Expert: Dr. Brendon J. O`Brien, D.C. - 11/2/2004

Question
i think i have myofascial pain but i am not sure. i am now a 38 year old male who has been involved in sports and weigh training.my si joint as has been diagnosed by 2 chiropractors is definently not working properly on the right side for sure. it all started 17 years ago with a seemingly not that bad ice hockey accident that i feel a few times on hip on the side to the ice. i did go to a chiro before after the event but he did not really fix the problem. it has steadly gotten much worse over the years. first i would just get pain in the si joint area but now i get pain even sitting down not just in the si joint but in many areas around the hip and lower back. i did go to really good chiro who said that in his experience the way to get rid of alot of peoples back pains was to get the spine more moving individually. and he did in about 6 seesions get the spine more mobile but the pain has remained. i have had back x rays and the side of the hip is 6 mm shorter than the other. the pain is never ending every day i have it when i do any kinds of bending over or sitting.


my understanding is that myofascial pain just turn into a downward spiral as trigger points can further create satellite trigger points and so on. i have tried rolling on a foam 6 inch by 1 foot roller (it is under my body and my won bodyweight is used) (also have used small round objects such as glass jars) on the piriformus muscle with that leg being brought up diagonally to the opposite shoulder. it takes some shifting around to get just the right spots but i can get hit into great pain and can after playing around with it sometimes reduce the pain a bit. have also tried dry needling with electric for 15 minutes at a time. but i dont think i have found the exact spot to try it on yet.

do you have other techniques or suggestions i can try? thanking you in advance.

Answer
Hello Jii,

    If there is no arthritis to be seen on x-ray or MRI, it may be a myofascial condition.  You may want to find a doctor of chiropractic who specializes in Sports/Myofascial Injuries.  Also make sure they have experience in Myofascial Release.  You may want to try 2 or 3 doctors to find who you think will best resolve your condition.  Your home care sounds to be on track, keep stretching and working those trigger points.  You can also try body weight squats, 2-3 sets with 30 reps.  Use good form, and go below parallel with the knees to the floor to incorporate the glutes.  If thats to painful you can use a ball to place on your back and lean against the wall to take some of the pressure off.

Hope the advice helps!

Dr. Brendon O'Brien D.C.