Hi Mary--
I'm not sure if I know enough about your situation to advise you
accurately, but there are some things I can tell you. Accupuncture, to
date, has not fared very well when researched for it's effectiveness in
helping with back pain. My observations in 23 years of practice have
rather supported that. A steroid shot is a rarity for treating
sacroiliac pain, and in my opinion would not solve your problem.
Maybe it would help if I clarify a couple of things, so you can ask
better questions of whomever is treating you. Pain traveling down the
leg is very, very common. True sciatica, however, is fairly rare. True
sciatica isn't just pain traveling down the leg. It must travel along
the course of the sciatic nerve, and worsen with tests that are designed
to provoke that nerve. Radiating pain is pain that travels down a known
nerve. Referred pain is different, in that it is usually vague, deep,
achy, and covers a larger area. Most leg pain, by far, is referred.
That's a good thing, though. Much more easily treated.
When you stand, your weight is resting on your ball-and-socket hip
joints. When you sit, your weight shifts to the " butt bones." This
shifting of weight is accomodated by your sacroiliac joints, which are
located under each of the two dimples you can see on most people just
below the waistline. Sitting astride a horse accentuates the weight
bearing shift caused by sitting, and if your sacroiliac joints are
locked, it will hurt to ride or to stand up from a sitting position.
Chances are your problem is mechanical, meaning you have dysfunction in
the joints of the hips and spine, and the treatment of choice is
manipulation. Exercises alone won't work. They help after treatment has
been given. The fact that your chiropractor mentions the "upper
sacroiliac joint" indicates to me that he probably knows what he's
doing. I would let him treat you until you are both satisfied, or both
frustrated, in which case there are other things to be considered. The
long range effects of not addressing the underlying cause of back pain
(for example by taking Ibuprofen and waiting out the pain) is eventual
potential damage to the other structures of the spine (discs, vertebrae,
synovial joints,ligaments) due to the wear and tear from all the
compensation that the spine undergoes trying to get you through another
day with loss of function. Being pain free mustn't be confused with a
good recovery.
I hope this helps, and remember that it only takes one chiropractor to
screw in a light bulb. But it does take 20 visits! Bruce Weary DC
