Lower back pain due to possible Sacroiliitis

Patient

Q: I was at the chiropractors 2 days ago and was told id 5th joint out in my lower spine and the joints out above my bum cheeks, he put them back in but im still in agony sitting moving and now getting pains all over my back. does this sound right or should i get it checked?

Doctor

A:    Your description may correspond to a Sacroiliitis, this an inflammation of the bottom part of the spine, sacro-iliac joints, this may occur due to trauma, extreme movements,degenerative arthritis and in some cases is associated with some rheumatological  conditions as: ankylosing spondylitis, Behcet syndrome, Reiter’s syndrome. If you have persistent low back pain  and  sacroiliac pain, the differential diagnoses to be considered are: Hip overuse Syndrome, Iliotibial band Syndrome, Lumbosacral facet Syndrome, Piriformis Syndrome, Trochanteric bursitis, Lumbosacral radiculopathy, Sacroiliac joint infection, Seronegative spondyloarthropathy, Reiter Syndrome. Some studies show that sacroiliac pain would appear to be at least 13% and perhaps as high a 30% in patients with low back and buttock pain. I recommend that you get a thoroughly re-evaluation including physical exam and lab and imaging tests to rule out some of the conditions mentioned above (seronegative spondyloarthritis, Reiter Syndrome).

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