Almost all people will have back pain at some point in their life. Whether it’s due to injury, posture, or chronic issues, it’s an unfortunate reality. While you can do things like getting adjusted, stretching, practicing good posture, and making sure you’re active, sometimes it’s inevitable. It’s essential to narrow down where the problem is to address it accurately. Generally, for low back pain, the discomfort is coming from either the actual low back (lumbar spine) or the pelvis (SI joints). Being able to differentiate the origin point helps your chiropractor focus on that area rather than having a more general approach and even helps you dictate what to do at home to help yourself.

I know what my back is, what’s my SI joint?

Your SI joint, or sacroiliac joint, is the junction between your ilium and sacrum. Your ilium is what people usually think of as their hip when people say, “Put your hands on your hips.” The sacrum is what people typically think of as their tail bone instead of their coccyx, which is lower than most people realize.

You have two of these joints, one on each side, that make up the back of the pelvis. You can roughly find these by looking at someone’s “back dimples,” these are the junctions. These joints, along with the pubic symphysis in the front of the pelvis, allow the pelvis movement as we go about the day. With it being so active, there’s no wonder that sometimes it gets irritated, causing low back pain that people mistake for being in the actual lumbar spine.

Why is it getting irritated?

The sacroiliac joint can be irritated in many ways. Sitting for long periods, lots of on your feet work, poor form when lifting, the list goes on. When sitting, you rock your pelvis up and tuck your rear under you when you sit. This movement is only possible due to the SI joints allowing the sacrum to stay stable while both sides of the pelvis rock up, allowing you to sit and not be a statue. While this is fine for periods, with the advent of technology and current jobs, more and more people have sitting jobs.

Sitting puts a constant (but small) pressure on the joint, which is normal. Most muscles are continually working to keep you going, but at some point they start to fatigue. With more and more sitting jobs, the hours and days and weeks and months and years of sitting add up. When the muscles surrounding the joint eventually fatigue, the pressure gets put onto the actual joint, which is what gives the discomfort.

Active standing work and bad form usually go hand-in-hand. As things get busy, you modify your form to get it done quickly, and sometimes you lean too far to the side or lift using your back (and pelvis) instead of your legs. These problems are similar to any other type of injury, but these joints are especially vulnerable to this type of motion because of the hinge type movement of lifting.

So how do I tell?

Being able to differentiate if the lumbar spine or the SI joints are to blame for your discomfort is not so simple. Both regions can share the same referral pattern, or where you feel is discomfort, concerning where the problem is. So, you may sense the pain right off of your lumbar spine, but the problem is in the pelvis or vice-versa. Potentially it can even get hairier when you’re feeling discomfort in your spine, but there is an added muscle component. It can be muscular discomfort coming from the attempted compensation due to a reduction of movement in the SI joint.

As you can see, it can get complicated fast. That’s why it’s essential to get checked out by a licensed chiropractor qualified to find the differences between the two, so they can treat that area specifically to help get you back on your feet as quickly as possible. These are some general things that can point toward SI joint dysfunction rather than lumbar spine dysfunction if it’s a cut and dry case.

The Signs

The discomfort is usually either sharp like someone is poking a fire poker into your low back, or a dull ache that won’t leave you alone. While these are differentiated typically into acute or chronic issues based on the presentation, that is not always warranted.

The discomfort is usually brought on more by standing for long periods or leaning backward at the waist. This tenderness is due to the joint compressing while being extended. It makes sense, if something is already irritated and then you squeeze it, it’s probably not going to feel too good. It’s usually relieved by sitting or leaning forward at the waist. It’s giving the joint some room to breathe, and it’s stretching out the muscular components worked to their max.

Ironic that while sitting too much can cause SI pain, it’s also what relieves it. It is because the muscles have become weak and tired, and doing these things means the muscles don’t have to work. The same thought process behind posture and why lousy posture is usually more comfortable than good posture, but it’s a destructive self-repeating cycle the same as with lower cross syndrome.

We’ve got some more information from another chiropractor on this same topic here!

It’s important to know that these are generalities and not at all an excuse not to get checked out by a licensed medical provider to help officially diagnose the problems at hand. Here at Express Chiropractic of Frisco, we have licensed chiropractors and massage therapists to help diagnose the root of the problem and help put you back on your path.

Your first visit (with a potential 10 dollars off) includes an initial consultation to make sure you’re the right candidate. If you are, we will proceed with an exam, including orthopedic and neurologic testing, if necessary, to make sure there are no reasons not to be adjusted. After ruling that out, we will get you adjusted and make sure our massage therapist knows exactly where to focus on you specifically, so we’re all on the same page.

We can’t wait to see you!