All Posts in Category: General Information

Sacroiliac Joint Pain [Updated 2024]

There are many causes for low back pain that are treated here at Legacy. One common condition that can often be overlooked originates at the sacroiliac (SI) joints. They are located where the ilium of the pelvis meets the sacrum—the left and right sides of the sacrum.  Strong ligaments and muscles hold the SI joints in place and allow only a few millimeters of movement when the body bears weight or flexes forward. Arthritic and certain age-related degenerative disorders may gradually erode protective joint cartilage, which can subsequently lead to instability and pain that can mimic some of the symptoms of lumbar pathologies.

Understanding Sacroiliac (SI) Joint Dysfunction

The Role of the SI Joints

The sacroiliac joints play a crucial role in transferring weight and forces between the upper body and the legs. Strong ligaments and muscles support these joints, allowing limited movement. This movement is essential for activities such as walking and lifting. However, the SI joints are also susceptible to dysfunction, leading to lower back pain.

Causes Beyond Arthritis and Degeneration

While arthritis and degenerative disorders are common culprits of SI joint dysfunction, other factors can contribute to or exacerbate the condition:

  • Injury: A fall, car accident, or any impact that affects the lower back can injure the SI joints.
  • Pregnancy and Childbirth: The body releases hormones during pregnancy that allow ligaments to relax, potentially leading to altered joint function and pain.
  • Gait Issues: Abnormal walking patterns can place uneven pressure on the SI joints, leading to dysfunction.
  • Hypermobility or Hypomobility: Either too much or too little movement in the SI joints can cause pain.

Identifying SI Joint Dysfunction

Diagnostic Challenges

SI joint dysfunction can mimic other lumbar spine disorders, making diagnosis challenging. A comprehensive assessment is crucial, which may include:

  • Physical Examination: Specific maneuvers, such as the FABER (flexion, abduction, and external rotation) test, can indicate SI joint involvement.
  • Imaging Tests: While X-rays, MRI, and CT scans can help rule out other conditions, they may not always clearly identify SI joint dysfunction.
  • Diagnostic Injections: Injecting a local anesthetic into the SI joint is often the most definitive way to diagnose SI joint dysfunction.

Expanded Treatment Options

Conservative Approaches

  • Manual Therapy: Chiropractic adjustments or osteopathic manipulation can help alleviate pain by restoring proper alignment and function.
  • SI Joint Belts: These can provide additional support, especially during pregnancy or early stages of rehabilitation.

Advanced Treatments

  • Radiofrequency Ablation: This minimally invasive procedure can provide long-term pain relief by disabling the nerves that send pain signals from the SI joint.
  • SI Joint Fusion: In severe cases, surgically fusing the SI joint may be considered to stabilize the joint and reduce pain.

Lifestyle and Home Remedies

  • Exercise: Tailored exercises to strengthen the core, pelvic floor, and buttocks can improve joint stability.
  • Posture: Educating patients on proper posture and ergonomics can prevent further strain on the SI joints.

Recent Advancements

Recent research has focused on improving diagnostic techniques and treatment outcomes for SI joint dysfunction. Innovations in minimally invasive surgery, such as robotic-assisted SI joint fusion, have shown promising results, offering greater precision and potentially faster recovery times.


Understanding the complexities of SI joint dysfunction is crucial for effective treatment and management. By considering a wide range of causes, employing thorough diagnostic strategies, and utilizing both conservative and advanced treatment options, healthcare providers can offer relief to those suffering from this condition. Staying informed about the latest advancements in treatment can further enhance patient care.

Adding these details will provide your readers with a comprehensive understanding of SI joint dysfunction, its impact, and the multifaceted approaches to treatment available at Legacy. This expansion not only enriches your original content but also positions your blog as a valuable resource for those seeking to understand and find relief from low back pain.





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Toothache? OR Trigeminal Neuralgia? [Updated 2023]

Trigeminal Neuralgia (TN), also known as Tic Douloureux and or the suicide disease, is a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head.

Trigeminal Neuralgia is often misdiagnosed as dental pain, since pain is frequently triggered when someone chews or talks. However, pain can also occur when someone touches their face, shaves or simply feels the wind.

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Memory Loss

Memory loss is a common neurological concern. Often, mild forgetfulness is due to stress, distraction, or even depression. Though patients can experience a little forgetfulness with aging, significant changes in memory or thinking are never only attributed to age.

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Writers Cramp

Task-specific dystonia, also known as “writers cramp” can occur in people who do repetitive movements.

It gets its name task-specific because classically, it only occurs during one specific task. It can be inherited, secondary to an underlying neurologic cause, or occur sporadically.

It is often initiated by voluntary movement with symptoms “overflowing” into adjacent muscles causing involuntary muscle cramping of adjacent fingers, wrist, and can include forearm. It can sometimes resemble a tremor. The most common task-specific dystonia is writers cramp, but this also frequently occurs in musicians due to the repetitive motions of playing an instrument. Treatments range from conservative measures such as occupational therapy and stretching to Botulinum toxin (Botox) injections of affected muscles if severely limiting function.

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Numbness of the Hands

Patients frequently complain of numbness and tingling of the hands.

The most common causes include:

    • Carpal Tunnel Syndrome (CTS)
    • Ulnar Nerve Compression
    • Spinal cord compression and other conditions of the spinal cord that cause cervical myelopathy.
    • Cervical radiculopathy
    • Peripheral neuropathy.
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Smoking adds complicated risks to spinal procedures

Many surgeons, especially neurosurgeons, urge patients to stop smoking before spinal procedures, particularly, spinal fusions.


An extensive amount of research has found that smoking cigarettes prolongs the healing process and causes complications. Below is a list of problems that can arise:

  • Decreased rate of successful fusion (called non-union or pseudoarthroses)
  • Poorer clinical outcomes, including pain reduction
  • Poor rehabilitation after surgery, and prolonged healing process
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Tremor is an involuntary shaking movement, usually affecting the hands and head, but may affect any part of the body included the feet or torso.
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Bone Spurs

What is a bone spur?

A bone spur or ‘osteophyte’ is new bone that forms at the end of bones or joints. Bone spurs form in response to movement when one bone comes into contact with another bone across a joint or disk space.   Bone spurs can occur throughout the body but are common in the spine because of numerous bony joints and disks that make up and support the spine. Bone spur formation occurs to varying degrees and is expected in the aging spine but will be more common in patients that have significant arthritis.

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Parkinson’s Disease

Parkinson’s is a progressive disease caused by a decreased level of dopamine produced by nerve cells in the brain, in an area called the substantia nigra. Dopamine levels drop as the disease progresses.  Dopamine sends messages in the brain to areas that control movement and coordination. With decreased dopamine, patients have difficulty controlling their limb and overall body movement along with their emotions.

Approximately 1,000,000 adults in the USA have Parkinson’s Disease, while males have a 50% higher risk than females.

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Physical Therapist: experts in movement and function

Legacy Physical Therapy

Physical therapists are defined by the APTA as “experts in movement and function” but are very often associated with an environment in which they deal with patients who are ill or have undergone surgery. A large part of a physical therapist’s program is directed at preventing injury, loss of movement, and even surgery.

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