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Posted on 08-25-2014

Often Overlooked Cause of Lower Back Pain Following Baltimore Auto Accidents

When the general public think of me as a Baltimore chiropractor by in large they think of me for two reasons; the first is "back pain doctor" and the second is "the guy you see when you've been in a Baltimore auto accident."

Both of these statements are true and while I like to think that I do more than just treat patients with whiplash, headaches, neck pain, and back pain, these injuries do constitute the majority of the injuries that I see day to day. One of the areas that often gets overlooked as a cause of lower back pain following Baltimore auto accidents are the sacroiliac joints, or SI joints. These are joints that serve to attach the pelvis to the sacrum. As viewed from behind, these are often noted as the "low back dimples" and you can see them on yourself if you look in a mirror. I was trying to find some pictures to post on this blog but the vast majority of them are NSFW (not safe for work).

Rear end automobile crashes of only 15 mph can subject the sacroiliac joints (SI joints) to over 7000 N of force (nearly 1600 pounds of force). Despite being relatively stable joints with a lot of ligaments to hold them in place, there can be enough force with only a moderate impact to sprain these joints or even to tear a ligament entirely. (See page 118 of Dr. Croft's Book: "Whiplash and Mild Traumatic Injuries, A Guide for Patients and Practitioners"). If you click this link you can see just how many supportive ligaments serve to anchor the pelvis and the sacrum together.

Typically speaking these injuries are not that hard to diagnose. Patients who are able to point directly to one or both of their SI joints as a site of pain are usually good at describing the type of discomfort they are experiencing. Where these injuries usually go undiagnosed is in ER or Urgent Care facilities where "nothing is wrong on x-ray" and where the patient is able to ambulate into and out of the facility. A thorough history as well as a proper understanding of the forces resulting from a rear-end auto accident can usually lead the treating provider to an appropriate diagnosis.

In future blog posts I will talk about the other signs and symptoms of SI joint dysfunction as well as the appropriate treatment of such a condition.

In the meantime, if you, or someone you know, has lower back pain from a Baltimore auto accident and you want to get an opinion as to the best way to care for it, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be glad to help!

Dr. Gulitz

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