Paul in Merthyr Tydfyl, Wales asks:
"I have a sports injury to my lower back. My chiropractor tells me that my symptoms present as classic SI joint trouble. I have been having treatment for several weeks which involves manipulation of the SI joint and related soft tissue and while this certainly helps, the relief is short-lived - the piercing pain always returns with a vengeance. Should I continue with the treatment? What are the alternatives?"
T J Salih, Senior Chartered Physiotherapist at the back2normal back and neck clinic, London replies:
"If you look critically at the region your chiropractitioner has diagnosed the problem, there are two other anatomical structures that can produce similar symptoms that are very close to the SIJ, namely the L5/S1 facet joint and the L5/S1 disc.
"It is very common for people who have been diagnosed with SIJ problems, who fail to respond to treatment, to then subsequently be diagnosed with problems related to the L5/S1 segment.
"If the treatment that you are receiving has failed to help, either the treatment is wrong, the diagnosis is wrong or the problem is not curable with chiropractic treatment.
"The next stage would be to ensure that the diagnosis is correct by obtaining an MRI scan of the Lumbosacral spine. This can be used to diagnose the problem and redirect the treatment appropriately.
"It should be noted that treatment to any of these regions is often only partially successful and a holistic approach is often required using the combined expertise of a specialist sports trainer, a physiotherapist, a chiropractitioner and an Orthopaedic Surgeon before appropriate treatments can be instituted."
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