Expert: Dr. Nekessa Remy - 4/26/2010

Question
Hi,
I woke up 2 weeks ago with severe lower back pain. It feels like extreme muscle spasms to me, right above the "butt crack" in a space about the size of a softball, sometimes across the whole back. The only time it is truly relieved is when I lay on a hard surface on my stomach with my arms tucked under my chest. My doctor said it is probably the sacroiliac but he is not positive. Since I have no heath insurance and am unemployed, I could not afford an x-ray or MRI. He suggested a couple of days rest, followed by normal activity that did not cause pain. Well, everything hurts, to certain degrees. I am still in so much pain I do not feel comfortable starting strengthening exercises yet, but I do move around as close to normal as possible. My question is this. How do I sit? Do I sit with my back straight and my legs at a 90 degree angle? What about in bed or on the soft sofa? I have been sitting on my hips, moving from one to the other, but that is very uncomfortable after a short time. Will sitting damage my spine or joints (assuming his diagnosis could be incorrect and it could be a herniated disk or something) or prevent the healing process? I am confused since standing and laying down restrict activities and one does need to sit!.
Thanks!

Answer
If this is indeed a sacroiliac joint issue, then you may want to talk to your doctor about anti-inflammatory medication to help with the pain. As long as there is inflammation there will be pain when you sit.  I would sit on hard surfaces for additional support. But you want to avoid as much sitting as possible, as sitting puts more pressure on the spine than standing. Sitting will not damage your spine, it will just irritate your symptoms.  X-rays are important. I understand that you can't afford it, but it is something you should try to save for as your health is very important. Kegal exercises are a great way to strengthen your pelvic muscles and you can do them lying down. Ask your doctor before starting.

Hope this helps