Differential diagnosis alternative causes

From a functional point of view, a distinction is made between pelvic vaulting and ISG blockade Pelvic vaulting is actually a normal process when walking. However, if functional disorders occur that are not caused by the ISG, but by the spine, for example, or the upper cervicals, pelvic dislocation can also occur as a compensation mechanism. The pelvic contortion is characterized by: To treat pelvic torsion, the cause must be found and treated.

It must be differentiated whether the cause lies in the joint or in the musculature. The pelvic torsion and ISG blockade can also be present in combination.

An asymmetry of the pelvic position, the position of the pubic branches and an indifference of the iliac spines on one side.
The ISG blockage usually does not have these asymmetries.
A positive leading phenomenon on the corresponding side, which disappears again after 20-30 seconds at maximum torso flexion. In case of a blockage, the forward motion remains constant.
Normal joint play.

Inflammation is often a chronic process that first appears in early adulthood. Typical is a rather insidious onset without apparent cause.

The pain is particularly severe when there is a lack of movement. Through specific laboratory diagnostics or a contrast medium MRI, an inflammation can be distinguished from an ISG blockage. Therapy is more likely to be carried out using anti-inflammatory drugs, but regular exercise therapy is also an important part of the treatment.

Duration

The duration of the ISG blockade cannot always be accurately predicted. The decisive factors are the cause of the blockage, the degree of pain and the response to treatment by the orthopaedist. A distinction must be made between an acute and a chronic blockade.

The latter is also called “permanent blockage”. In acute cases of ISG blockage, which is mostly caused by muscle tension, a single therapy may be sufficient to eliminate the cause and the pain. A typical treatment, which consists of slow mobilization of the muscles or jerky manipulation in the joint, takes about 30 minutes a day.

In acute cases, the pain improves with each session and the blockage should be released after 2-3 weeks at the latest. However, the pain can also develop chronically. This means that it remains for several weeks and months.

In these cases, the treatment benefits from extensive physiotherapy and consistent muscle building in the lower back. If possible, the training of the muscles should be maintained for life. The pain and blockage usually disappear after months of consistent muscle building.

If the cause of the ISG blockage is not an easily relieved muscle tension, other treatment steps must be taken. The pain often occurs over several weeks and is not caused by a single event. Likewise, the treatment and subsidence of the pain cannot be guaranteed with a single visit to an orthopedic surgeon.

Mobilization and manipulation by doctors or therapists must be followed by exercise therapy and muscle building. Within the scope of targeted muscle training in the lower back, patients strengthen the trunk and pelvic muscles. In addition, they get to know their movement possibilities better or learn to deal with the blockage and a pain and achieve a better body feeling. The aim of therapy for chronic ISG blockage is to relieve pain and avoid medication.