The sacroiliac joint: Part 1
Low back pain? Leg pain? Sciatica? Often we have come to think of that as a disc problem.
Your spine is made of vertebrae stacked on top of each other. Sandwiched in between the vertebra is the intervertebral disc. Discs are like padding between the vertebra. When a disc ruptures, its jelly-like contents can spill, irritating nerve roots and causing pain.
Discs became popular as the culprits of low back pain when MRI's came out and you could really see the discs. But here's the catch: there are a lot of abnormal MRI's with unhappy looking discs and the people have no low back pain at all! .
Turns out that discs aren't the cause of a majority of low back pain cases. What has been overlooked for a long time by the medical field is the sacroiliac joint. Chiropractors have been talking about it since the 1920's. And medicine is now catching on.
Sacro-who? The sacrum is the bone at the base of the spine. It's the one people call their tailbone, although technically the tailbone is the coccyx which is one segment lower. The sacrum attaches to your hip bone to form the sacroiliac joint and your pelvis.
Here's some random trivia: The word sacrum derived from the Latin word Sacer meaning sacred. The sacrum in Latin was os sacrum meaning "holy bone." The holiness of the bone is up for debate, but its importance is not - it's really important!
The sacroiliac joint has had some controversy. Chiropractors said it moved. Medical doctors said it was immobile. And everyone argued over it. It's accepted now that portions of it do move.
The sacroiliac joint forms the foundation of the spine. Think of the foundation of your house. A house with a solid foundation will be solid. A house on a cliff with a bad foundation will be in all sorts of trouble. And so will your spine if if it doesn't have a properly functioning sacroiliac joint.
The sacroiliac joint has multiple functions. In part 1 of the sacroiliac joint blog, I'm going to talk about the weight bearing part.
Weight bearing means joints and those that respond to things like standing. The sacroiliac joint has a weight bearing part. Other weight bearing joints include your hips, knees, your ankles. The weight bearing part of the sacroiliac joint should not move (another part should move - see part 2 of this series). The weight bearing portion of the sacroiliac joint held together by strong ligaments.
Problem is, these ligaments can become stretched and the part of the sacroiliac joint that shouldn't be moving starts moving. This creates instability in the pelvis --- and everything resting on top of that pelvis gets disrupted too (remember the house with the bad foundation?). The muscles of the low back and pelvis respond, tightening in an attempt to stabilize things. And there is your low back pain. It's really quite simple in these instances --- if you stabilize the sacroiliac joint, the muscles will quiet down and suddenly there isn't pain anymore. Although if the problem has been there for 10 or 20 years, the muscles will need some work too.
But what else is above the pelvis? How about the shoulder. Many shoulder problems are actually reactions to pelvis problems. I had a patient in my office the other day complaining of not being able to raise their arm (frozen shoulder). I corrected the sacroiliac joint and the person was suddenly able to lift their arm. I never even touched their shoulder! What connects to the shoulder? How about the elbows and wrists. And you guessed it, elbow and wrist problems can be the result of a sacroiliac joint problem. Wild, isn't it?
It gets even more crazy though. The neck sits on top of the shoulders. Yep, neck pain can be the result of a sacroiliac joint problem. What's on top of the neck? The head, of course. Tempromandibular joint (TMJ) problems or jaw problems can be (and always are related to) sacroiliac joint problems.
By now I should have rocked your world. Let me rock it a little more.
What about the other weight-bearing structures: remember, the hips, knees and ankles. Well they are also affected by the sacroiliac joint. Knee pain, ankle pain, foot pain, hip pain - they all can be caused by an unstable sacroiliac joint. Similarly, problems in the knees, ankles, hips, and feet can cause sacroiliac problems, but that's for another blog entry.
I specialize in sacroiliac joints and love to fix them. And I mean that, I really am passionate about it. I had a patient who had been to 4 other chiropractors, a physical therapist and a pain management clinic for low back pain with minimal results. The problem was they were treating her disc and the problem was, you guessed it, her sacroiliac joint. One adjustment and she was feeling much better.
Watch out for part 2 of the series on the sacroiliac joint - the part that is supposed to move.
1/31/2018 09:16:05 am
I think I am a text book case of these issues relating to the sacroiliac joint pain. I have pain on my left side from my neck all the way down to my knee. Reading this article makes complete sense now why everything on the left hurts. I'm 54 years old and have been very active all of my life. For about 6 months my lower back has been hurting and now my neck hurts as well as a pain down my inner thigh to my knee. As soon as I can afford to come and see you, I'll be there!1
1/31/2018 10:00:24 am
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I'm a Chiropractic Physician, Psychotherapist and researcher. I'm interested in helping people live their lives to their full potential. That could be simply without pain. Or it could be without more complicated physical or mental health problems. Or it could be getting help in making changes in their life so that they can achieve their dreams.