not warming up). Ever since I have had lower back troubles which continue to this day, and which I feel at times, will never heal.
I also live in Vancouver and am concerned with wait lists to see specialists and the amount of coverage we are permitted. I am also frustrated with the lack of support and help we are given.
Six years later, my pain has returned in a bad way. Very chronic and debilitating. The doctors have ruled out structural damage (vertebrae misalignment) through X-rays, although I am having a bone scan done next week to reaffirm any cracks or fractures. Has your doctor recommended you have this done?
You may have suffered spondylolisis(thesis) which is a stress fracture to your lower vertebrae (pars) from squatting, and allows vertebrae to slide over each other. Apparently, I don’t suffer from this, but it is worth looking into. I will also be referred to a physiatrist, but this will take ages to get an appointment.
For me, physiotherapy, chiropractic and even prolotherapy havent helped, but I might suggest looking into prolotherapy for your case. I have also started trying intramuscular stimulation (IMS with needles), but to this end, no benefit has been established.
About these injections you speak of. Are you talking about cortisone? I havent had this done yet either, but may come as a last resort for pain management. I am still not sure whether my pain derives from joint/bone issues or muscle/tendon problems.
The lower back is a hard one to treat, and the longer it takes to cure, the more desperate we become for answers. Like you, I also can’t afford to spend a fortune looking for that answer either, but I also don’t want to be doomed to a life of pain.
After your squatting injury, did you have trouble standing upright? Are your lower back muscles permanently tense or spasming? Can you pinpoint the exact location of your pain with your finger or does it spread done to your hips and legs? Do you ‘feel’ that more of the pain is in the bones or in the muscles? Did you ever wear a lumbar support after your injury?
I am beginning to think my problem might be more of a muscular-neuropathic problem in which IMS should be the solution.
Feel free to contact me if you ever have questions or want to share experiences. -
Ask you docto to give you Embrel, this injection will fix the problem once and for all! Good luck, I know exactly how you feel.
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