Forgotten Cause of Back Pain

[Tori]

Sacro iliac Joint Dysfunction

http://www.kalindra.com/spinecenterguide.pdf

 

[Summer ???]

I've posted this elsewhere, but it's worth repeating here, there seems to be a bit of a campaign on these boards about SIJD at the moment, it is NOT the be all and end all of mechanical pain, and beware of any practitioner who thinks that it (or any other problem) is. It can be used as a differential diagnosis in many many cases, and may be part of teh cause, but using it a diagnosis#1 for every patient means you've got a lazy therapist. It comes under the quote in my signature

As a chiropractor, I would be amazed at any colleague who doesn't know about this, but probably calls it something entirely different. I for one, have never (that I can recall) used that set of initials, so wouldn't immediately know what they were if someone came to me with that as a previous diagnosis.
I would also query the validity of the link I followed ("this is SIJD"), it's an article on one person's oppinion, and is very subjective.

I assume that when you are talking about "doctors" you're meaning GPs, who tend to know little about biomechanical medicine, as it doesn't fit with their training, until relatively recently there was debate (in orthodox medicine) as to whether the SI joint was even a mobile joint (as opposed to a fused suture).

 

[BLAH BLAH BLAH]

I like your comment that refers to "GPs"...I have posted a rather controversial ramble including that very point elsewhere regarding prolotherapy.

 

[ledzepfan203]

But it is forgotten. I went through over 20 doctors and medical specialists during 20 years and they found nothing that could help me. Only one chiro and one physio found "something wrong" in my pelvis, but they couldn't correct it. Finally one old doc checked my pelvis and diagnosed "vorlauf" on flexion test. Then he corrected it. No longer pain.

Afterwards I have been reading about it and many doctors think it is not possible to have such a problem in pelvis. And they never check that! Even there are millions of patients who obviously have it with the same or similar symptoms like I had.

 

[JCprince]

I wonder if you can find any article about ilium or sacroiliac upslip from Lancet? If there is none, the doctors don't believe it exists!

Tom LeBlanc, PT
Symptoms of an Upslip
Do you feel as if you are walking on uneven ground, even though you know the floor is level? Does it hurt to sit too long? Do you sometimes misjudge distance, while walking through an open door, and bang your shoulder into the door jamb? Do you feel off balance and frequently have to catch yourself to keep from falling? Have you noticed yourself "running out of steam" much earlier in the day since having an accident or a fall? If you answered yes to any of these questions, you may be suffering from an upslip.
What is an Upslip?
An upslip, or superior ilium, is a condition where one ilium (pelvis bone) is slightly higher than the ilium on the opposite side.
http://www.home-entrepreneurs.com/html/the_upslip.htm

"The ilium can be rotated anteriorly or posteriorly. There can be an upslip (the most frequent) or downslip. Often, the sacrum is also rotated, placing strain on the facets (the joints of the spine). Those subluxations can be determined by clinical examination and reduced with various manipulations and exercises."
http://www.sidysfunction.com/anatomy.html
http://www.spineandsacroiliac.com/sacrodysfunction.html

"A chronic upslip will often present with tightness in quadratus lumborum, psoas major, and sacrotuberous ligament."
http://www.amta.com.au/article1.html

Wayne E. Rasmussen, MS, PT, ATC
"The pelvic ring dysfunction presented two alignment changes. The left side of Nichole's pelvis was rotated posterior and elevated. The elevation is called an 'Up Slip', where one seat bone was higher than the other."
http://www.flyingchanges.com/htmls/2002/Jan02Therapy.html

Upslips and Downslips: Ilio-Sacral Shears
"I want to introduce to you an IS pattern with which most of you probably are unfamiliar. The ilium can shear vertically on the sacrum; this is called an upslip or downslip. When this occurs is critical, because shears are nonphysiological patterns, rather than rotations within the joint's normal planes of motion. In this shear, the ilium has ridden superior or inferior on the sacrum, losing its normal relationship. Once you know how to assess for IS shears, they become obvious, and relatively easy to correct."
http://www.chiroweb.com/archives/21/03/08.html

"Most manual therapists, however, be they physical therapists, chiropractors, or osteopaths, appear to believe that appreciable motion exists in the SIJ, that careful clinical testing can isolate SIJ dysfunction, and that specific treatment procedures can affect SIJ dysfunction. Sacroiliac joint dysfunction is variously termed subluxation, "upslip," "downslip," or posterior or, more frequently, anterior fixed innominate.[2-5]"
[2] Lee D. The Pelvic Girdle. New York, NY: Churchill Livingstone Inc; 1989. [3] DonTigny RL. Function and pathomechanics of the sacroiliac joint: a review. Phys Ther. 1985;65:35-44. [4] Nyberg R. Clinical studies of sacroiliac movement. In: International Federation of Orthopaedic manipulative Therapists Fifth International Conference, Vail, Colorado, June 1992. 1992:A90. Abstract. [5] Grieve EFM. Mechanical dysfunction of the sacro-iliac joint. Int Rehabil Med. 1983;5:46-52.

And yet many doctors say it can not exist!

"MD’s, Radiologists, Orthopedist and Neurosurgeons rarely consider the sacroiliac joint complex a factor, either. Some surgeons believe this joint doesn’t even move."

"As Orthopaedic and Neurosurgical residents are not taught to consider S.I. dysfunction as a cause of back pain, it is not surprising that surgeons know little of diagnosis and treatment."

 

[E B]

Don't fret tonitoni...there are plenty of doctors, orthopedic specialists and surgeons who do believe..or rather know..that it is possible to injur the SIJ and stretch the ligaments and that in some cases an unstable or imbalanced pelvis cuases stresses elsewhere that can cause pain - one of the orthopedic specialists I saw said that it was not possible to injur the joint but when I returned to tell him how my treatment went he contacted the other doctor and was very interested to learn about how to detect it and treat it - his opinion has now changed - he now refers patients to somebody who has a long track record of diagnosing and succesfully treating this problem. It doesn't matter if there are many who don't know so long as we know how to finbd the ones that do ! On the NHS that is of course very difficult but so is finding a dentist !

 

[Acid]

Sure there are, but too few. It took 20 years for me untill I found one. And many patients has the same experience. I have interviewed over 100. There are a lot of them who still haven't found that kind of doctor. Even some doctors tell it is very poorly known area yet very common problem.

This patient had been looking for help form doctors in many different countries. They had no clue... He even had one surgery, but it didn't help. There are millions of patients like him looking for help. Many of them are not that active and stop looking when first doctor says: "Nothing can be done. Just accept your pains."

And I didn't have ligament problem. It was only malposition of SIJ called upslip or rotated ilium or twisted pelvis that I had had since I was a child. No stretching, physical theraphy or pain pills helped.