T Nation

Low Back Issues


#1

I've been in and out of the chiropractor for around a year now. No matter what I do I can't seem to get my SI joint to stay in place. It comes out all the time and I have to constantly get adjusted. The muscles around it are chronically tight causing it to pull out of place when I move around. My left leg is 7mm shorter than my right so I have a lift in the heel of my left shoe. Does anyone know of any stretches or exercises that may help with the stability of the Sacro-Iliad hip joint?


#2

Have you had any deep tissue massage therapy? This can be painful, but may be a more problem direct than treating the mechanical symptoms. You will need anti-oxidants and NSAIDS to get the best healing response to the deep tissue work. Stretching will be important during the healing response. Some massage therapists might be a great resource for stretching and exercises.

Deep tissue work can release a lot of histamines leading to blurry vision, puffy face and congestion. You might want to have some benadryl or other allergy product on hand if you have those effects.

Any history of prednisone?

Using fish oil or other EFAs -which have some anti-inflammatory properties?


#3

Toradol is a very strong anti-inflammatory that may help decrease inflammation and help you be more responsive to stretching and deep tissue massage, its not recommneded to be used longer then 5 days, also recommend some liver protections like NAC/n-acetyl cysteine.

Its difficult to get the right diagnosis with back pain. I tried facet joint injections with cortisone and a local anaesthetic and i got instant relief from my back pain as well as alot of other funny aches and pains throughout my hips, shoulderblades etc, alot of different muscles not directly involved are affected in lower back pain, try and compensate for other muscles not working etc especially in chronic back pain like yours. Facet joint injections are not just a treatment but a dianostic tool, if they dont work then you start looking for other causes like disc problems etc.

cheers


#4

I have pretty much this exact problem, plus a bunch of herniated discs. I was experiencing utter misery with the SI joint several months ago that prompted me to try this:

http://www.somatics.com/page7.htm#BACK%20BOOK

Although the "somatics" stuff may sound new agey and weird, I knew that most of my pain was caused by muscle spasm which is controlled by the CNS and resistant to any kind of stretching (or foam rolling, soft tissue work, adjustments, etc.). I also knew that the spasm was caused by L5-S1 pressing on the left nerve root. I did not need to see a doctor to figure this out, because the pain and spasm were through the whole dermatome of that nerve root, all the way to the foot. The left piriformis was the worst culprit, but I had a whole pattern of muscles on the left side of my body in spasm. However, even if you don't have radiating pain/spasm, you probably have a very similar problem at the disc.

Soft tissue work provided temporary relief, but the spasm would always return. For my doctoral work in cognitive neuroscience, I had studied the motor system, and I thought the attention-sensation-contraction method of this somatics stuff was consistent with how the motor system works, and thus worth a try. It eliminated the persistent spasm in my left piriformis that caused so much misery. For the month or so I did the relevant routines (module 2A The Wiggling Jig), I actually had new pains in new areas, but I could tell I was on the right track. My SI joint is in a different state now and pain-free for the first time in many YEARS.

I bought the e-book and audio files shown in the above link. The audio files were a must, because some of the movement combos have too many different steps to remember after simply reading them.

I did 2 other postures at this time which also helped the cause of my problem, from Pete Egoscue's Pain Free book. I pictured in my mind what particular posture would cause L5-S1 to press on the left nerve root. Then I looked for a posture (not really a movement) that would push that disc back to where it belongs. I don't have the book with me now because I am traveling, but I will identify the postures when I get home if you're interested. I consider this book essential for anyone who has pain.