The sacroiliac joint can be the cause of debilitating low back and buttock pain. It can additionally be the culprit of pseudo-sciatica, which was described by Smith-Peterson in 1926. Unfortunately, in as much as muscles are the “orphan organ” in the diagnosis of chronic pain, the sacroiliac joint is the “orphan joint” in the differential diagnosis of spinal disorders and low back pain. What is more disturbing is that in order to effectively treat SIJ injury and dysfunction, one must have an understanding of both myofascial and joint dysfunction. This could easily explain the controversy in evaluation, diagnosis and treatment. Fortunately, studies in the last decade have validated that the SIJ may be the primary pain generator in up to 30% of patients reporting low back pain below the level of L5 –S1 (Schwarzer, A et. al). Other studies and physicians treating SIJ have supported this conclusion as well. [Read more…]