Sacroiliac pain

by | Dec 4, 2019 | Lower Back Health, Lower back pain | 0 comments

Sacroiliac Joint - a common cause of low back pain

The sacroiliac joint – one contributor to lower back pain

Do you experience pain in the buttock, low back, upper thigh or groin? Your problem may be related to the functioning of your sacroiliac joint.

The sacroiliac joint (SIJ) is one of the largest in your body. Although there’s only a small amount of motion that occurs at the SI joint, the limited range of motion that does occur is the important link between movement of the legs and movement of the trunk.

Sacroiliac Joint

Sacroiliac Joint

And there’s another, even more critical role of the sacroiliac joint, which is to transmit the downward force of the weight of your torso to each side, where it’s borne by your legs.

Because of its limited range of motion, its nearness to so many other structures of the low back, and the complexity of the nerve supply to the pelvis and lumbar spine, a controversy has existed within the allopathic (standard) medical community as to whether the SI joint is a common source of pain.

First, let’s leave aside the issue as to whether any individual structure should be viewed as a “source” of pain (given the complex nature of pain signal integration in the brain.) Ignoring that thorny issue, the various allopathic medical viewpoints seem to be coming into agreement that the sacroiliac joint can be a source of low back pain.

How is sacroiliac pain diagnosed?

A number of indications are used to determine that the sacroiliac joint is the source of low back pain. The important ones from the allopathic perspective include:

  • Location of pain and point of maximal tenderness
  • Provocative movement tests – the examiner introduces various forces through the SI joint to see if they cause pain
  • Imaging tests – usually not too helpful but they can spot joint inflammation if it’s significant
  • Diagnostic injections – not a technique I use, but if you inject steroids into the joint (or the ligaments that span the joint) and it relieves pain, that points to the joint as the original pain source

There’s one important diagnostic test that doesn’t usually make the “allopathic” list – a “therapeutic trial” of manual therapy, carefully making note of the results. This is one of the diagnostic methods I rely on the most.

There are three big advantages of using the “therapeutic trial” diagnostic method.

One advantage is that manual therapy is most likely to be helpful to most people. It make sense to start with a treatment that’s safe and frequently effective.

A second advantage is that it answers two questions at once:

  • What’s wrong?
  • What treatment will be most helpful?

Other diagnostic methods perhaps help to answer the first question (“what’s wrong?”) but still leave you with the problem of figuring out what’s going to help.

And the third big advantage of the “therapeutic trial” method is that even during the diagnostic process, chances are you’re already beginning to see pain improvement. It gets right to the heart of the problem for most people.

Need to get your sacroiliac joint checked out?

Call or e-mail me for a convenient appointment.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.


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