Can back pain caused by symptom-giving sacroiliac joint relaxation ...

1.3. Pathophysiology
In the literature [17, 29, 41, 35, 37] various denominations are used to describe
"symptom-giving sacroiliac joint relaxation in pregnancy" or a similar complex of
symptoms in the pelvic region. These symptoms are also interpreted quite differently
depending on geographical regions or professional groups. Even every language
has, within the scope of its linguistic possibilities, different descriptions of this
phenomenon. In the following I want to illustrate briefly some of the denominations
and diagnoses describing this complex of symptoms.
1.3.1. Blockage of the SIJ
.
Niethart et al. [41] define an SIJ blockage as an event where usually a rotational
movement gives rise to acute pain in the sacroiliac region. The reason for this pain is
a blockage of the sacroiliac joint by a locking of the joint surfaces. [41 p. 403]. As a
consequence the range of motion in this joint is considerably limited. In osteopathy
as well as in other manual therapeutic concepts (chiropractic, manual therapy
according to the Kaltenborn or to the Maitland concept), the incorrect position of the
sacrum and the ilium are analysed and treated in SIJ blockage. If one or both SIJ(s)
is/are limited in its/their range of motion, this rarely causes symptoms in the affected
SIJ; it rather affects the surrounding joints, especially the hip joint, the region of the
lumbar spine, or even structures much further away, which become overstrained and
therefore show symptoms in the respective region. [54]
Typical SIJ symptoms appearing in highly acute pain episodes are caused by great
instability with very loose structures (ligaments) in the SIJ region.
As the SIJ is a planar joint with ridges or bumps, which normally increase stability, a
very loose (or a very unstable) SIJ leads time and again to a so-called blockage of
motion at the end of the range of motion. The two joint partners lock up and severe
symptoms appear in the SIJ region. This complex pattern poses a great challenge for
the therapist: to treat a blocked joint that, primarily, is a hypermobile one. Therefore it
Master’s Thesis Wolfgang Aspalter 21