SI Joint Dysfunction

The Sacroiliac Joint (SI Joint) is involved in about 22% of patients with lower back pain.

The pain and dysfunction of the SI Joint is often overlooked and underdiagnosed by physicians.

The pain pattern can overlap with spine (lower back) and hip conditions.  Which is the main reason why it is often missed by physicians or physical therapists who are making a diagnosis.

Some physicians may not think of the SI Joint as a pain generator in the case of lower back pain.

It's possible that some doctors may not know about SI Joint dysfunction because they do not se it enough or treat it enough.

Patients may end up seeing multiple physicians, doctors of physical therapy or other health care providers, get multiple diagnoses, and get many imaging studies including x-ray, MRI, or diagnostic ultrasound imaging. 

The only way that true SI Joint pain can be diagnosed is by a proper movement screen typically performed by a doctor of physical therapy...

Where you (the patient) may have pain with bending, twisting, prolonged sitting, getting up from a chair, or walking up stairs. 

SI Joint Dysfunction - Self Test: "Fortin Finger Test"

The Fortin Finger Test is a diagnostic tool to help find and confirm SI Joint dysfunction. Here's how the test is performed:

The patient will point to the spot on their body that is most irritable or where they feel a majority of their current lower back pain.

Once the individual points to the location, the doctor of physical therapy memorizes the spot and allows the patient to relax. 

Five to ten minutes later, the doctor asks the patient again to point to the area where they feel the most pain.  A positive Fortin finger test is determined by when the patient twice identifies their most painful region within one centimeter of the area known as the posterior superior iliac spine.

The test is positive (+) because it shows the patient is able to consistently identify the source of pain even though some time has passed.

A positive result from the Fortin Finger Test indicates a strong likelihood that the patient is dealing with an SI Joint condition.

See the image below to see the specific area that we're talking about...

Now that you have read above, have you performed the test yourself? 

Do you have a spouse or family member who can confirm that your finger is also pointing to the same location described in the Fortin Finger Test?  Or, are you able to confirm this location by standing in front of a large mirror to see the reflection of where your finger is pointing to?

Either you have a high likelihood of your SI Joint being your source of pain, or it would be a low likelihood.

Now that you have gotten a little more clarity about your potential root cause of your lower back/SI Joint pain...

Are you at the point where you are trying to resolve it on your own?  Or, are you at your "wits end" in finding and fixing the root cause of this pain?

If you are ready to have an expert doctor of physical therapy find and naturally fix the root cause of your pain...

In a convenient manner where we travel to you...

Then, feel free to contact us by writing into the "Contact Us" form or by calling us any time 24/7 at (646)-781-8884.

"What Can I Do To Avoid Back Surgery?..."

"Is It Possible To Put Off or Prevent Back Back Surgery?..."

If you have back pain and if you met with a spine surgeon (who mentioned that you may need back surgery), you may have asked yourself one or more of these questions.

So, if you are dealing with annoying, nagging, chronic Back Pain, you may be willing to do just about anything to find comfort... or to get your pain under control.  And, that means that you probably just want to be able to return to your normal way of life, and possibly even if it means agreeing to undergo risky back surgery. 

As you know, back pain is no joke, but neither is back surgery.

We all know that back pain is very frustrating and uncomfortable to live with.  And, that's because it can get in the way of your sleep, work, daily activities, and simply living your life.  However, that does not mean that you should quickly agree to a major spine surgery such as spinal fusion (screws, plates, and big hardware that locks up your spine) or discectomy surgery (removing some or all of your flexible and soft cushion-like spine discs)!

These invasive back surgeries may or may not relieve your pain.  In fact, a bad back surgery or "failed" back surgery can leave you in even more pain symptoms and agony than before the procedure.

Therefore, it makes the most logical sense to start with and try less invasive treatments and non-surgical options first.

Below, are 5 effective tips to you can try to address your back pain naturally, safely, and non-surgically... in order to start finding and feeling the relief  that you have been searching for - once and for all.

1.) Transcutaneous Electrical Nerve Stimulation (TENS):  Transcutaneous electrical nerve stimulation, or TENS, is a state-of-the-art method for easing back pain. Sticky electrodes attached to the back and spine area send out electrical signals that stimulate the nerves. The impulses affect neural “pain gates” and/or trigger the production of endorphins. 

2.) Myofascial Release and Soft Tissue Work:  These hands-on soft tissue techniques and treatment options can benefit your back in several ways.  A skilled healthcare provider, such as a doctor of physical therapy performs manipulation of soft tissue (muscles and tendons) near the skin surface will help improve blood flow circulation in exhausted muscles, sore muscles, or in tight muscles and tendons. 

The doctor of PT may use a combination of their hands directly and/or a comfortable hand-held tool to help ease, relax, and lengthen these muscles.  This increased blood flow and fluid drainage will clear out and quickly reduce inflammation, and help heal and recover damaged tissues.  At the same time, this hands-on treatment technique decreases painful muscle spasms in the muscles.  

A firmer or stronger treatment is named deep tissue massage and goes even further.  Manipulation of deeper muscle groups can break up adhesions, masses of scar tissue that sometimes form over an injury site. Once the muscles have been freed from the scar tissue, they can function without pain and stiffness. 

Now, unfortunately, most traditional massage therapists nearby are not trained in healing back injuries, nor helping folks prevent back surgery.  Which is why a licensed doctor of PT uses these specific techniques that target and break up the adhesions. In turn, this will loosen and unbind your muscles.  Myofascial release and soft tissue work is a very important part of your physical therapy program because being adhesion-free is important for relieving pain and restoring a proper range of motion.

3.) Targeted Stretches and Assisted Stretch: Tight, rigid muscles can directly cause back pain or make existing back pain feel even worse. Stretching muscles will cause them to limber up, alleviate your pain and improve your movement. Loose muscles in the back are less likely to get new injuries as well. Typical physical therapy exercises for the back could include knee-to-chest stretches, kneeling lunges, back flexion stretches, stretching your piriformis muscle, prone press ups, and back bends.

4.) Strength-Building Exercises and Stability Drills: Back pain may be caused by structural changes such as herniated discs, spinal stenosis, or spondylolisthesis. The stronger you can make your back muscles, the more effectively those muscles can compensate for these changes. With a stronger back, you can maintain a straighter posture with less pain. Common exercises to strengthen the back include bridges, lying lateral leg raises, and partial curls.

5.) Heat and Cold Therapy: Heat and cold have their own distinct healing and pain-relieving properties. Our doctor of physical therapy may administer either technique or both techniques together (in sessions of 15 to 20 minutes each). Heat boosts the circulation, helping inflammatory substances to exit the tissues and relaxing painful muscles. Cold therapy can prove especially useful as an immediate treatment for acute back injuries or when dealing with severe muscle strain. The cold reduces inflammation and swelling while also numbing the nerves.  There is a full blog post on Heat vs Ice/Cold Therapy, if you click right here.