How To Diagnose Iliolumbar Ligament Pain | Iliolumbar Ligament Injury

Dr Musson discusses how to diagnose iliolumbar ligament pain. Teasing out the source of lower back pain can be complicated. This is one potential cause of lower back pain. See if this is what may be causing your back pain.
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[@doreenjohnson5315]

I just found this video while searching for an answer to my lower back pain. The pain is progressing over a few years. I’m 68 and moderately active. I’m scheduled for an X-ray but I’m not super hopeful it will show anything. But my insurance will cover that as a starting point. My pain is directly behind the sacrum and radiates to the hip and buttocks. I live near Corvallis so it’s not an issue to see you at your clinic.

[@daltonvoss7693]

Right Here!!! Lifting injury. Horrible ache and instability

[@BlackStonePhysicalMedicine]

Sorry to hear! Best of luck with your recovery!

[@Mr-Chris]

This closely describes my pain in my lower right back area. I have a home office with guest bed. I find it helpful laying down in bed and lifting and resting my right leg high onto my office chair headrest. Using my left foot, I push the office chair while the weight of my body keeps my in bed. This gives me a deep stretch in this area. After stretching for a short period of time, it gives me relief.

[@mdougf]

Thank you!! I think this is what I have! How do I know what physical therapy will help this? And okay I will go to prolotherapy place here in LA

[@BlackStonePhysicalMedicine]

Usually a good physical therapist will help no matter what the underlying issue is. It's possible, if the injury is severe enough, that PT alone won't be sufficient. Either way, proper rehab is key to recovery with or without any other intervention. Sometimes if the pelvis muscles and hamstrings are very tight it will put extra stress on the iliolumbar ligament resulting on continued irritation. Best of luck!

[@ceciliarondon8584]

Can the injury shift to the other side as well? I started just with the left side and now I have it on the right as well.

[@BlackStonePhysicalMedicine]

It's not uncommon to have the issue on both sides. Sometimes pain flip flops side to side. Some folks are predisposed to injuring certain areas of the back based on their particular anatomy, so it makes sense that they may be at higher risk to aggravate both sides.

[@sheldonhagerman6324]

Describes mine well. Was doing a sit up and felt a pop in my lower right hand side. It's been a month and I'm doing much better but still can't do a sit up.

[@BlackStonePhysicalMedicine]

Very frustrating indeed. Hopefully things recover well for you. In the meantime planks can be helpful for core strengthening without stressing lower back area. Best of luck!

[@Anthonyprinciotti]

Does Iliolumbar ligament laxity contribute to SI joint instability, causing a cycle in which hypermobility of the SI joint puts extra strain on the ligament, thus continually inflaming it? I suspect that's what's going on in my case. Also, I've failed PT multiple times with different, highly-skilled practitioners, simply because doing PT inflames the ligament. Is that unusual?

[@BlackStonePhysicalMedicine]

Oh man, sorry to hear. I'm not sure if an injured ligament, either SI or IL, would contribute to the other. Sometimes I'll see folks with really just one that's problematic but many times both the SI and IL ligaments are problematic. Best of luck getting things fixed up!

[@will123345]

This describes my injury almost exactly. PT or strengthening exercises irritate the area though. How many sessions of prp are typically needed for recovery in your experience?

[@BlackStonePhysicalMedicine]

I'd say around 50% of the time we do just one. Depending on severity of injury and patient's ability to heal sometimes as many as 3 times. I've had 80 year olds have 80-90% relief with a single treatment, then some you healthy mid 20 year old require more. Hard for me to predict. Usually if someone does prolotherapy they'll require 3-6 treatments as it's not as potent.

[@nagsentorne]

Would you recommend resistance training during iliolumbar ligament injury? It’s been more than three months. Though marginally improved now, it refuses to get better and I am loosing my fitness levels. Can I get back to the gym and resistance training?

[@BlackStonePhysicalMedicine]

@nagsentorne That's very frustrating. I would be losing patience by 3 months. I would say go ahead with resistance training, just go easy on lumbar flexion based activities. If anything really flares it up, avoid that for a while. Keep working on mobility/flexibility too.

[@nagsentorne]

@@BlackStonePhysicalMedicine Thank you for the reply. Just the words I needed to hear. :)

[@BlackStonePhysicalMedicine]

@@nagsentorneYou're welcome! Best of luck!

[@bingchen5784]

How about "shockwave therapy"? Will it help?

[@BlackStonePhysicalMedicine]

I'm not a ECSW expert. If you could penetrate deep enough then sure. I think you can get to a depth of up to 2 inches with ECSW. When I inject I use at least a 3.5 inch needle and depending on the patient I may be 2 inches deep to hit the attachment. I can be deeper than that but I don't think I'm much more shallow unless someone is thin and has minimal musculature.

[@xToymachine1031]

Powerlifter here, I live in Camas WA not too far from your location of practice. I been dealing with right buttock pain for about 7 months and counting. Pain started in the Greater Trochanter and kind of moved up towards the pelvic crest, but I do get a lot of SI joint pain and feel very unstable. Si joint pain started after about 6 months in my injury. Could it be possible to have ligament damage and Memic glute pain or vice versa as suppose have a glute injury, Medius to be exact and cause SI joint pain?

[@BlackStonePhysicalMedicine]

Sorry to hear! That's a good question. Those ligaments can refer pain into the gluteal region. It's also possible to have a combination of issues, gluteal and SI. It's also possible that there are areas compensating for problem areas.

[@peterbrown954]

Im certain that this ligament is the cause of my back pain. The pain is now migrating into my groin and just recently my testicle. I have a very physical job and physiotherapy hasn’t helped at all. Do I have any other options?

[@BlackStonePhysicalMedicine]

Other than definitive treatment with PRP or prolotherapy options include very strict (every day at home or gym) pelvis mobility (hamstrings, deep rotators, hip flexors) and core strengthening to minimize the stress on the IL ligament. Back bracing may give temporary relief.

[@peterbrown954]

@@BlackStonePhysicalMedicine thanks for the reply. It’s worrying now the pain has migrated.

[@BlackStonePhysicalMedicine]

@@peterbrown954 Ya that referred pain can be tricky as it can overlap with other problem areas. Best of luck!

[@meganmerchant704]

In your experience with the people you've treated for this injury, does laying flat on their back make the pain worse? I have been struggling with very similar pain to what you described in the video for 20 years. Laying down at all is so painful. But laying flat on my back is impossible. If I do, I cannot sit up without excruciating pain in the same area you pointed out in the video. Walking helps tremendously. Ive also had chronic bilateral pars defect (l4/l5) and an on/off herniated disc since at least age 15 (first time I had a scan). But no injury ever occured. I am now 35 yr old. Nobody knows how to help me and I've been trying for years to figure it out on my own. Ive seen so many doctors who see "chronic pars defect" on my reports and say oh its nothing, no need to worry. But the stress fractures and herniated disc have been seen in every single MRI ive ever had. If it's nothing, why doesnt it ever go away 😔 Anyway, I'm so sorry for venting. Thank you for posting this video, I appreciate it very much.

[@BlackStonePhysicalMedicine]

Sorry to hear. Ya these issues are hard to diagnose since they don't show up on imaging. Everyone is different, depending on what is damaged. So pain while lying on your back could be an indicator of a ligament issue. Or it could be related to muscular tightness leading to increased pressure on facet joints. Don't give up, there are a lot of docs that do "prolotherapy" which can help. All docs have different backgrounds, experience, and training. Good luck!

[@meganmerchant704]

@@BlackStonePhysicalMedicine I appreciate your reply, thank you!

[@BlackStonePhysicalMedicine]

@@meganmerchant704 Best of luck!