Low back and butt pain: The case of Sidney K, Part 1

Back pain, Buttock pain, Understanding pain / Sunday, November 1st, 2009

The case of Sidney K is a good example of this complex of symptoms that occurs in the low back and butt. She had an incident four years ago working as a nanny when a child jumped on her left shoulder and pulled it down and back, almost knocking her over. She heard a crack, saw stars, and felt sharp pain into the base of her skull. Two weeks later she couldn’t get out of bed because of pain in her left butt and low back. A Physical Therapist diagnosed a sacroiliac (SI) injury and adjusted the joint. Since then she has had spasms in her low back and butt especially when she pivots on one leg to turn quickly.

Her symptoms started with pain in her low back that went down into her butt near the SI joint deep in the soft tissue. She felt bruised. She went to PT for 5 treatments and was given pelvic tilt and core strengthening exercises to do. When she started getting stinging pain after 3-4 sessions in her left groin radiating down to the inside of her knee, she began to doubt that the exercises were helping.  Lately she had been having daily tingling and numbness that started from her groin in her her thigh and went down into her foot. She felt clicking in her hip all the time.

She had a history of a tight piriformis muscle and used to do stretches for it, but hadn’t been able to stretch lately because of the pain. There was also a history of neck pain and migranes and an auto accident 5 years ago. Most recently her hip had begun to hurt at the trochanter (the bony bump at the top side of the thigh). She came to my office because the day before she had bent to pick something up and her butt had gone into spasm. Her employer sent her in to my Neuromuscular Therapy center near Boston for an evaluation.

The next post is about her treatment and my protocol for this syndrome.