Pelvis - quilty of causing LBP

[jessica c]

well he comes from the view point that in many cases its very difficult to be 100% sure what the underlying cause is - there are often multiple causes. he tries to approach with an open mind and does not rule out any possiblities until hes sure.

no nothing in printing on HVT. his view was that spinal manipulation can be (and often is overused). His view was that if a joint needs constantly manipulating then you there is an underlying cause of this that needs to be addressed. ie in your si keeps coming "out of alignment" then stability needs to be addressed. he also htought that too much manipulation can lead to hypermobility but this is very difficult to prove and does not like to rule out any possibility (many would say its impossible and not even entertain the thought!)

Finally he felt that if manipulation is used as a sole long term treatment approach (when little no no improvement is made) then the you have to question the validity of that approach for THAT PARTICULAR INDIVIDUAL!

i know he has done quite a few seminars down london way and used to work from St Marys Uni in west london one day a week.

just as a note i received an email that dontigny is coming over to the uk to run a seminar. I'll get the details for you

cheers

ian

 

[PastorTom]

On that point especially, I'd say that he's far from unique.
It often takes a few treatments before you start seeing an improvement, but generally speaking if you haven't in 6 or so, then you're unlikley to, and by 10 you give up on that (I'd only get that far in very chronic cases). I'd also be surprised if there are that many therapists out there that would manipulation as the sole long term treatment (especially not if you're limiting this to the SI joint, which I think you're implying). Again, if you're being treated like this, I'd suggest you have either a lazy therapist, or someone who's more interest in your money than in your health.
I often use manipulation as the first choice therapy, and if it works well, then I propably won't bother looking into other things in the short term. For the long term I will always look into other things, most especially the soft tissues (combination of massage and rehab) and not infrequently, some amateur psychobabble.
I prefer to keep these other treatments in house if I can, because I can keep tabs on what the patient is doing, and it's so much easier to integrate their care properly - I don't do more than basic rehab currently as I simply don't have the space and equipment, and my knowledge is out of date. I'm very interested in taking on a sports therapist/physio/pilates teacher as soon as realistically possible though (almost did over the summer, but we couldn't offer enough security on income).

Look at my signature for why I think all this.
For the instance I've quoted from you, only 1 treatmetn regime has been tried, long-term and with no benefit; it's not working, try something else, or at least refer to someone who will/can

 

[KELLi]

im sound with all of what BUT there are many out there who put people on long term programs of the same treatmement. I know someone who went for manipulation only for three yrs! over one hundred manipulations. after each session the pain would greatly reduce but return after two or 3 days!

my thoughts of pilates is that you need a teacher who has experience with back problems. many exercises are too advanced/incorrect technique used. too many exercises aimed at the general population

think your right when you say talk about trying to keep things in house to monitor. I went to a massage therapist who claimed they were experienced enough to do HVT. I had a look at his qualifications and did not bother going back (especially when he said back specialists were a bunch of money grabbing w's! - at the same time as saying i needed to come in 3 times a week!)

its good to read that not eveyone takes such an approach

thanks

ian

 

[luiselbatigol1981]

Expatient, I don't quite know what your motivation is for these posts. Are you a practitioner as well as an expatient? Where did you get the xrays you include on the link? This x-ray, for example, http://personal.inet.fi/koti/pallo/Selkasivut/Kuvat/pelvis6.jpg you give as SIJD causing scoliosis but what is the line projected over the abdomen? If you look closer you will see that the patient has spina bifida and the line is a ventricular shunt for hydocephalus- plenty enough reason to have scoliosis and pelvic tilt. Pelvic tilt alone is meaningless- some will be due to scoliosis and some due to leg length discrepancy. A small number will be due to pelvic deformity-usually after major trauma. Pelvic tilt for whatever cause will cause degenerative change in the lower back but the SI joints show no more degenerative change than they do in the normal population (where it is almost universal in old age). It does worry me when single issue fanatics get together and, as in this case, use the xrays of someone who, for all I can tell, is wheelchair bound from a birth defect (spinal bifida) as an example of some fictitious disease.

 

[Walt]

Agree with you again here Paul; though of course the biggest problem I have with Roengenometrics is determining patient positioning acurrately enough to make presumptions based on you subsequent findings. I find it fascinating, but can't get my head around it being an accurate enough representation for a 0.5mm measurement to be relevant.

A blatant SBO and shunt on your linked X-ray too btw; was it one of expatient's dodgy links? (I tend to be too lazy to follow the inactive ones)

 

[Louise Davis]

Don't be amazed but understanding. There are many chiropractors who don't understand what that SIJ problem is. I guess most of them don't. Many of them think they do. Many think the joint is not possible to move so there is nothing to manipulate. Then they only stretch their patients. I was treated many times by one of those chiropractors.

One chiro explaned to me that there are tens of different techniques how to treat SIJ and most of them doesn't work at all. Like placing two chops under the patient and rotating the pelvis using by pushing it. That is how it was done to me many times - no help at all. Yet many chiros use that technique explaning it is very efficient...

Many of the chiropractors don't understand that SIJ pain is just one symptom of many possible and SIJ can be locked or moved&locked and not be painfull. The pain can be in many other places because of malfunction of pelvis. Most often it is on low back or close to SIJs. Usually it is on the other side than the locked SIJ. So most often many experts try to treat the wrong side because they follow the pain!!

Have you seen those scoliosis pictures they show in the Internet? 9 out of 10 pictures there is an ilium upslip meaning lifted&locked ilium. And that twisted pelvis is the main cause of idiopathic scoliosis, like I had it since I was a child. The cause was ilium upslip ie. moved and locked SIJ. I got it corrected at age 35 after suffering 10-15 year of many kind of pains and other symptoms too. And medical experts didn't understand at all what was the cause of my problems. I also visited few manual treatment experts like chiros, but they couldn't help me. They didn't know how to correct my upslip. Many of them didn't even check my pelvis but offered a heel lift under my short leg that is no longer short...


But the whole spine is on top of it. If pelvis is misaligned the spine gets curves to compensate the balance.


That is your opinion. Many other experts tell the anatomical leg length discrepancy is very rare and usually if length difference is diagnosed it is because of twisted pelvis that can be found from over 80% of all people..

 

[James Bob]

I've edited the first few posts [on page 1] in this thread to activate the links ... but it IS a long thread, and the inactive links CAN be viewed by copying and pasting the actual URL into the address bar, ie what's inside the code [link= ] [ /link] ... that's for anyone who doesn't know how to do it, BTW

Holistic

 

[Gregory House M.D.]

BIA wrote: "A blatant SBO and shunt on your linked X-ray too btw; was it one of expatient's dodgy links? "

I'm not sure this was just spina bifida occulta since there is a lot of deformity and seems to be associated with hydrocephalus.
The x-ray supposed to show pelvic tilt actually shows partial lumbarisation of S1 on the right and there is also asymmetry of the 12th ribs so this is a longstanding scoliosis. If there is asymmetry of the pelvis position it is secondary to this.
You are right to suggest that measurements are confounded by positioning. I do measurements sometimes to determine leg length discrepancy but, like people's face or chest there is always going to be a slight asymmetry of the pelvis normally and only a single issue fanatic would make a big deal of this (while ignoring much more relevant pathology!).
Yes pelvic tilt is associated with spinal arthritis because the spinal arthritis causes it especially if there is a scoliosis. To me, treating the spinal arthritis by concentrating on the pelvic tilt makes as much sense as treating diarrhoea by inserting a cork in the anus!

 

[Morgan Le Fay]

Yes, in face one common reason for asymmetry is TMJ. Hippokrates described it 2500 years ago and also wrote how to correct it when dislocated. Still many doctors don't believe it even exists.

 

[Pompal 09.]

Ahh the old TMJ chestnut. Another "illness" loved by the snake oil salesmen.
I think most doctors know how to correct TMJ dislocation- you close your mouth as it is normal for the TMJ to dislocate on mouth opening. A dislocated meniscus or arthritis of the TMJs is different but most people diagnosed with TMJ disease actually have teeth grinding due to stress and respond well to quack remedies.

 

[mudpuppie_80]

Yes, when other TMJ is not properly on its place it can slip out when opening the mouth. Many people have that situation. It can be corrected by pushing the TMJ deeper to its place.

But many people have both sides out of place and then they have problems of opening the mouth and pain when jewing food.

If jaw is out of place it causes muscle activities like teeth grinding, and automatic biting. Muscles have tension and spasms because jaw is not moving as it should.

Doctors then offer bite splints or even worse: They grind your teeth. And many studies tell it is useless.


You mean pelvic tilt (uplifted ilium, rotated innominate) causes scoliosis. If pelvis is not aligned the sacrum is not aligned. On top of the sacrum there lies the spine that makes curves to create balance = scoliosis.

And when pelvis is not moving symmetrically it causes tension to muscles all over and stresses lumbar spine by rotation twist. Malaligned pelvis causes problems to feet and to neck and shoulders and everything between them. It is the center of the body skeleton system.

Most have had asymmetry in pelvis since child. Plenty of time to cause wear and tear to lumbar spine, hips, knees, etc. and pains/arthritis come as years go by.

In sports world the experts know all this. One example:

Thomsen, L. The Relationship Between Postural Asymmetry and Cycling Injuries: Parts I-3.
http://www.posturalrestoration.com/resources/faculty.html

"This pelvic asymmetry on the left which orients the pelvis and weight bearing to the right now causes rotation at the sacrum (base of the spine) and lower lumbar spine at L4-L5 to the right. The femurs (thigh bones) also compensate for this forwardly rotated and anteriorly tipped pelvis. The left femur bone actively goes out (external rotation) and the right goes in (internal rotation). This is required for the patient to walk or cycle straight ahead. Now if the left femur bone is actively in external rotation the lower shin bone (tibia) is oriented in, the patella (knee cap) will not track correctly and knee pain results as was demonstrated with this patient."