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Andrea Glover
Mar 4, 2009 - 12:53PM
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what is the difference between sacroiliac pain and sciatica?
I am 25 years of age, I was diagnosed with a slipped disc and osteoarthritis when I was 20 years old. I have undergone quite a few facet joint injections which left me pain free for months at a time, however I have not been able to walk drive or carry out daily tasks. I have suffered a cold sharp flashing type pain from my lower back to my left toes, as well as numbness in my feet buttocks and fingers. I have mentioned this to my consultant at a private hospital and he has advised me that i am suffering from sacroiliac joint pain. I have also been advised that this can lead to sciatica. What is the difference between sacroiliac joint pain and sciatica? and can sacroiliac joint pain lead to sciatica?
Email andrea.glover007@hotmail.co.uk
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awaq
Mar 10, 2009 - 2:27PM
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Re: what is the difference between sacroiliac pain and sciatica?
In non-inflammatory sacroiliac dysfunction the underlying muscle imbalance must be addressed. These are the deep rotators of the legs. These muscles are located underneath the glutes (butt) muscles. The sacroiliac joint is simply an innocent bystander as this region of the lower back becomes dysfunctional.
Patients do not walk in such a stiffened manner and trunk range of motion usually is uninhibited, but one can detect a subtle pivotal movement in the region of the sacroiliac joint when the patient moves from an extension to a full flexion position.
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awaq
Mar 10, 2009 - 10:16PM
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Re: what is the difference between sacroiliac pain and sciatica?
Also, as I am just a layman, take this for what its worth. Looking at just your sacroiliac / sciatica problem this seems to be tight muscles in your butt. (sciatica can be caused by a tight piriformis muscle). The question to ask is "Why are my muscles tight?". Usually when you find one muscle that is overcontracted, there is a corresponding muscle that is weak muscularly or neurologically (nerves) inhibited. So if one side of your glutes is tight and strong, the other side will tend to be weak. This leads to sacroiliac dysfunction.
Or the weakness could in another place. Consider both the glutes and the abs keep the pelvis from tipping forward. If your abs are weak, the glutes will have to work extra hard to rotate the pelvis backwards.
If you have disc problems it is important not to slouch where you round the lower back. This makes the discs bulge and herniate. Use a lumbar support in your lower back when sitting and especially driving as vibrations when seated are particularly damaging to the back.
Take care.
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Steven Hefferon
Mar 11, 2009 - 12:43PM
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Re: what is the difference between sacroiliac pain and sciatica?
Andrea, Dave H. has written extensively on this subject please use the search box in the upper right of the page...
with all the key words that you have questions about...
Steve
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awaq
Mar 12, 2009 - 2:39PM
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Re: what is the difference between sacroiliac pain and sciatica?
Here is a simple self-diagnosis test you can do to see if you have dysfunction in the deep hip rotators which may lead to sacroiliac pain. It is also good for strengthening the deep rotators.
1) Lie face down.
2) Legs are substantially straight, rotate your legs out from the hip socket. Do not rotate through the knees or feet. Your heels should be 6-12" apart at most.
Important: You glutes (butt) should be completely relaxed. If you grab them with your hand they should be completely flaccid. Most books say that outward rotation of the leg is done by squeezing the glutes. That is completely incorrect. The glutes extend the hips and that is all. That is: either extend the leg back or push the hips forward.
3) Notice if one leg rotates out more than the other.
4) Try to increase the outward rotation at the hip socket by trying to press the inner thighs down towards the floor. Notice if one inner thigh muscle is tighter or weaker than the other.
5) Rock the hips side to side, pressing the left hip to the floor then rock and press the right hip bone into the floor. Can you feel any asymmetries in either hip?
After trying this test, you may also find it is easier to arch your lower back. Engaging the inner thigh muscles and rotating the legs outwards is one way to increase the curve in the lower back.
Good Luck!
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awaq
Mar 13, 2009 - 8:46PM
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Re: what is the difference between sacroiliac pain and sciatica?
Also should mention you should put one thumb under each hip ASIS to make sure the hips are not twisted.
You can also put your feet up against the wall to try to make sure your torso is straight.
It's interesting to note the relationship between engagement of the inner thighs (which most people don't do) and the arch in your lower back (which most people don't have). The result is not only back pain but a torn ACL. If the inner thigh does not engage the femur rotates internally and voila, torn ACL.
That's my theory anyhow. If anyone knows better I would be interested.