What if you have pain near the pelvis? 4 causes of lumbar pelvic painAnesthesiologist Jiyeon Shin, Woo

 

 

 

 

 

 

 

Patients suffering from lumbar pelvic pain come to the hospital complaining of pain in the same area, although the words vary from patient to patient, such as "pelvis pain", "hip pain", "hip pain", and "back pain". The area near the pelvis is extensive and complex with many structures, so diagnosing the cause of pain requires a number of tests. We tell you the main causes of lumbar pelvic pain and their treatment.

 

First, pain in the lower lumbar spine

 

Lower lumbar pain is a degenerative disease that can appear without a specific cause, or it can be caused by a lumbar sprain. It is located between the 4th and 5th lumbar vertebrae, which are located at the lower part of the lumbar bone, and the line where the belt is located, causes hip/pelvic pain.

 

There are three main causes of lower lumbar pain. If there is associated pain due to a ruptured disc, if it originates from the intervertebral joints of the spine and causes associated pain, it is caused by the erector muscle being knotted. And it can be a combination of these three causes.

 

In order to diagnose lumbar pain, X-rays are usually performed to check the condition of the bones, the spacing of the discs, and the narrowness of the intervertebral joints, and if you want to see more detail, MRI and CT scans are also checked.

 

Treatment of lower lumbar pain is as follows:

 

In general, initial pain associated with all joints is treated with medication and conservative physical therapy. With this treatment, simple muscle pain often improves within 1~2 weeks.

*Conservative treatment: Treatment that does not address the ultimate cause of the disease, but treats the symptoms present and expects improvement.

 

If the patient does not improve quickly or if the patient complains of severe pain, injection treatments such as extradiaphragmatic nerve block and medial limb nerve block are given priority over medication.

 

For rosacea treatment, steroid injections are sometimes prescribed, but steroid injections are recommended only within 4 times in 6 months and 6 times in 12 months.

 

In the case of lumbar pain, especially if it is degenerative, exercise as a treatment is essential. However, these treatments are non-reimbursable treatments, so you should discuss your needs with your doctor before proceeding.

 

In addition, it is helpful to do core exercises such as planks on your own.

 

Second, sacroiliac joint syndrome

 

The largest joint in the human body in the lower pelvis is the sacroiliac joint. The pain occurs a little further down than lumbar vertebrae 4 and 5, which had lower lumbar pain earlier, on the side that holds it between the pelvic bones. Sacroiliac joint syndrome is much more common in women, and up to 45% of pregnant women suffer during pregnancy.

 

The treatment for sacroiliac joint syndrome is also similar to the previous treatment for lower lumbar pain. The first is medication and conservative physiotherapy, the second is steroid and Prolo* injections, and the third is manual therapy and rehabilitation exercise therapy. Ultimately, the pain originates from the joints, so manual therapy or rehabilitation exercises are performed for the muscles around the joints that can support the joints.

*Prolo: An injection treatment that induces tissue regeneration and proliferation by injecting a substance that triggers an inflammatory response into a weakened tendon or ligament

 

Third, piriformis syndrome

 

 

The muscle that connects the pelvis to the thigh femur is called the piriformis muscle. The piriformis muscle itself can also be painful, but the piriformis muscle can compress the sciatic nerve, causing sciatica. Symptoms similar to those seen in the sacrum, back stenosis, or herniated discs can occur, so it is necessary for the doctor to take care of them in detail.

 

The causes of piriformis syndrome are divided into congenital and acquired. Eighty-eight percent of the population has a normal path, but the sciatic nerve is congenitally unusual. Not everyone is sick in these cases, but if they irritate the nerves, they need to be treated.

Or, due to an acquired fall, the muscle may be damaged or a hematoma may form, resulting in piriformis pain and sciatica.

 

Treatment options for piriformis syndrome include medications, conservative physical therapy, injections that are injected directly into the piriformis muscle to relieve tension and reduce pressure on the sciatic nerve, and sciatic nerve block if inflammation is observed around the sciatic nerve. In addition, extracorporeal shock waves, manual therapy, and stretching should be performed for preventive care after treatment.

 

Fourth, sciatic bursitis

 

 

The sciatic process, which is located at the bottom of the sacrum, is connected to the hamstrings at the bottom, and there is a bursa that looks like a water bag at the top. This is when the area becomes inflamed and causes pain.

Sciatic bursitis is usually caused by a lot of pressure and inflammation around the saddle after a long bike ride. When hamstring problems occur, bursitis can also occur. In some cases, back treatment may be required for sciatic bursitis, so it is necessary to receive a proper diagnosis through a physical examination and receive appropriate treatment.

Sciatic bursitis can be treated with anti-inflammatory drugs to eliminate inflammation and conservative physical therapy, and treatment can be performed by injecting directly into the problem area by the doctor or by checking it with ultrasound.

Since the sciatic bursa is connected by tendons, extracorporeal shock wave therapy may be available if the inflammation is not too severe or if injection treatment is not a burden.

In addition, there are various pain factors such as gluteus medius myofascial pain syndrome and hip impingement syndrome, so if you are uncomfortable with lumbar pain, it is better to visit the hospital and see a specialist before proceeding with appropriate treatment.