Tom wasn't accustomed to not knowing the right answer. A business executive in his 50s, he had been suffering from agonizing back pain for nearly two years, and all his doctors could tell him was that they couldn't find the cause or an appropriate treatment.

So Tom did what most people wouldn't -- he started researching to find a doctor anywhere in the world who could help him.

The problem, as it turned out, was that Tom's doctors were looking at his spine for the source of his pain, and that's not where it was coming from. He was suffering from sacroiliac joint dysfunction, the deterioration of the two joints on the side of the lower spine that connect it to the pelvis.

Studies have found that 20 to 25 percent of all chronic lower back pain comes not from the spine but from the sacroliac, or SI, joint, which bears and transfers weight and movement from your upper body to your legs. When the ligaments wear out and the SI joint becomes unstable, it can generate a similar kind of sharp back pain -- or sciatica-like pain down your leg -- as a ruptured disc.

Most spine surgeons, however, aren't trained to look at the sacroiliac joint; they generally don't learn about it during their residency or fellowships. And it doesn't occur to most patients to ask. Then X-rays, MRIs and CT scans of aching, aging backs show narrowing spinal discs, without actually showing whether these discs are producing pain ... further confusing the diagnosis of the suffering patient.

As a result, many people progress through the usual stages of back pain treatment, from physical therapy and chiropractic treatment to injections, laser procedures and finally to surgery, without ever addressing the true source of the pain.

One study found that among "failed" spinal fusion patients -- people who had their lumbar vertebrae fused and were still in pain afterward -- the SI joint was the real culprit in more than half the cases.

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