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OTHER LUMBAR SPINE INJURIES

Comprehensive treatment for sacroiliac joint pain, piriformis syndrome, vertebral fractures, and coccydynia. Proprietary procedures pioneered by Dr. Deukmedjian — not available at other spine centers.

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  • 95%+ Pain Elimination
  • 1-3 Days Recovery
  • No Hospitalization
Man sitting with highlighted spine in orange, indicating back pain.
Sacroiliitis
Piriformis Syndrome
Vertebral Fractures
Coccydynia

Condition 01

Sacroiliitis

Inflammation of the sacroiliac joint — the most common cause of SIJ pain and the leading cause of sacroiliac joint dysfunction. The third most common cause of chronic lower back pain.

What Is Sacroiliitis?

Arthritis of the sacroiliac joint caused by trauma. There are two SIJs connecting the spine to the hips. Forceful injuries tear the ligaments, allowing excessive movement and chronic pain.

Causes & Traditional Treatments

Traumatic injuries to the pelvis from falls, sports injuries, or motor vehicle accidents destabilize the joint. Over time, it becomes unstable and deteriorates into arthritis. Traditional treatments include physical therapy, anti-inflammatory medications, steroid injections, heat, ice, and emerging therapies like stem cells or PRP—though benefits are temporary.

Diagnosis

Focused physical exam of the joint. X-rays, CT scan and MRI may be helpful, but diagnosis is mainly clinical. Nerve blocks can confirm the SIJ as the actual pain source.

Deuk Plasma Rhizotomy®

Pioneered in 2023 by Dr. Ara Deukmedjian. Uses a small probe to permanently destroy pain nerves. Band-aid incision, no hospitalization, 95%+ success rate. Not the same as radiofrequency ablation (RFA).

Treatment Comparison

Deuk Method

Traditional

Procedure

Plasma Rhizotomy

Fusion Surgery

Incision

Band-aid size

Large incision

Success Rate

95%+

Variable

Recovery

1-3 days

Months

Hospitalization

None

Required

Understanding the Sacroiliac Joint

Sacroiliitis, or inflammation of the sacroiliac joint, is the most common cause of sacroiliac joint pain and the leading cause of sacroiliac joint dysfunction. Trauma is the leading cause of sacroiliitis. Traumatic injuries to the pelvis can occur with a fall, sports injury or motor vehicle accident. Once the sacroiliac joint is injured it becomes unstable and deteriorates over several years resulting in lower back pain to the side of the butt crack.
There are two sacroiliac joints (SIJ) located in the lower back. The sacroiliac joint connects the spine to the hips. The SIJ is a large weight bearing joint and can be injured easily with forceful injuries to the pelvis or hips. Strong ligaments hold the sacrum to the iliac bones and normally prevent excessive movement at the joint. Forceful injuries tear the ligaments and loosen the joint allowing excessive movement and this can result in pain.
A man's lower back with an X-ray view highlighting hip joints in pain with red flares.

Diagnosis & Traditional Treatment Limitations

Diagnosing sacroiliac joint pain requires a focused physical exam of the joint. X-rays, cat scan and MRI can be ordered and may be helpful at times, but the diagnosis is mainly based on the clinical exam. Occasionally, a nerve block is needed to confirm the sacroiliac joint is the actual source of back pain. These diagnostic tests are performed routinely at Deuk Spine Institute. At Deuk Spine Institute the diagnosis and treatment of sacroiliac joint pain is well established and performed daily.
Traditional treatment of sacroiliitis (sacroiliac joint arthritis) includes physical therapy, anti-inflammatories, pain medication, injections, heat and ice, creams and even stem cells or PRP. These treatments may help for a short time but usually wear off and the pain returns. Episodes of sacroiliac joint pain can be disruptive to daily routines and lead to unnecessary suffering.
Illustration of a spinal procedure with highlighted nerves and surgical instrument.

The Deuk Plasma Rhizotomy® Solution

Deuk Spine Institute pioneered a proprietary new treatment to permanently eliminate sacroiliac joint pain in over 95% of cases by using a small probe to destroy the pain nerves to the painful joint. This procedure is called the Deuk Plasma Rhizotomy® for the sacroiliac joint. This procedure was pioneered at Deuk Spine Institute in 2023 by founder neurosurgeon, Dr. Ara Deukmedjian MD.
The Deuk Plasma Rhizotomy® is the safest, most effective and durable treatment for sacroiliac joint dysfunction. It is not the same as an RFA (radiofrequency ablation). Now, there is no need for complicated surgery or fusion, Deuk Plasma Rhizotomy® is performed with a band aid incision under anesthesia and no hospitalization or down time. Most patients return to work within 1-3 days after the procedure.

Condition 02

Piriformis Syndrome

Lower back or hip pain from an injured piriformis muscle deep in the buttock. The 4th most common cause of chronic lower back pain and 2nd most common cause of sciatica after lumbar spinal stenosis.

Symptoms

Pain deep under the gluteus muscle. Severe tenderness to touch. Because the sciatic nerve passes under the piriformis, leg pain, numbness, tingling and weakness are possible.

Root Cause

Always begins with a tear across the belly of the piriformis muscle, which originates at the sacrum and inserts onto the hip’s greater trochanter. Occurs when bending to lift while twisting at the waist. Common in deconditioned individuals with poor body mechanics.

Conservative Treatment

Muscle relaxers, anti-inflammatories, steroid or Botox injection, therapy and rest. May help mild symptoms early on but rarely resolves completely without treatment.

Deuk Piriformis Muscle Release®

Minor surgical procedure available only at Deuk Spine Institute. Most doctors don’t know how to diagnose this condition. Now curable with proper treatment.
⚠️ Important: Most doctors don’t know how to diagnose piriformis syndrome, and many don’t know of its existence. More invasive treatments available elsewhere cause major side effects and should be avoided.
Illustration showing the piriformis muscle and sciatic nerve in the lower back and pelvis.

How Common Is Piriformis Syndrome?

Piriformis syndrome is lower back or hip pain originating from an injured piriformis muscle deep within the buttock. The pain is usually located deep under the gluteus muscle in the top half of the buttock. Severe tenderness of the buttock to touch is a common symptom when the injury flares up. Because the sciatic nerve passes under the piriformis muscle, leg pain, numbness, tingling and weakness are possible when the piriformis muscle is inflamed.
Piriformis syndrome is the fourth most common cause of chronic lower back pain following disc herniation, facet joint arthritis and sacroiliac joint inflammation. Piriformis syndrome is the second most common cause of sciatica following lumbar spinal stenosis from a disc herniation. Most doctors don’t know how to diagnose piriformis syndrome, and many do not know of its existence. Piriformis syndrome is now curable with proper treatment at Deuk Spine Institute.

Why Does Piriformis Syndrome Occur?

Piriformis syndrome always begins with a tear across the belly in the middle of the piriformis muscle. This muscle has its origin at the lateral border of the sacrum and inserts its tendon onto the greater trochanter of the hip. The muscle runs deep to the gluteus maximus muscle in the buttock. Tears of the muscle belly occur when the patient bends over to lift something while also twisting at the waist.
The piriformis muscle is normally a thin, short muscle prone to injury in people that are deconditioned from lack of regular exercise or due to bad body mechanics. Chronic back pain from spine issues is the most common predisposing condition to getting a piriformis muscle tear.

Treatment at Deuk Spine Institute

When the back and leg pain is mild, piriformis syndrome can be treated with muscle relaxers, anti-inflammatories, injection of steroid or Botox into the injured muscle belly, therapy and rest. Early on when injury to the piriformis muscle is minimal, piriformis syndrome symptoms can improve with conservative (non-surgical) treatment.
Rarely does piriformis syndrome resolve completely without a minor surgical procedure available only at Deuk Spine Institute called the Deuk Piriformis Muscle Release®. More invasive treatments are available but cause major side effects and they should be avoided.
Illustration of a glowing muscle connecting to a hip joint with surrounding nerves.

Condition 03

Vertebral Fractures

Account for less than 1% of chronic lower back pain. Can involve bones or ligaments. Bone fractures are more common than ligament fractures.

Osteoporotic Compression Fractures

Most common type. Osteoporosis weakens bones due to hormonal imbalance. Both men and women get osteoporosis.

Traumatic Spine Fractures

High speed and force injuries from motor vehicle and sporting accidents.

Pathological

Bone destruction from spine tumors or infection weakens vertebrae, making them susceptible to fracture.

Treatment Approach

All three types can cause chronic lower back pain that can require surgical treatment to decompress and stabilize the spine. Deuk Spine Institute evaluates each case individually and recommends the least invasive approach to restore stability and eliminate pain.

Key Fact

Vertebral fractures account for less than 1% of chronic lower back pain cases. However, when they do occur, proper diagnosis and treatment are critical to prevent long-term disability.
Learn more

Osteoporosis & Bone Metabolism

Spine fractures account for less than 1% of the causes of chronic lower back pain. The most common type is osteoporotic compression fractures due to weakened bones in the spine and other areas of the body.
Osteoporosis is due to a hormonal imbalance in the body that shifts bone metabolism into a resorptive state where bone lysis outpaces bone formation resulting in weakened bones susceptible to fracture. Both men and women get osteoporosis.
Illustration of a human lower spine with highlighted lumbar disc herniation.
Illustration of a spine with a highlighted fractured vertebra in red.

Other Causes & Treatment

Traumatic spine fractures occur with high speed and force injuries that occur with motor vehicle and sporting accidents. Another cause for spine fractures occurs in the setting of focally weakened bone from destruction of the bone by spine tumors or infection. Bone destruction is a common occurrence with spine tumors and infection through inflammation in the bone adjacent to the tumor cells or infective agent.
Spinal fractures may require both decompression of neural elements such as nerve roots or spinal cord combined with stabilizing procedures like fusion and instrumentation. Fortunately spine fractures are not a common occurrence and represent less than 1% of chronic back pain.

Condition 04

Coccydynia

Pain at the tip of the tailbone (coccyx) just above the anus. Caused by trauma — most commonly a fall while landing on the buttocks.

What Happens

  • Trauma overstretches the coccygeal ligament
  • Tears form in the ligament
  • Inflammation causes pain and tenderness
  • Pain worsens sitting on hard surfaces

Good News

No Surgery Needed

Coccydynia can be effectively treated with a steroid injection directly into the coccygeal ligament. This reduces inflammation and pain, allowing the ligament to heal.

Important: This is NOT an epidural steroid injection. The steroid medication must be injected directly into the coccygeal ligament, not the epidural space.

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Understanding Coccydynia

Coccydynia is pain located at the tip of the tailbone just above the anus. Pressing on the tip of the tailbone causes the pain to worsen. The cause of coccydynia is trauma to the tailbone. This most commonly occurs with a fall while landing on your butt. The most common symptom is pain in the tailbone that gets worse with sitting on a hard surface like a chair.
Pain comes from inflammation of a ligament that connects the coccyx to the end of the sacrum bone. Trauma to the coccyx overstretches the ligament and causes tears to form in the ligament. The ligament tears cause inflammation to occur within the ligament which in turn causes pain and tenderness in the “tailbone”.
Illustration of sacrococcygeal and anococcygeal ligaments with focus on coccyx.

Treatment: Not an Epidural Injection

Good news is that treatment doesn’t require surgery in most patients. An injection of steroid medication into the coccygeal ligament usually is all that is needed. The steroid medication fights off inflammation. Some patients require more than one steroid injection into the ligament.
This treatment should not be confused with epidural steroid injection. Epidural steroid injection is not the correct treatment for coccydynia. The steroid medication must be injected into the coccygeal ligament directly and not the epidural space.

95%+

SIJ Pain Relief

1-3 Days

Return to Work

Zero

No Hospitalization

2023

Pioneered

Accurately Diagnose Your Pain

Pain generators are the specific joints, muscles and nerves causing your pain. Dr. Ara Deukmedjian personally evaluates every MRI to identify the true sources of chronic back pain — not just treat the symptoms.
  • Submit your MRI for free review
  • Dr. Deukmedjian personally reviews your case
  • Receive your diagnosis and treatment plan
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Most major insurance plans accepted. No referral required.

300K+

Patients Treated

30+

Years Experience

3,000+

MRIs Reviewed