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REPRINTED WITH PERMISSION
This article is reprinted with permission from Full-Spectrum Somatics.
https://lawrencegoldsomatics.blogspot.com/2011/04/understanding-sacro-iliac-joints.html
Understanding SacroIliac Joint Pain,
Stopping the Pain and Weird Symptoms
THIS ARTICLE is about SACROILIAC JOINT PAIN (also called, SACRAL TORSION, S-I JOINT SPRAIN or STRAIN, SACROILEITIS, and "TWISTED (or TURNED) SACRUM" COVERS:
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symptoms of sacroiliac joint dysfunction
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what happens to cause sacroiliac joint dysfunction (look at your own history of injury)
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different forms of treatment explained in a way that I expect will make sense, to you (and match your experience), so you can act based upon sensible understanding, rather than blind trust
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a clickable link to the approach used in clinical somatic education to correct the problem ( scroll down )
You can read a more technical article, here.
If You Have a Turned Sacrum
If you have a turned sacrum, you have a lot more symptoms than pain at one S-I (sacro-iliac) joint (at the waistline, in back, to one side). You have symptoms at many locations throughout the body for which your doctor has been able to give only "by the book" diagnoses (without being able to explain why they all appeared, together), and for which your therapist has been able to give you only partial and temporary relief (at best).
You have clusters of symptoms that mysteriously appeared at about the same time, more or less, which your therapist has addressed as if they were separate from each other without understanding what they have in common ("Which pain do you want to work on, today?"), and which have not responded to the usual therapeutic techniques or even to opioid medication. You may have been recommended surgery.
A turned sacrum typically causes excruciating pain that doesn't let up and makes you afraid to move. Some symptoms may get better and worse, but there is always pain that makes you incapable of doing things you need to do. It's a kind of life-crisis. (Isn't it.)
About This Article
This article explains the common cause of those symptoms in a way that will make sense, to you. It also describes a practical, holistic approach for eliminating those symptoms that is totally different from the approaches used by your doctor, surgeon, or therapist -- an approach that has worked consistently for those who have taken it. "Holistic" is its advantage, as regards its effectiveness.
This entry is descriptive and fairly extensive. However, you don't need a thorough intellectual understanding of your condition to get relief from it; you don't even need to read this entire entry. You just need enough information that you become willing to do what I say works to restore your comfort and regain your freedom of movement.
A word in advance: It's work -- but it works.
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Read this article, if . . .
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You have found the information provided both by health professionals to be "thin soup" standard answers that don't increase your understanding, much
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You feel pessimistic about your chance of full recovery.
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You have tried therapies and/or surgery and are still in pain.
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You are willing to consider a different approach and do the work to get out of pain.
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The Article:
A SIMPLE EXPLANATION OF SACROILIAC JOINT SYNDROME (DYSFUNCTION)
"If you can't explain it simply, you don't really understand it."
Richard P. Feynman
Sacroiliac joint dysfunction (SIJD) comes from displacement (misalignment) of the bones of the pelvis (of which the sacrum is one), from muscular gripping caused by that misalignment, and from strain in the ligaments that bind the S-I joints together and that line the pelvic cavity.
The shape of the pelvis, which is supposed to be symmetrical, gets distorted. Symptoms follow and may worsen, over time.
Of the symptoms of SIJD, pain at a sacroiliac joint (at waistline level, in back, two to three inches to one side) combined with groin pain are the most common. I list other frequent symptoms, below.
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SYMPTOMS OF S-I JOINT PAIN SYNDROME
Following are the most common symptoms of sacroiliac joint dysfunction.
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pain at the groin and waistline, in back, same side - in combination
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pain around the top rim of the pelvis
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deep buttock pain, one side
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reduced ability either to bend forward or to stand up straight
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There are a lot more symptoms listed on the VIEW OTHER SYMPTOMS page.
On that page, I list and explain more symptoms grouped by:
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SENSATIONS
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SKELETAL ALIGNMENT CHANGES
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MUSCLE/MOVEMENT MEMORY CHANGES
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EMOTIONAL SYMPTOMS
Many common symptoms exist that vary from individual to individual.
CLICK HERE FOR OTHER COMMON SYMPTOMS.
If you have two or more of the symptoms listed on this page, you likely have SacroIliac Joint Dysfunction (SIJD).
But don't assume that, from the symptoms. Numerous conditions may cause the same symptoms. Symptoms only suggest where to look for the cause.
The definitive test to tell if you have SIJD is by manual examination of your sacroiliac joints -- something you can do, by yourself, as instructed in the video, immediately below, SELF-ASSESSMENT OF SACRAL POSITION. You can feel the difference in the two S-I joints with your fingers, by this self-assessment.
You might as well do the self-check, right away. You may save yourself some "reading time". If you find one side deeper, that's it: a turned sacrum and S-I joint strain.
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The Self-Check
Follow the instructions. Self-examination involves a simple movement with your hands to feel the region of your S-I joints. Pay close attention to the spoken instructions so you know what you're feeling for. Don't guess. Either you can feel it, or you can't.
If you can't tell, you may visit a chiropractor or osteopath to get a diagnosis and to get trained how to examine yourself. (If you're going to use the program of action patterns (movement-memory training patterns) to correct your own SIJD, you'll need to be able to examine yourself before each exercise practice session to know which side to do.)
SELF-ASSESSMENT OF SACRAL POSITION
By feeling the region of your back described in the video, you can feel ridges on both sides with your fingertips. These are not the S-I joints, but the edges of the neighboring hip bones. Toward the midline (the spinal line), next to those ridges, you feel, and others may see, dimples. Your S-I joints are deep to the dimples.
If, by doing this self-assessment, you've found one side sacroiliac joint deeper ("jammed"), you know what's going on with you.
Now, you know what you need: a way to normalize the position of your sacrum so it stays normal. ( Click here for a way to normalize the position of your sacrum. )
NOTE: The side that hurts is usually the non-jammed side (contrary to what one might expect).
If neither side S-I joint seems deeper, your symptoms may come from other injuries -- which is good news for you because other injuries are much easier to clear up than SIJD. Visit the Consultation page to get a free Functional Assessment form. Complete it and return it by email for a recommendation of the program you need.
WHY SYMPTOMS may be UNRECOGNIZED as coming
from S-I JOINT DYSFUNCTION
Some symptoms of sacroiliac joint dysfunction occur at locations distant from or seemingly unrelated to the sacrum or S-I joints.
That's because the nervous and muscular systems are involved and not just mechanical relationships between the bones of the pelvis.
Some of these pains are medically un-diagnosable -- meaning, their causes are mysterious to medical practitioners or they are "not well understood".
If you've had extended therapy for pain, and therapy didn't help, or didn't help enough, or didn't bring lasting relief (common), it's a sign that either the symptoms were coming from your sacrum being turned but were being treated as if they were coming from the location of the pain, or the therapy used wasn't well-suited for a lasting relief of that kind of pain.
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Causes of a Turned Sacrum
THE SACRO-ILIAC (S-I) JOINT LIGAMENTS ARE NOT THE CAUSE OF S-I JOINT DYSFUNCTION, BUT THE VICTIM OF IT
This Mayo Clinic entry describes recognized causes of a turned sacrum.
Sacroileitis — Comprehensive overview covers symptoms, causes, diagnosis, treatment of inflammation of the sacroiliac joints.
Causes for sacroiliac joint dysfunction include:
Traumatic injury. A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints.
Arthritis. Wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac joints, as can ankylosing spondylitis — a type of inflammatory arthritis that affects the spine.
Pregnancy. The sacroiliac joints must loosen and stretch to accommodate childbirth. The added weight and altered gait during pregnancy can cause additional stress on these joints and can lead to abnormal wear.
Infection. In rare cases, the sacroiliac joint can become infected.
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ref: Overview - Sacroileitis (alternate spelling) - Mayo Clinic​
In my clients' experience, nearly all cases came from an injury, rarely from pregnancy or other causes. Injuries include falls (bicycle, horse, rooftop, skating, ladder, etc.) and motor vehicle accidents with one foot on the brake at the moment of impact jamming the leg into the hip on one side.
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Approaches Used to Clear Up S-I Joint Pain
Two surgical measures used to stop S-I joint pain are radio frequency nerve ablation ("RFA" - cooking the nerve endings) and Sacro-Iliac Joint Fusion.
Neither measure corrects the underlying problem, but, at best, only minimizes symptoms.
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(TEMPORARY PAIN RELIEF:) Nerve ablation ("RFA") costs about $2,100 and lasts 9-12 months before the nerve regenerates -- making repetition necessary.
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(NOT RELIABLE: See the article, below.) Sacro-Iliac Joint Fusion surgery costs about $22,000 and has side effects.
Click the image, below, to read the article on
S-I joint fusion surgery by Dr. Centeno.
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(MODEST EFFECTIVENESS:) Skeletal manipulation
Bones go where muscles pull and hold them. Because muscle spasms get triggered by a turned sacrum and commonly persist, despite skeletal adjustments, skeletal manipulation of the sacrum doesn't "take". Muscular pulls and weight-bearing forces that distort the pelvis cause distortions of pelvic shape -- and symptoms -- to return.
Two other approaches have to do with the ligaments that bind the S-I joints -- and they're opposites.
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Massage: Loosen the ligaments by direct or manipulation.
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Prolotherapy: Tighten the ligaments.
It may strike you that these are two opposite approaches to the same problem -- suggesting that these approaches may be "shot in the dark" efforts. If ligament strain was the cause and, if treated, would SIJD be considered so difficult to clear up?
Ligaments are not the cause, but the victims of the turned sacrum.
Other approaches include electrical stimulation and drugs to mask the pain without correcting its cause.
A successful approach should somehow address the condition in terms of its cause, don't you think? Wouldn't the results be telling?
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ACTIONABLE UNDERSTANDING
By now, we can see how the forces of an injury initially distorted the pelvis and how muscular contractions, maintained by muscle/movement memory, have kept the problem in place.
We also see that the strain on ligaments is not the fault of the ligaments, but of the nervous system and muscular actions moving the bones of the pelvis into unnatural position. That puts strain on the ligaments.
That means that we can't correct the problem in any lasting way by addressing the ligaments. (To tighten the ligaments, as in prolotherapy, misses the point and to stretch or loosen the ligaments may reduce their strain, but doesn't correct pelvic shape or habituated muscular tension patterns).
It also means that we can't massage away the problem (have you noticed?). It means that we have to free the person from the grip of cringe response and develop balanced, well-coordinated movement that supports the sacrum properly and induces the pelvis to become symmetrical.
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What I Say Works
What I say works is to do is a series of action patterns that thoroughly retrain your movement memory (wrecked by injury) so that your own muscles exert ongoing forces that cause your sacrum (and your whole body) to straighten, progressively, over time. That's the unique approach given, here. You'll feel it.
These action patterns work with both chronic (long-term) pain and (sudden onset) acute pain and they produce feel-able changes almost immediately. The instructions are presented in an easy to follow program available at the end of this entry.
The thing is, you must do the work; it can't be done for you or to you. You must follow the spoken instructions (which are clear, descriptive, slowly paced, shown in the video, and easy to follow). You must not cut corners or hurry; if you do cut corners or hurry, your results will show it.
You will learn diligence, patience and care, you will get the promised results -- and you will save yourself from the pain, expense, and disappointment of the conventional therapeutic options. You will get better and better in a fraction of the time you have already spent in unsuccessful therapy.
That's my promise, to you.
Clinical Somatic Education to Eliminate Sacroiliac Joint Pain and Related Symptoms
Because the field of clinical somatic education is relatively new and not well-known, I'll briefly explain it, to you.
Clinical somatic education is a non-mainstream health discipline that works reliably to extinguish pain and improve mobility by means completely different from standard therapies.
It works by normalizing movement, muscular tensions and posture distorted by injury, to reshape the pelvis and normalize sacral position. Muscles relax, joints loosen, and nerve pain ends.
Instead of stretching and strengthening, the common techniques of physical therapy, we use a completely different technique that changes muscular activity at the brain-level, so the body becomes self-correcting.
The technique is called, pandiculation.
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Pandiculation: The Direct and Natural Way to Change Movement Memory and Pelvic Shape
Pandiculation is an action pattern done by every animal with a backbone. Related to yawning, it normalizes muscular tension levels, improves mobility and restores physical comfort.
It's ideally suited for normalizing muscle/movement memory and the forces that control pelvic shape and sacral position.
DOES STRETCHING "ONE BETTER"
Everyone has experienced pandiculation in ordinary life (although not in the "assisted" way used in clinical somatic education).
Pandiculation is what cats, dogs, and every animal with a backbone does, upon arising from rest. Some people call it, "stretching", but it isn't stretching; it's tightening and relaxing muscles in a patterned way, as explained in the video clip. It's completely different from therapeutic (or athletic) stretching in that it retrains movement-memory ("muscle" memory).
The “morning yawn and stretch” is pandiculation. You can be taught to pandiculate in more ways than just yawning or the morning "waking up" stretch. You can do it to correct the movement changes and to eliminate the pain caused by most injuries.
Pandiculation is the easiest and most efficient way to reprogram muscles and movement. Unlike stretching, it affects movement memory directly, so changes occur comfortably and, for the most part, quickly.
My earlier description of the causes of SIJD cites muscular involvement and distortion of pelvic shape. The two go together, as I have explained -- but, to put it more succinctly, "Bones go where muscles pull them." Clinical somatic education addresses the muscular involvement and skeletal alignment.
Pandiculation unlocks muscle/movement memory, so movement and posture can be changed to recover comfortable freedom of movement. You must unlock something, first, before you can adjust it, so clinical somatic education uses pandiculation as its primary technique.
After the unlocking, other action patterns that use pandiculation change movement memory. The pelvis starts to reshape and the sacrum gradually migrates to a new, healthier position. As the pelvis reshapes, symptoms disappear. This statement is a bit of an oversimplification, but that's how clinical somatic education works.
After unlocking and repatterning, pandiculation exercises reinforce the new pattern. Job done. All kinds of ordinary activity, including strenuous activity, are now safe to do.
The system of somatic education exercises I developed to correct my own SIJD uses patterned movements to retrain muscle/movement memory. Changes of muscular pulls cause the pelvis to reshape. These changes can clearly be felt. Again, "bones go where muscles pull them."
Click on the image, below, to see the entire comment.
TO SUMMARIZE: Compression and twisting forces that converge at the S-I joints cause compression of the S-I joints, strain the S-I ligaments, trigger reflexive muscular contractions throughout the trunk and legs that cause muscle and cause radiating nerve pain (that may be mistaken for spasm) -- symptoms that never let up, day or night.
S-I Joint Dysfunction or Sacroiliac Pain Syndrome (the word, "syndrome " meaning a recognizable cluster of symptoms) causes a complex collection of symptoms that doesn't respond to therapy, when addressed directly. The key to stopping the pain is to get the position of the sacrum to straighten.
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ADDENDUM
Clinical Somatic Education to Correct Sacroiliac Joint Dysfunction:
The Role of Muscle/Movement Memory
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The medical model, which uses drugs, surgery, and electrical or mechanical devices, generally targets a specific symptom or location of pain, but does not, typically, address muscle/movement memory -- even if it does address skeletal alignment, as in chiropractic or osteopathy. Moreover, the medical specialty, "pain management", is a branch of anaesthesiology; it's primary approach is to mask or hide pain, not to eliminate its cause.
Unlike the medical model and standard therapeutics, clinical somatic education uses action (movement) patterns to free -- and then re-pattern -- the muscular tensions that cause the pain of S-I joint dysfunction and keep the condition in place.
The key term, here, is, "patterns". Thomas Hanna, in his book, Somatics | ReAwakening the Mind's Control of Movement, Flexibility and Health (available at many public libraries and via amazon.com), talks about how those tension patterns form with an injury and the process of ending them and their symptoms.
These changes of muscular tension pattern influence pelvic shape over the long term. It's an entirely new, brain-muscle-based approach that works without need for stretching, strengthening, or soft-tissue manipulation. Instead, it corrects muscle/movement memory, and thereby gets all of the effects of strengthening, stretching, and soft-tissue manipulation -- but in a lasting way.
Somatic education causes no undesirable side-effects, other than occasional, short-term soreness immediately after a practice session and lasting 1-2 hours.
With clinical somatic education, we correct S-I Joint Dysfunction in three stages.
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Unlock the Situation. We reduce the tension levels of the involved muscles, sufficiently to unjam the jammed S-I joint to permit repatterning of the forces that keep the pelvis distorted.
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Reshape muscular tension and movement patterns through practice of movement patterns consistent with a sound, symmetrical pelvis and healthy S-I joint function.
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Reinforce healthy, free, balanced patterns of movement -- not by strengthening, but by developing better integrated movement habits. These movement habits become second nature and do not require special attention in daily life.
Click on the image, above, to see entire comment.
Comforting Your S-I Joints | A RECIPE for RELIEF
If you're used to exercises or therapies that produce such small changes that you can hardly tell if anything is different, this isn't that. With somatic education exercises, you can feel changes rather quickly (obvious after two practice sessions). As, your movement and posture change, the symptoms of SIJD fade out.
This self-renewal program been well-tested and found consistently reliable -- starting with myself as the first "guinea pig". I had most of the symptoms listed. Once I found the exercises worked in me, I published them as preliminary instructional videos and then started teaching them to clients. When they reported success, I rendered the videos into "polished form" and published the paid program.
I understand why someone might be afraid to take an alternate approach to clearing up the problem: it's very painful and you might be afraid of getting worse -- and I suspect that you may already have tried other approaches, to little avail. Those are good reasons to hesitate.
What I can say is that most people have gotten better -- completely or partially -- and no one has gotten worse, with this approach.
Everyone I have worked with, personally (I've been in practice since 1990), has been pleased with the relief -- and I offer a lifetime satisfaction refund guarantee.
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THE PROGRAM
The program, Comforting Your S-I Joints, consists of a system of safe-to-do action patterns (somatic education exercises) done in a specific order.
As in a recipe, no one ingredient constitutes the entire recipe, and there are steps of preparation; each action pattern may be viewed as an ingredient and the whole program is the recipe.
Who is This Program For?
The "Gentle Spine Waves exercise" in Unit 1 of the program is such an ingredient and a step of preparation. It's not expected to relieve your S-I symptoms, by itself (although it works for simple back pain); it's a necessary step to unlock the situation. What it does is relax the back muscles; this step is one of preparation, not of "cure".
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To get started with the program, Comforting Your S-I Joints and to see a statement of the expected result of each section of exercises, you may enter your information, below.
A quick-response email message will come to your email address requesting permission to mail to you. Once you give permission, "Getting Started for Free" emails will come to you with bite-size steps for Unit 1 of Comforting Your S-I Joints.
Comforting Your S-I Joints is a system of movement-based exercises that reprograms muscle/movement memory in a lasting way. You'll feel changes for the better with each practice session; changes accumulate over time. The entire system extinguishes the pain and restores mobility. They enabled me to get back to my life with no limitations.
See the section, below, to get started with Comforting Your S-I Joints, for free. It's free because I expect you to find it effective and to purchase the rest of the program.
By getting started with Unit 1, you can develop the confidence that you actually can succeed at this program and, as improbable as it may seem, do for yourself what medical professionals and therapists have been unable to do, for you. Structured exercises that retrain muscle/movement memory can do for you what manipulation, drugs, TENS ("transcutaneous electrical nerve stimulation" -- nerve stimulation through the skin), or surgery, cannot.