Low back pain (LBP) can arise from a number of structures that comprise the lower back like the intervertebral disk, the facet joints, the muscles and/or tendon attachments, the ligaments that hold bone to bone, the hip, and the sacroiliac joint (SIJ). Though several of these can generate pain simultaneously, the focus of this month will center on the SIJ.

The role of the SIJ is quite unique, as it has a big job: it is the transition point between the flexible axial skeleton (our spine) and the pelvis, below which are the lower extremities or legs. The pelvis supports the weight of the torso, which usually accounts for about two-thirds of our body weight. The SIJ is shaped at an oblique angle that diverges or opens at the front and converges inwards at the back of the joint in order to support the weight on top of it. Because the sacrum/tailbone is “V” shaped, it fits like a wedge and is held together with very strong ligaments, making it an inflexible but sturdy joint.

Making a diagnosis of SIJ syndrome or identifying it as a pain generator can be a challenge. Your chiropractor may depend on several types of examinations in order to arrive at an SIJ syndrome diagnosis, such as palpation looking for pain directly over the SIJ; compression tests of the pelvis; front-to-back hip movements to stretch the joint; and imaging, such as x-ray, CT scans, and MRI.

Since the SIJ is NOT a flat and smooth oblique joint, x-ray has many limitations. However, the pubic bone called the “symphysis pubis” (SP), which is located in the front of the pelvis, can be easily seen on x-ray. Because the pelvis is a ring-like structure, an SP that is out of alignment may indicate SIJ dysfunction.

In a recent study, two independent orthopedic surgeons analyzed the x-rays of 20 consecutive patients (17 women and 3 men) with proven SIJ dysfunction and LBP (confirmed by SIJ injection testing), which resulted in the findings of osteoarthritic degeneration and subluxation (misalignment) in 18 of the 20 subjects.

When they assessed the SP in 20 non-SIJ LBP control subjects (16 women and 4 men), 7 had abnormal SP findings (35%) versus 18 of 20 with SIJ-LBP mentioned above (90%). A review of the patients’ past radiology reports found that only three reports mentioned this in the SIJ-LBP group and none reported this in the control group. The authors concluded that SP findings are underreported by radiologists, and because SP is much easier to “read” or assess than the SIJ itself, it NEEDS to be looked at!

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This is a great place.  Dr. Pommerehn was so good. I had lots of problems with my shoulder, which we tried therapy on to fix.  He explained everything in detail, and finally when my shoulder did not get completely better, he sent me for an MRI, which showed a tear.  He said I would might need surgery. No one could believe that a Chiropractor was helping me so much – I really appreciated the work that he did with me, and the honesty with which he treated me. I will definitely use this place again.
Ellen
The doctors here are wonderful. Dr Pommerehn helped me find ways to take care of my back after it had left me immobilized and unable to go to work.
Sean
I had broken my tailbone a few years ago and recently was having more pain around it. I thought surgery may be my only option, but decided to try chiropractic care for the injury and I’m so glad I found this place! Dr. Pommerehn is amazing! He was very upfront and honest during our initial exam and thoroughly explained every part of the treatment plan. Given the extent of my I injury we weren’t sure treatment would help, but his patience and treatment paid off! After a few weeks of intense treatment (three times a week) I have been able to manage the pain of this injury. I no longer have r…
Kassandra
Great service and great people.  I’ve had chronic back problems over the last 20 years and have been to a number of loop area places and Chicago Whole Health is definitely the standout.  On my first visit it was clear that their interests truly lie in resolving the issue rather than ensuring a larger number of visits (they showed me how to effectively self treat to the extent possible).  While I went there only for lower back issues, they offer a pretty expansive line of services.  I highly recommend this place to anyone.
Paul
Let me first start by saying that I was totally against any type of chiropractic care until I hurt my back earlier this year.  After some nudging from a coworker, I decided it was time to get help.  I searched for a Chiropractor in my area and the Chicago Whole Health Center came up.  I called immediately and spoke with Dr. Graham Pommerehn aka “Dr. Feel Good”!  I was truly surprised and overjoyed that I felt so much better after my first visit!  “Dr. Feel Good” worked his magic on me and did it with the best bedside manner I have ever experienced.  He is patient, gentle, funny and kind. I…
Carolyn
I have had some medical issues that I have not been able to resolve for the past few years. Having tried Western medicine and holistic methods, I decided to try out acupuncture. I was not sure where to find a good acupuncturist (other than Chinatown). I really wanted someone I could communicate my problems to and who could communicate with me so that I could understand everything. Dr. Zhao was the answer to my problems. She speaks English and some Mandarin! I had told Dr. Zhao that it was my first time to acupuncture and told her my problems.  She explained everything thoroughly to me a…
Janet