The back pain most surgeons won't find - CNN.com

The back pain most surgeons won't find

By Dr. Nick Shamie, Special to CNN

updated 7:35 AM EDT, Wed September 18, 2013

The sacroliac, or SI, joint, bears and transfers weight and movement from your upper body to your legs.

STORY HIGHLIGHTS

• Studies show 20 to 25% of all chronic lower back pain comes from the sacroliac joint
• Most spine surgeons aren't trained to look at this joint and may miss it in a patient
• Finding out if the SI joint is the source of pain is usually pretty easy, Dr. Nick Shamie says

Editor's note: Dr. Nick Shamie is Chief of Orthopaedic Spine Surgery at Ronald Reagan UCLA Medical Center and is a professor of orthopedic surgery and neurosurgery at UCLA School of Medicine. He is also President of the American College of Spine Surgery.

(CNN) -- Tom wasn't accustomed to not knowing the right answer. A business executive in his 50s, he had been suffering from agonizing back pain for nearly two years, and all his doctors could tell him was that they couldn't find the cause or an appropriate treatment.

So Tom did what most people wouldn't -- he started researching to find a doctor anywhere in the world who could help him.

The problem, as it turned out, was that Tom's doctors were looking at his spine for the source of his pain, and that's not where it was coming from. He was suffering from sacroiliac joint dysfunction, the deterioration of the two joints on the side of the lower spine that connect it to the pelvis.

Studies have found that 20 to 25% of all chronic lower back pain comes not from the spine but from the sacroliac, or SI, joint, which bears and transfers weight and movement from your upper body to your legs. When the ligaments wear out and the SI joint becomes unstable, it can generate a similar kind of sharp back pain -- or sciatica-like pain down your leg -- as a ruptured disc.

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