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Sacro-Ileac Pain

Sacro-Ileac Pain Dr R P Graham The sacro-ileac syndrome is a very flexing to the same side is a herni­ MB BS common condition which normally ated disc. Remember, if stretching receives inadequate treatment. This ently lengthening the leg, and the hurts, it is a sacro-ileac: if kinking hurts, it is a disc) is partly because the pathology is sacro-spinalis muscle goes into hotly disputed and little under­ spasm in an unsuccessful attemptto e positive Downing's sign on the pull it back. The doctor feels the stood. Nevertheless, I believe that affected side spasm, the patient says 'ouch', and acupuncture treatment can achieve eback pain on springing the 51 considerable success in reducing a confident diagnosis is made. joint. inflammation, relieving pain and If there hasbeen an injury, it isa stimulating natura! healing. So, what do you do for the pulled muscle or a strained liga­ The sacro-ileac joint is a large, patient who comes to your surgery ment; if not, it is lumbar fibrositis. flat, gliding synovial joint where the in intense pain and acute spasm Sometimes the displacement arrow-head of the sacrum 15 presses on the piriformis muscle with or without a locked back? First wedged into the pelvis. The sacrum which runs acrossthe pelvic aspect take the history and examine the glides forward slightly on the patient as best you can. Having of the joint, and that goes into innominate during lumbar forward excluded dangerous conditions, spasm, causing pain in the hip. flexion; it has no muscles to give it you may safely apply acupuncture Sometimes the patient develops a stability since the low back muscles compensatory lumbar scoliosis to treatment, using periosteal pecking run vertically and not across the bring the short leg to the ground. at the insertion of the low back liga­ joint, so it depends mainly on the The orthopaedic surgeon, how­ ments to stimulate healing, reduce low back ligaments and partly on ever, says this cannot happen and inflammation and relieve pain. This the roughnessof its surfaceto hold it that the symptoms aredue to lesions technique can be carried out asper in place. In the autopsy room it is a in the lumbo-sacral zygo­ Barbour or Mooney. If the treat­ rigid, immovable joint, held by the apophyseal joints. Cyriax, on the ment is unsuccessful, try injecting now hardened ligament. procaine into the same area, then other hand, says everything in the This area can be damaged in apply adhesive zinc oxide vertical lumbar region is a disc. Many many ways but acute - and sub­ doctors think the pain is purely liga­ strapping. Bring the patient back in sequently chronic - strain is most mentous and believe the discomfort three or four days, repeat the acu­ often caused by lifting while is felt on stretching and after use in puncture above and below the bending forwards, a whiplash car the sameway astennis elbow. strapping and manipulate. injury, softening of the ligaments Whatever the true pathology of The best acupuncture points to during pregnancy, coupled with use, in my experience, are: 828823 the sacro-ileac syndrome, the same menstrual hormone changes or symptoms, signs and recom­ HKl 825 831-34 G34 G20 814 Li4 wear on the joint as a result of mended treatment apply. In the first and periosteal acupuncture. If you ageing. Many people inherit dry place, though, it is necessary to ease the spasm, the circulation will joints and are more liable to prob­ exclude the rarer and more serious flow again and remove the waste products. lfthe joint is subluxated, it lems than others. causes of sacro-ileac pain, such as Pain and local tenderness are should be replaced by manipula­ sacro-ililtls, malignant secondary usually felt about one to two inches deposits, rheumatoid arthritis, tion. from the mid-line. The discomfort, ankylosing spondylitis multiple Manipulation is not always which is not normally aggravatedby myelomatosis etc. Most of these needed, however, and some cases coughing, sometimes radiates conditions can be indicated by the will correct themselves after acu­ across, or up, the back, or down the history and observation of puncture alone. Itreated this type of lower limb. It is worse after strenu­ abnormal muscle spasm and con­ case with reasonableresultsby pure ous exercise and with prolonged firmed by X-ray or, by the ESR, acupuncture for nine years before I standing. The pain on standing for a which takes only one hour to pro­ was taught how to reduce the dis­ long time in one position is typical duce results. placement. ForsixyearsI usedtrad i­ of an enthesopathy of the posterior The signs of sacro-ileac syn­ tional acupuncture, manipulating sacro-ileac and ileo-l umbar liga­ drome are: the needles by hand, before I ments and is known in the trade as learned that electro-acupuncture e scoliosis (sometimes) 'the cocktail party syndrome'. prod uced superior resuIts. etenderness in the depression However, there is much dis­ If the condition recurs, the best below the posterior superior ileac pute about the pathology of this plan is to repeat the treatment, fol­ spine condition. The osteopaths say that lowing any manipulation with acu­ ethe posterior superior ileac spine the sacrum subluxates forwards on puncture to reduce the post-mani­ on the affected side rises on lumbar the ileum and jams in that position. pulation discomfort. If it goes on forward flexion This causes pain and stiffness. recurring, try injecting with a prolif­ Sometimes the back locks and the e pain on the affected side when erant solution to produce new sufferer cannot straighten up. The side-flexing the lumbar spine to the fibrous tissue and tighten the slack pelvis tilts down on one side, appar- opposite side (Pain felt on side- joint. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

Sacro-Ileac Pain

Graham, R P
Acupuncture in Medicine , Volume 2 (1): 1 – Jan 1, 1984
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Publisher
SAGE
Copyright
© 1984 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/aim.2.1.20
Publisher site
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Abstract

Dr R P Graham The sacro-ileac syndrome is a very flexing to the same side is a herni­ MB BS common condition which normally ated disc. Remember, if stretching receives inadequate treatment. This ently lengthening the leg, and the hurts, it is a sacro-ileac: if kinking hurts, it is a disc) is partly because the pathology is sacro-spinalis muscle goes into hotly disputed and little under­ spasm in an unsuccessful attemptto e positive Downing's sign on the pull it back. The doctor feels the stood. Nevertheless, I believe that affected side spasm, the patient says 'ouch', and acupuncture treatment can achieve eback pain on springing the 51 considerable success in reducing a confident diagnosis is made. joint. inflammation, relieving pain and If there hasbeen an injury, it isa stimulating natura! healing. So, what do you do for the pulled muscle or a strained liga­ The sacro-ileac joint is a large, patient who comes to your surgery ment; if not, it is lumbar fibrositis. flat, gliding synovial joint where the in intense pain and acute spasm Sometimes the displacement arrow-head of the sacrum 15 presses on the piriformis muscle with or without a locked back? First wedged into the pelvis. The sacrum which runs acrossthe pelvic aspect take the history and examine the glides forward slightly on the patient as best you can. Having of the joint, and that goes into innominate during lumbar forward excluded dangerous conditions, spasm, causing pain in the hip. flexion; it has no muscles to give it you may safely apply acupuncture Sometimes the patient develops a stability since the low back muscles compensatory lumbar scoliosis to treatment, using periosteal pecking run vertically and not across the bring the short leg to the ground. at the insertion of the low back liga­ joint, so it depends mainly on the The orthopaedic surgeon, how­ ments to stimulate healing, reduce low back ligaments and partly on ever, says this cannot happen and inflammation and relieve pain. This the roughnessof its surfaceto hold it that the symptoms aredue to lesions technique can be carried out asper in place. In the autopsy room it is a in the lumbo-sacral zygo­ Barbour or Mooney. If the treat­ rigid, immovable joint, held by the apophyseal joints. Cyriax, on the ment is unsuccessful, try injecting now hardened ligament. procaine into the same area, then other hand, says everything in the This area can be damaged in apply adhesive zinc oxide vertical lumbar region is a disc. Many many ways but acute - and sub­ doctors think the pain is purely liga­ strapping. Bring the patient back in sequently chronic - strain is most mentous and believe the discomfort three or four days, repeat the acu­ often caused by lifting while is felt on stretching and after use in puncture above and below the bending forwards, a whiplash car the sameway astennis elbow. strapping and manipulate. injury, softening of the ligaments Whatever the true pathology of The best acupuncture points to during pregnancy, coupled with use, in my experience, are: 828823 the sacro-ileac syndrome, the same menstrual hormone changes or symptoms, signs and recom­ HKl 825 831-34 G34 G20 814 Li4 wear on the joint as a result of mended treatment apply. In the first and periosteal acupuncture. If you ageing. Many people inherit dry place, though, it is necessary to ease the spasm, the circulation will joints and are more liable to prob­ exclude the rarer and more serious flow again and remove the waste products. lfthe joint is subluxated, it lems than others. causes of sacro-ileac pain, such as Pain and local tenderness are should be replaced by manipula­ sacro-ililtls, malignant secondary usually felt about one to two inches deposits, rheumatoid arthritis, tion. from the mid-line. The discomfort, ankylosing spondylitis multiple Manipulation is not always which is not normally aggravatedby myelomatosis etc. Most of these needed, however, and some cases coughing, sometimes radiates conditions can be indicated by the will correct themselves after acu­ across, or up, the back, or down the history and observation of puncture alone. Itreated this type of lower limb. It is worse after strenu­ abnormal muscle spasm and con­ case with reasonableresultsby pure ous exercise and with prolonged firmed by X-ray or, by the ESR, acupuncture for nine years before I standing. The pain on standing for a which takes only one hour to pro­ was taught how to reduce the dis­ long time in one position is typical duce results. placement. ForsixyearsI usedtrad i­ of an enthesopathy of the posterior The signs of sacro-ileac syn­ tional acupuncture, manipulating sacro-ileac and ileo-l umbar liga­ drome are: the needles by hand, before I ments and is known in the trade as learned that electro-acupuncture e scoliosis (sometimes) 'the cocktail party syndrome'. prod uced superior resuIts. etenderness in the depression However, there is much dis­ If the condition recurs, the best below the posterior superior ileac pute about the pathology of this plan is to repeat the treatment, fol­ spine condition. The osteopaths say that lowing any manipulation with acu­ ethe posterior superior ileac spine the sacrum subluxates forwards on puncture to reduce the post-mani­ on the affected side rises on lumbar the ileum and jams in that position. pulation discomfort. If it goes on forward flexion This causes pain and stiffness. recurring, try injecting with a prolif­ Sometimes the back locks and the e pain on the affected side when erant solution to produce new sufferer cannot straighten up. The side-flexing the lumbar spine to the fibrous tissue and tighten the slack pelvis tilts down on one side, appar- opposite side (Pain felt on side- joint.

Journal

Acupuncture in Medicine – SAGE

Published: Jan 1, 1984

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