[hrishikesh.ganu]

#11911

Dear Dr. Corenman,
I’m a 34 year old male. I have the following symptoms since 3months:

1. Dull “bony” aching ( 3/10) in the upper sacrum ( in the region bounded laterally by the sacral ala and bounded between the superior articular processes from top )
2. The pain first started as a bony ache in the region of the left sacral ala just below the superior articular process. T
3. Earlier, the bony ache used to be follwed by muscle stiffness in my buttocks ( bilateral) and legs but now the stiffness is typically confined to the buttocks and the lower back. The stiffness is not constant but typically comes on after the bony aching sacral pain
4. One thing that I noticed is that the pain comes on after walking for more than 30-40 min and/or on standing for a long time. Sitting feels much better ( almost no pain) and lying down supine makes the pain vanish
5. I also had Vitamin D deficiency (level 5ng/ml) and Osteopenia/Osteomalacia but my level is 35ng/ml now
6. I visited an Orthopeadic doctor who ordered a lumbar spine x ray with AP and lateral views. The radiologist summarized it as “esssentially normal lumbar radiograph”. It had other details like disc space conserved and lordosis maintained

My questions:

1. The location of my pain is in the sacrum but could the Sacroiliac joints be a source of my pain?
2. Could I have suffered a sacral stress fracture( Vitamin D was low and I had Osteopenia at the time symptoms started)
3. My symptoms indicate lumbar stenosis based on your site(pain on walking/standing releived by sitting=flexion preference) but the only difference is I have no radicular pain at all either going into legs or into the sacrum-just a dull ache
4. What course of action would you recommend? I’m currently doing knees to chest exercises for 30 secs x 5 times and also curl ups

[Donald Corenman, MD, DC]

#11912

Sacroiliac joints can be a source of pain but rarely are painful. There is a disorder called spondyloarthropathy that can cause this pain. Look at “slideshare” on the internet as I had placed a lecture regarding this disorder on that service.

I have seen one sacral stress fracture in the past but obviously they are rare. An MRI will diagnose this injuries.

The most common source of this pain is most likely degenerative disc or facet disease.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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