What is the true cause of back pain?
Is it the damage that has occurred in your spine?
Or is the true cause of your pain the reason why the damage occurred?
In a recent CNN Health article, they reveal how recent studies show that in 20-25% of all chronic lower back pain comes not from the spine but from the sacroiliac, or SI, joint. The article goes on to say:
"Most spine surgeons, however, aren't trained to look at the sacroiliac joint; they generally don't learn about it during their residency or fellowships. Then X-rays, MRIs and CT scans of aching, aging backs show narrowing spinal discs, without actually showing whether these discs are producing pain...further confusing the diagnosis of the suffering patient."
"As a result, many people progress through the usual stages of back pain treatment, from physical therapy and chiropractic treatment to injections, laser procedures and finally to surgery, without ever addressing the true source of the pain."
I like this article and how it is putting light to the fact many doctors aren't trained in looking for SI joint dysfunction and scans don't tell us if what we see is where the pain is coming from, but I think we should ask the next logical question:
What caused the SI joint dysfunction?
I don't believe it's someones age, genetics, or random bad luck that caused the SI joint dysfunction.
Let's look what is the SI joint, how does it work, and why does it sometimes stop working the way it's designed and become dysfunctional. The SI joint is the juncture between your sacrum and iliac and is where the weight of your upper body is transferred to your legs through your pelvis. The SI joint is designed to allow less than 4 degrees of rotational range of motion and is stabilized by the surrounding ligaments and muscles. The first 1:24 of this video is great at showing and explaining the SI joint:
Is it the damage that has occurred in your spine?
Or is the true cause of your pain the reason why the damage occurred?
In a recent CNN Health article, they reveal how recent studies show that in 20-25% of all chronic lower back pain comes not from the spine but from the sacroiliac, or SI, joint. The article goes on to say:
"Most spine surgeons, however, aren't trained to look at the sacroiliac joint; they generally don't learn about it during their residency or fellowships. Then X-rays, MRIs and CT scans of aching, aging backs show narrowing spinal discs, without actually showing whether these discs are producing pain...further confusing the diagnosis of the suffering patient."
"As a result, many people progress through the usual stages of back pain treatment, from physical therapy and chiropractic treatment to injections, laser procedures and finally to surgery, without ever addressing the true source of the pain."
I like this article and how it is putting light to the fact many doctors aren't trained in looking for SI joint dysfunction and scans don't tell us if what we see is where the pain is coming from, but I think we should ask the next logical question:
What caused the SI joint dysfunction?
I don't believe it's someones age, genetics, or random bad luck that caused the SI joint dysfunction.
Let's look what is the SI joint, how does it work, and why does it sometimes stop working the way it's designed and become dysfunctional. The SI joint is the juncture between your sacrum and iliac and is where the weight of your upper body is transferred to your legs through your pelvis. The SI joint is designed to allow less than 4 degrees of rotational range of motion and is stabilized by the surrounding ligaments and muscles. The first 1:24 of this video is great at showing and explaining the SI joint:
I apologize for the doctor's terrible posture at 1:49 into the video - he obviously doesn't do Postural Alignment Therapy!
The human body has some joints that are designed to allow a great range of motion (shoulders, hips, ankles) and other joints that are designed to have less range of motion and be more stable joints (knee, elbow, lumbar spine). These joints typically alternate throughout the body to create efficient movement patterns. This can be seen in this image:
The human body has some joints that are designed to allow a great range of motion (shoulders, hips, ankles) and other joints that are designed to have less range of motion and be more stable joints (knee, elbow, lumbar spine). These joints typically alternate throughout the body to create efficient movement patterns. This can be seen in this image:
From the bottom up, the joints function like this: foot - stable, ankle - mobile, knee - stable, hip - mobile, pelvis/sacrum/lumbar spine - stable, thoracic spine - mobile, scapulothoracic - stable, glenohumeral/shoulder - mobile, elbow - stable, wrist - mobile, metatarsal/phalangeal - stable, cervical spine - stable, atlanto-axial - mobile.
Back to the SI joint...
What causes SI joint dysfunction?
Since the SI joint is supposed to be a stable joint, SI joint dysfunction and pain often show up when one or both of a person's SI joints have become excessively mobile and lost their stability. This excessive movement can cause ligament, muscle, nerve, and joint pain and damage.
What would cause excessive SI joint movement? Usually it is a lack of mobility at the hip joint which causes the body to compensate and ask the SI joint to move beyond its design range of motion.
Think about it this way: While keeping your knees locked straight, bend down to try to touch your toes or the floor. If you have good hip mobility you will be able to put your hands flat on the floor like this:
Back to the SI joint...
What causes SI joint dysfunction?
Since the SI joint is supposed to be a stable joint, SI joint dysfunction and pain often show up when one or both of a person's SI joints have become excessively mobile and lost their stability. This excessive movement can cause ligament, muscle, nerve, and joint pain and damage.
What would cause excessive SI joint movement? Usually it is a lack of mobility at the hip joint which causes the body to compensate and ask the SI joint to move beyond its design range of motion.
Think about it this way: While keeping your knees locked straight, bend down to try to touch your toes or the floor. If you have good hip mobility you will be able to put your hands flat on the floor like this:
If your hips have lost their mobility, your body will try to find a way to get to the floor, often causing excessive movement in your SI joints and lumbar spine as seen the the photo below:
Besides your hips losing their ability to flex as seen above, losing normal rotation range of motion can also strain the SI joints causing excessive movement and laxity in the SI joint(s) and cause pain. Our hips are designed to have about 45 degrees of internal rotation and 45 degrees of external rotation (seen below but not the exact degrees):
When your body loses range of motion somewhere, the hip for example, it has to make it up somewhere else and often the range of motion is created at the SI joint causing pain and injury. It is very common to have SI joint issues on only one side because of imbalances in hip range of motion and function left to right stressing only one SI joint excessively.
These SI joint problems can be easily and quickly corrected by restoring proper hip range of motion through Postural Alignment Therapy. At Oregon Exercise Therapy, we don't just look at hip range of motion and stop there either, we look at your entire posture and movement patterns to make sure we are correcting all the postural imbalances that are contributing to your SI joint dysfunction and lower back pain. This ensures that your pain will go away and stay away and you will be able to return to the activities and sports you love - pain free!
These SI joint problems can be easily and quickly corrected by restoring proper hip range of motion through Postural Alignment Therapy. At Oregon Exercise Therapy, we don't just look at hip range of motion and stop there either, we look at your entire posture and movement patterns to make sure we are correcting all the postural imbalances that are contributing to your SI joint dysfunction and lower back pain. This ensures that your pain will go away and stay away and you will be able to return to the activities and sports you love - pain free!
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