How to manage pain after reinjury of the sacroiliac joint?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am 66 years old, my height is 6 feet, and my weight is 165 pounds. I got an injury in my tailbone (left SI joint) and reinjured it after three months. Then with the arms straight in front of me, holding onto the back of a chair, I bent my back, the night later, I got a sore in my lower back and in my SI joint. When I lay on my right side, I get sharp pain at the top of the sacrum, like seven or eight out of ten. What should I do?

Please help.

Thank you.

Hi,

Welcome to icliniq.com.

I am sorry to hear about your injury.

Just a few questions to better help me answer your question. How did you first injure your SI (sacroiliac) joint? When was the reinjury later? Has the pain been constant since the second injury? Have you been evaluated by a chiropractor or medical provider? If so, did they take X-rays by chance? How would you describe the pain (sharp, dull, burning, achy)? Does anything make it better? Ice, heat, medication?

Answers to these questions should help me narrow down my recommendations.

Please let me know if you need any help.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

The answers to your questions are as follows:

1. How did you first injure your SI joint? - E-biking.

2. When was the reinjury later? - Resident doctor's assessment was too aggressive, causing injury.

3. Has the pain been constant since the second injury? - Before this third injury, there was improvement slightly. I could sit longer.

4. No X-ray - I just took a CT scan, and no abnormalities were detected.

5. How would you describe the pain (sharp, dull, burning, achy)? Does anything make it better? The right side at the point of the top of the sacrum (SI joint? or other problem) can be sharp and quite painful - I can no longer lay on my right side. This is a new injury. My tailbone and sacrum are more painful on sitting down for five to ten minutes when I have to stand up. Pain in the tailbone is quite sore while I do this. It is seven out of 10. The left SI joint was also more painful after the third incident. I must lay on this side because it causes the least pain, but it is quite painful. I stretched my back by holding the top of the chair at arms and body length. What should I do?

Please guide.

Thank you.

Hi doctor,

Welcome back to icliniq.com.

Without doing an examination, I cannot be certain of a diagnosis. That said, what you are describing sounds like a rotated sacrum. When the sacrum rotates, it can stress the SI (sacroiliac) joints, and limiting movement usually results in further pain as this is your body telling you, “something is not right.”

Do you have a chiropractor close by? I would recommend having a chiropractic evaluation to confirm the issue. Depending on the provider you see, you will get an examination, possible X-rays, and adjustments. It could take several adjustments before you return to your pre-injury status, but I would anticipate relief after just the first adjustment. I personally would recommend manual adjusting over instrument adjusting for this particular injury, but this is a personal preference, and your provider can explain which is most appropriate after your examination.

Please let me know if you need any help.

Thank you.

Medically reviewed byDr. K. Shobana

Published At October 29, 2022
Reviewed AtOctober 22, 2024

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