Episacroiliac Lipomas: A Possible Undetected Cause of Non-specific Low Back Pain

Background: Episacroiliac lipomas may be an undetected cause of low back pain with a high incidence in the general population. To date, research on these lipomas as a cause of non-specific low-back pain is limited. Therefore, the purpose of this case series isto describe the presentation and treatment of three patients who presented with non-specific low back pain where episacroiliaclipomas were observed. This could increase awareness in the identification of this condition and promote research into a more effective approach in the treatment of non-specific low back pain. Design: Case series. Methods: The first patient was a 66-year-old male who presented to physical therapy with chronic non-specific low back pain inthe left sacroiliac joint region with associated radiculopathy. The second patient was a 22-year-old female who also presented tophysical therapy with non-specific low back pain. The last patient was a 73-year-old male who presented with non-specific chroniclow back pain with associated radiculopathy. Results: Overall, the three patients showed improvements in pain levels when treatment specifically targeting the episacroiliaclipomas was initiated with deep tissue manual therapy localized to these lipomas. Conclusions: Pressure applied at the location of these lipomas reproduces symptoms experienced by the patients. This findingmay point to episacroiliac lipomas as major underlying cause of non-specific low back pain. Furthermore, most benefits were seen in patients while specifically targeting these lipomas. Traditional approaches to low back pain continue to be relatively ineffectiveand new options must be explored to determine more effective interventions.