CHRONIC LOW BACK PAIN RELIEF: relief of pain generated by a dysfunctional sacroiliac joint (SIJ) is a major accomplishment because this pain is so severe. Studies have shown that the SIJ is responsible for pain generation in 13-30% of people with chronic low back pain.
@painmednews 3/29/2020
“Two-thirds of patients receiving radiofrequency ablation for sacroiliac joint pain gained nearly 3 months’ pain relief, & half reduced opioid use by 30%”.
“Two-thirds of patients receiving radiofrequency ablation for sacroiliac joint pain gained nearly 3 months’ pain relief, & half reduced opioid use by 30%”.
Radiofrequency ablation of nerves responsible for SIJ pain involves treating afferent dorsal medial branch nerves that serve nociceptive pain transducers within sacroiliac joints & which exit the sacrum via dorsal sacral foramina.
Radiofrequency ablation uses the foramina landmarks as guideposts to needle placement & destroys distal strands of neural fibers that tract to the SIJ ligament capsule & carrying pain messages from stressed ligaments of the SIJ capsule to brain.
The distal neural fibers are gradually (several months) replaced by growth of new fibers that spring from the ablation site & grow distally within the neural tract sheath, which is not destroyed by the ablating radiofrequency field.
Extrapolation of data suggests that up to 1 of every 27 persons with chronic low back pain might be significantly relieved of their chronic low back pain by this procedure, which is not only therapeutic, but is also diagnostic.
Reduction of pain proves that the sacroiliac joint ligament capsule is the tissue of pain generation; d/t stretch of injured ligaments associated with an injured dysfunctional (subluxing) sacroiliac joint.
Injured sacroiliac joints (SIJ), each 17 cm squared in area, lose ligament tethering integrity d/t bio-mechanical ligament injury. SIJ dysfunction is diagnosed via provocation maneuvers (16 known) readily performed in the clinic.
Prolotherapy with stem cells (or platelets) can be employed to re-establish ligament integrity of the SIJ, extend the period of renewed SIJ ligament capsule integrity, & provide freedom from pain generated by this joint.
The secret is to know which of the two major ligament systems, Iliolumbar or Sacrotuberous, of the sacroiliac joint capsule to treat in order to re-establish ligament capsule integrity.
A clinical examination can be readily performed in the clinic to ascertain which of these ligament systems needs treatment. In doing this examination, the clinician must first become familiar with biomechanical function of the SIJ.
The sacroiliac joint has a normal range of motion of 0.5 cm. This does not seem like a lot, but it is enough to enable humans to walk upright; compared to gorillas which lack this joint within their pelvises.
As the sacroiliac joint shifts position, it moves in two general directions called Nutation & Counter-Nutation. These are terms that describe relative spacial stations of the sacrum & ilium.
Once clinician has mastered understanding of these spacial anatomical stations, exams for excessive Range Of Motion (ROM) can be undertaken. The examination includes a maneuver invented by the author & which evinces the “Badgley Book Sign”.
The Badgley Book Sign (BBS) is teachable, reproducible, & measurable, & does not rely on pain as an endpoint. Therefore, BBS abides by principles of the scientific method. Several of my library threads @threadreader unroll describe BBS.
In use, Badgley Book Sign instructs examiners whether patient is experiencing SIJ Nutation or Counter-Nutation. This is important because knowledge of excessive ROM of Nutation or Counter-Nutation suggests which Prolotherapy treatment is needed.
Nutation excess is enabled when the Sacrotuberous ligament system is injured and lax. Counter-Nutation is enabled when the Iliolumbar ligament system is injured and lax.
Once the specific injured SIJ ligament system has been identified, ultrasound guided Prolotherapy can be applied to the specific ligament systems. This therapy, like radiofrequency neural ablation, is an outpatient procedure.
The purpose of Prolotherapy is to provide patients with a natural non-toxic way to re-establish pelvic girdle & sacroiliac joint integrity & significant remission from chronic low back pain.
Prolotherapy is a safe outpatient procedure that treats one of the largest joints in the human body, & a joint responsible for a good deal of human suffering and misery.
#Regenexx in the Cayman Islands is an expert facility whereat licensed US Orthopedists use stem cell Prolotherapy to regenerate integrity & function of various human joints.
In my various @threadreader unrolls, I have included detailed discussions about the Badgley Book Sign and diagnosis and treatment of sacroiliac joint disorders.
Also included within my library of @threadreader unrolls, are extensive discussions about Fibromyalgia causation, diagnosis, & therapy.
As I have studied Fibromyalgia (FM) sufferers over the last decade, I have come to regard that low back pain is a sine qua non of the diagnosis. I have also discovered that most FM sufferers’ low back pain is d/t SIJ dysfunction.
A clinical postulate that I have come to regard is that a major part of the rehabilitative effort for Fibromyalgia includes bio-mechanical stabilization of & reduction of pain within injured sacroiliac joints.
The pelvic girdle is a bio-mechanical platform for the human body. A platform unstable d/t SIJ subluxation evokes functional scoliosis, asymmetric shoulders & crossed muscle syndromes within the upright body tower.
These disorders cause chronic widespread painful soft tissue spasms and abnormal joint functions of neck, shoulder, & spine, & which in turn arouse widespread autonomic neural impingements.
Several of the chronic pain syndromes & dysautonomias associated with Fibromyalgia include Migraine, Cervicalgia, TMJ, TOS, POTS, Panic Attacks, Gastroparesis, IBS, & IC. Endometriosis might be another.
Fibromyalgia is a Super Syndrome that includes a variety of Sub Syndromes; all causally related. This is the reason that Fibromyalgia includes such a broad and disparate constellation of symptoms.
FM is a multifactorial disorder for which different sufferers accrue the core symptoms of chronic widespread pain, depression, & disturbed sleep via idiosyncratic clinical injuries, disorders, & pathology evolutions.
Efforts to discover a singular etiologic factor for Fibromyalgia (FM) are all for naught. It is this multifactorial nature of FM causation that confounds clinical researchers as they struggle to explain this curious Super Syndrome.
The insights and clinical impressions herein are of my own inventions and gained via an iterative evidence based method of medical discovery.
@threadreaderapp unroll
