We know Loudoun County ranks number 1 as the richest county in America! It’s obvious we’re hard workers! But I’m guessing we might just rank number one for low back pain too! Most people in Loudoun County commute an average of 32 miles one way. We all know a 32-mile commute takes at least 45 minutes or longer to travel. The same people have a job where they sit for at least six hours a day once they get to work. It’s not surprising to hear, most people in Loudoun County are sitting on average eight hours a day. All that sitting causes low back pain! Did you know, sitting also makes your back lazy??

In my 30 years of practice, I have found sacroiliac joint problems to be the most common cause of low back pain and buttocks pain. Symptoms of sacroiliac joint problems can present as the following:

  • Low back pain, below the last vertebrae (L5) in the spine
  • Tail bone pain
  • Pain in the buttocks
  • Pain in the groin
  • Pain going from sitting to standing or getting in & out of the car
  • Sensations of numbness & tingling in the legs
  • Sensation of ‘hip wanting to give away’


The sacroiliac (SI) is a joint between the sacrum and the ilium (hip bone). Although it’s not a ball and socket joint as our shoulders and hips, there still should be motion in that region. Sitting all day, causes the muscles of the buttocks to become deactivated and weak. The usual culprits are deactivated piriformis and gluteus medius muscles. I call these ‘inhibited’ or ‘lazy’ muscles. They have become lazy from sitting all day!


When we’re diagnosing Sacroiliac Joint Dysfunction, we must make sure it’s not a lumbar disc herniation. Some of the typical tests we will do in our clinic:

  • Palpate the SI to check for tenderness
  • Feel for motion in the SI Joint by asking you to raise your leg while laying on your stomach
  • Bend your knee, while laying on your stomach, bringing heel to your buttocks. Then try to bring the heel over to the opposite buttocks. Pain while doing this indicates SI joint dysfunction


Our goal is to increase motion of the SI joint and to activate the inhibited muscles of the buttocks. We do this in the following ways:

  • Chiropractic manipulation for the sacroiliac joint
  • Electrical muscle stimulation to the piriformis & the gluteus medius muscles to activate them
  • Intersegmental traction to help loosen the SI joint. (Patients refer to this as the ‘massage table’ because if feels so good!)
  • Massage therapy for all the muscles around the SI joint.


Unless you’re ready to shorten your commute or quit your job, chances are you’ll continue to have SI joint trouble. Knowing this problem won’t go away without a lifestyle change, means you’ll have to stay on top of this by doing the following:

  • Single knee to chest while laying on your back. Keep the opposite knee bent w/ your feet flat on the floor if it’s too painful to straighten. Hold this stretch for 5 to 10 sec. Do 8 to 10 reps on both sides.
  • Side to side knee rotations: Lay flat on our back with knees bent and feet flat on the floor. Slowly allow your knees to sway to one side, while keeping back anchored to the floor. Tighten the abdominal muscles muscles while doing this. Feel the stretch in your buttocks. Hold for 5 to 10 secs, then slowly return to starting position. Then repeat on the opposite side. Do 8 to 10 reps on each side.
  • Bridge Position: While laying flat on your back with knees bent and feet flat on the floor, tighten your abdominal muscles and slowly raise your hips up. Tighten the buttocks as you come up and hold for 5 to 10 sec. Repeat 8 to 10 reps.
  • Bird Dog: Get on your hands and knees while keeping your neck & back flat. Extend one arm and the opposite leg out. Tighten buttocks muscles and abdominal muscles while holding this position for 5 to 10 sec. Repeat 8 to 10 reps on each side.
  • muscle stick helps with low back painUse a muscle stick: this is a very intuitive appliance! Simply roll the stick over your sore buttocks region as if you were giving yourself a massage! Make sure you apply comfortable pressure, so you don’t bruise yourself. I like using this for about 5 minutes many times during the day. Take this to work with you!
  • Apply essential oils such as peppermint topically on your SI joint. Peppermint is a natural muscle activator and it helps relieve soreness. We only use certain brands of essential oil to ensure purity. Not all essential oils are created equal. So please ask us to recommend some for you.
  • Ask for a standing desk. Sitting all day long is just not healthy. A standing desk gives you the ability to switch it up.
  • Take many breaks: This goes along with the standing desk idea. If you’re on a call, then stand or walk
  • Exercise: 30 to 40 min of cardio 5 days a week will really help your SI joints. Cardio does NOT mean strenuous…walking counts! You can even break the 40 min up into 2 or 3 times of short bursts of exercise throughout the day!

Let’s make some changes in Loudoun County! We can still be Number 1 without lazy back muscles! Let’s be Number 1 in healthy for life, naturally!