Therapy of an ISG blockade

General

First, the acute pain should be relieved with pain medication.
This prevents a relieving posture and the associated worsening of the deformity. The drugs are usually both anti-inflammatory and analgesic and can either be injected directly into the affected joint or taken orally through tablets.

The advantage of direct injections is the lower systemic effect of the drugs.

Even a trained chiropractor can lead to direct pain relief through a successful direct blockage solution.
After a manipulation, the patient should always walk a little so that the affected ligamentous apparatus normalizes itself through natural movement.
So that the ligaments and muscles are strengthened, incorrect posture corrected and a renewed blockage of the sacroiliac joint is avoided, a blockage solution should always be followed by long-term physiotherapy.

Manual therapy of an SI joint blockade

The ISG blockade is primarily a muscular problem that makes any movement in the lower back very painful. It is important to eliminate most of the pain before starting manual therapy. This is mainly done through drugs that allow pain-free movement. Otherwise, two subsequent problems can occur during therapy. In the case of inadequate pain therapy, pain can become chronic despite eliminating the cause and lead to permanent complaints in the lower back. On the other hand, painful movements in physiotherapy can lead to relieving postures and the learning of incorrect movement sequences.

Manual therapy includes interventions by doctors, chiropractors or physiotherapists, through which the blockage is to be released with the help of certain grips and massage techniques. There are certain techniques for this, which vary with the practitioner. An established method is the "cross handle". The patient lies on his stomach and the therapist reaches over the patient from the unaffected side and mobilizes the joint forwards and sideways.

After a successful manual therapy, improvements occur immediately in many cases. Ideally, the ISG blockage can be completely resolved in a few sessions. Otherwise you can do additional exercises yourself under supervision.

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Duration / forecast

How long this therapy has to be carried out cannot be determined for the general public, but has to be decided individually.
Blockages caused by constant bad posture, in particular, require longer and more intensive therapy than blockages triggered by an acute event, such as incorrect movement.

Depending on the current pain situation, defined rest periods must be observed in order not to overload the patient and the affected sacroiliac joint.

Read more on the topic: Duration of an ISG block

Further alternative therapy options

In some cases, alternative therapy methods such as acupuncture, electrotherapy or naturopathic methods also help. However, there is no scientifically proven effectiveness for this and must therefore be evaluated by the patient himself.

If all attempts at treatment do not lead to an improvement in the symptoms, contact should be made with a pain therapist. This can initiate individual pain therapy and use local measures to reduce side effects.

In some cases, medication can be used to tighten the ligaments to help hold the SI joint in place.

In no case should alternative treatment methods be sought too quickly. In most cases, an ISJ blockade requires long-term and regular therapy, which can hardly be successful without continuous cooperation from the patient. A possible change in behavior in everyday life, more exercise or weight reduction can also make an important contribution to successful therapy, which makes it clear that effective therapy is not possible without the cooperation of the patient.

Also read: SIJ blockade symptoms

Figure ISG - blockage

Figure ISG - blockade: groin pain (left) and back pain (right)

ISG - blockade - conduction symptoms

  1. Sacrum-iliac joint
    (Sacroiliac joint,
    abbreviated ISG)
    Articulatio sacroiliaca
  2. Front Sacrum-iliac ligament
    Lig. Sacroiliacum anterius
  3. Iliac bone - Os ilium
  4. Sacrum - Sacrum
  5. Lumbar and sacrum kink -
    Promontory
  6. Fifth lumbar vertebra -
    Vertebra lumbalis V
  7. First lumbar vertebra -
    Vertebra lumbalis I
  8. Thoracolumbar junction
  9. Twelfth thoracic vertebra -
    Vertebra thoracica XII
  10. Hip joint - Articulatio coxae

    Pain radiation areas:
    A - lumbar spine (lumbar spine)
    B - buttock region - Gluteal region
    C - Groin - Inguinal region
    D - front and back leg
    E - knee

You can find an overview of all Dr-Gumpert images at: medical illustrations

The therapy of an SIJ blockade in pregnancy

Pregnancy represents such a change in hormones, weight loads and physiological processes in the body that an ISG blockade can occur more favorably. This is mainly due to hormones that are released in preparation for birth and that loosen the muscles throughout the body. The muscles of the back are also loosened, which leads to a loss of stability in the hips and spine. The additional weight load in the pelvic area with increased pressure in the abdominal cavity can quickly lead to an ISG blockage.

Even during pregnancy, pain relief must first be achieved with light medication. Therapy then consists of a combination of manual manipulation by a physiotherapist or chiropractor with independent strength exercises at home. Pregnancy is by no means a contraindication for these exercises. Only overexertion should be avoided.

Exercises to strengthen the back and muscles can also be used to prevent the occurrence of the SI joint blockade. These also facilitate the sudden change after the birth of the child, which is also a drastic change for the body.

Figure pelvis from the front: sacrum-iliac joint (red)
  1. Sacrum-iliac joint
    (Sacroiliac joint, abbreviated ISG)
    Articulatio sacroiliaca
  2. Iliac bone -
    Os ilium
  3. Sacrum -
    Sacrum
  4. Anterior sacrum-iliac bone
    -Tape -
    Lig. Sacroiliacum anterius
  5. Fifth lumbar vertebra -
    Vertebra lumbalis V
  6. Fourth lumbar vertebra -
    Vertebra lumbalis IV
  7. Tailbone -
    Os coccyxis
  8. Pubic bone -
    Pubis
  9. Femoral shaft -
    Corpus femoris
  10. Lumbar cruciate ligament kink -
    Promontory

You can find an overview of all Dr-Gumpert images at: medical illustrations

Solve ISG blockade through exercises

ISG blockages can be achieved through targeted exercises, both under the guidance of a Physiotherapists or on your own at home can be performed, can be solved.
On the one hand, there are certain Stretching exercises used to loosen the sacroiliac joint: in the supine position, for example, the legs can be set up and moved from side to side without moving the upper body or shoulders (movement only takes place in the pelvis). In the same way, only one leg can be set up at the level of the other knee joint and pulled over the other, lying leg with the hand, so that the muscles surrounding the joint are stretched.

Stabilizing exercises for the pelvic / back or trunk muscles are just as important to compensate for imbalances, shortening and deficits.

Exercises according to Dorn

The Dorn method or Dorn therapy is a manual treatment measure that the Allgäu farmer Dieter Dorn developed around 1975. The methodology is one Mixture of chiropractic, meridian theory and traditional Chinese medicine. Recognition in science has not yet been achieved, however, because no concrete, measurable proof of effectiveness could be proven.
The Dorn method is mainly used in Germany and is preferably used for problems with the back and joints.

The aim of therapy according to Dorn is Correct leg length differences and to bring the vertebral bodies of the spine back into the correct position in order to correct bad posture and incorrect strain and to alleviate pain symptoms.
The therapist uses light pulling and pushing techniques and, at the same time, targeted movement by the patient to correct incorrect loads and bad posture, relieve muscle tension and blockages and correct muscle shortening.

Dorn's therapy can also be used in the case of an ISG blockage and help to resolve the joint tilt.

Exercises with the tennis ball

With a tennis ball it is possible to work a little against the ISG blockade on your own at home. The tennis ball can be used for a "self-massage" and complement the relaxing massages of a physiotherapist.
The is to be carried out Tennis ball massage either standing or lying down, the tennis ball is placed between the back and a wall or between the back and the floor. The painful areas or pressure points can then be massaged by rolling the tennis ball over the back with a pressure of your choice.