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ginger -> Re: sij dysfunction/ achilles tendinosis (December 20, 2005 12:59:00 PM)
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Jon , reminds me of the zeal with which surgeons approach the shoulder in cases of so called frozen shoulder. To state there were no complications after surgery is a little bizarre, but that's another matter.
When referred conditions arise, as is very common from lumbar structures, pain at the site of that pain can easily be altered by effects to that site. ie an injection of corticosteroid , use of modalities, ice etc. The referred pain may be relieved , providing a period of sensory "rest" as it were , allowing other factors, ie movement, recovery on a broader sense, to take place.
The results from this study suggest that the intervention at the SiJ was the relevent effect bringing about change to the pain picture( though no details on how and when this was measured are shown). The difficulty I have with using this study as an establishment for perceptiion about SIJ , from a pathophysiological view, or a treatment intervention view, is that sometimes even the wrong treatment works.
If corticosteroid is injected into a joint where referred events produce pain, pain releif happens, the effect is temporary in most cases. This is seen where steroid is improperly injected for those complaining of 'tennis 'elbow. In this clinic, three treatments to the relevant upper spine is the norm for elimination of this problem, without any attention to the elbow itself.
The same goes for shoulder pain of referred origin. Sure , an injection will dull the receptors and reduce inflammation , so will acupuncture, ice, modalities. No doubt the effect of even inapropriate sugery will provide relief from some referred pain.
I have not seen any individual with discrete SIJ pain in many years. many complain of pain in the sacral area, with palpable tenderness to SIJ's, In every case under my supervision or direct attention , this is eliminated with mobs to upper lumbar facet joints, along with some dural stretching. I am not convinced there is such a thing as discrete SIJ pain, which is not referred, unless injury has been the cause.
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