Treated for a Disc Problem, but Still in Pain? The Often Overlooked Source of Up to 30% of Low Back Pain

You go to your doctor because your lower back has been hurting for weeks, or maybe even months. The pain shoots into your buttock, groin, or down the back of your thigh. A low back MRI is ordered.

The results: a bulging or herniated disc.

It seems to explain everything.

And for many people, it does. Physical therapy, medications, activity changes, or injections often bring relief when a disc is truly the problem.

But what happens when they don’t?

The MRI Doesn’t Always Tell the Whole Story

Disc changes are extremely common as we age. By 60, most people show signs of disc degeneration on an MRI - even without accompanying back pain.

So a bulging disc doesn’t automatically mean it’s the source of pain.

That doesn’t mean your doctor was wrong. MRIs provide valuable information, but they only show structure, not always the true source of pain. So when disc-focused treatments fail to bring relief, it’s worth asking:

What else could it be?

Meet the Sacroiliac Joints

One commonly overlooked cause of low back pain are the sacroiliac (SI) joints, located where the spine meets the pelvis. These joints transfer force between your upper body and legs when you stand, walk, or lift.

After a fall, a twisting injury, pregnancy, or even a minor car accident, the SI joints can become inflamed or unstable. The pain is often deep and aching in the lower back or buttock, sometimes radiating into the back of the thigh or groin.

Sound familiar?

That’s because it closely mimics symptoms  from a disc problem.

Unlike disc bulges, SI joint dysfunction usually doesn’t appear clearly on an MRI or X-rays. When both conditions exist (and they often do) the visible disc abnormality frequently gets blamed, even if it isn’t the actual source of pain.

Finding the Real Cause

At Gaylord Specialty Healthcare’s Interventional Pain Center, we often see patients frustrated by pain that hasn’t improved.

Diagnosis starts with listening to patient’s history and a targeted physical exam. If the SI joint is suspected, the most reliable confirmation is a minimally invasive, image-guided injection. If numbing the joint significantly reduces the pain, the diagnosis is clear. Anti-inflammatory medication delivered during the same procedure also provides long-lasting relief.

For many patients, identifying the SI joint as the true source becomes the turning point in finding relief sometimes after months or even years of treating the wrong diagnosis.

You Don’t Have to Live with Persistent Back Pain

Ongoing back pain doesn’t mean you have to live with it. An MRI is a powerful diagnostic tool, but it isn’t always a final verdict.

If disc treatment hasn’t helped, it may be time to look beyond what shows up on the scan.

For a timely appointment with Gaylord’s Interventional Pain Center, call (203) 284-2825 or visit www.gaylord.org/pain-center.