Pelvic Pain, Arlington Texas
Pelvic Pain: When It Is The Joint And When It Is Not
The short answer
Pelvic pain has mechanical causes and it has medical ones, and the first job is telling them apart. The mechanical version usually involves the sacroiliac joints where the spine meets the pelvis, and it typically sits low and to one side, changes with position, and is worse getting out of a car or turning over in bed. No single test identifies that joint reliably, which is why a group of provocation tests is used rather than one. Where the pattern is not mechanical, it belongs with your physician and you get pointed there instead.
What Is Actually Happening
Where The Spine Hands Its Load To The Legs
The sacroiliac joints barely move. What they do instead is transfer everything above them into the legs.
The sacrum is the wedge of bone at the base of the spine, and it meets the two halves of the pelvis at the sacroiliac joints. They are built for stability rather than range, so they move only a few degrees. Their job is to pass load from the trunk into the legs and back again, one side at a time, every step you take. When one of them stops sharing that load evenly, or when the ligaments around it get irritated, you get pain that sits low and off to one side, often pointed to with one finger just below the belt line.
The giveaway is usually in what makes it worse: getting out of a car, rolling over in bed, standing on one leg to put trousers on, or sitting on one buttock. It is also why it gets mistaken for the low back and sometimes for the hip. Pain referral from this joint varies enormously between people, which is exactly why it needs testing rather than assuming.
What The Research Says
A Real Share Of Back Pain, And No Single Test Finds It
Expert Review of Neurotherapeutics, 2013 (Cohen, Chen and Neufeld, Johns Hopkins School of Medicine): sacroiliac joint pain is described as an underappreciated source of mechanical low back pain, affecting between 15 and 30 percent of people with chronic pain that does not run down the leg. People with this problem are more likely than others to name a specific event that started it, and to have pain on one side below the L5 level. No single physical examination finding or piece of history reliably identifies a painful sacroiliac joint, but a battery of three or more provocation tests predicts the response to diagnostic blocks. Named predisposing factors include a true or apparent leg length difference, older age, inflammatory arthritis, previous spine surgery, pregnancy and trauma.
What this means in plain terms: this is common enough to be worth taking seriously, and it cannot be found with one test. That is the practical reason a pelvic examination here takes longer than one movement and a press with a thumb.
Two of those predisposing factors are worth naming out loud. Previous spine surgery changes how load is shared and shows up here often. So does pregnancy, and Dr. Monet does treat pregnant patients using pelvic balancing techniques. She is not Webster certified and that is never claimed.
What Gets Examined
A Group Of Tests, Then A Plan You Can Repeat Back
Because no single test settles it, several provocation tests are used together and the pattern across them is what counts. Alongside that, the hips and the low back get examined, because they refer into the same area and because a stiff hip is one of the common reasons a sacroiliac joint ends up doing more than its share. How you load each leg standing, stepping and squatting is part of it too.
Dr. Monet is certified in applied kinesiology, and manual muscle testing is used here as part of that examination rather than as a test standing alone. Around a pelvis it is a practical way to compare left and right under load. Nothing here is a promise of a particular result. If the examination says this is not a mechanical problem, you get told plainly and pointed at the right person.
Read This First
Pelvic Pain That Needs A Doctor First
If You Notice Any of These Warning Signs, Please Seek Emergency Room Care Right Away.
- Loss of bowel or bladder control, or numbness through the saddle area or inner thighs. This can be cauda equina syndrome and it is an emergency
- Weakness in both legs, or weakness anywhere that is getting worse day by day
- Fever alongside pelvic or spinal pain, or unexplained weight loss
- Pelvic pain with bleeding, with a change in urination, or with severe abdominal pain
- Pain following a significant fall or collision, or a suspected fracture
- New pelvic or spinal pain with a history of cancer
- In pregnancy: bleeding, leaking fluid, contractions before term, severe headache or vision change, or reduced fetal movement. Call your obstetric team or go to labour and delivery, not here
There is no imaging in this building, so anything needing an X ray or an MRI means a referral rather than a guess. Call 817-800-7136 and describe it, and you will be told plainly where to go.
Common Questions
Pelvic Pain, Asked And Answered
Is this the same as low back pain?
Not quite. Sacroiliac pain usually sits lower and to one side, often below the belt line, and it changes with things like getting out of a car or standing on one leg. The 2013 review puts it at 15 to 30 percent of chronic pain that does not run down the leg, so it is a real and separate slice.
Can you tell with one test?
No, and anyone who says otherwise is overstating it. The review is explicit that no single examination finding or history item reliably identifies a painful sacroiliac joint. A group of three or more provocation tests is used instead, and the pattern across them is what carries the weight.
I am pregnant. Can I be treated?
Yes. Dr. Monet treats pregnant patients using pelvic balancing techniques. She is not Webster certified and that is never claimed. Bleeding, leaking fluid, contractions before term, severe headache or vision change, or reduced fetal movement all mean calling your obstetric team rather than this clinic.
Does one leg being longer cause it?
A true or apparent leg length difference is one of the predisposing factors named in the review, alongside older age, inflammatory arthritis, previous spine surgery, pregnancy and trauma. It is a contributor rather than an explanation on its own.
What if it is not mechanical?
Then it belongs with your physician or your gynaecologist and you get told that. Pelvic pain with fever, bleeding, a change in urination or severe abdominal pain needs a medical opinion first, and that is not a referral anyone here will delay.
Do you take insurance for this?
Insurance and paying directly both work. Call 817-800-7136 and ask before you book, and you will be told how it works in your case. Appointments only, so a visit has to be booked.
Sources
Where The Numbers On This Page Come From
- Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Cohen SP, Chen Y, Neufeld NJ. Expert Review of Neurotherapeutics 2013;13(1):99 to 116. Source of the 15 to 30 percent share of chronic non-radicular low back pain, the finding that no single examination or history item reliably identifies the joint while a battery of three or more provocation tests predicts response to diagnostic blocks, the unilateral pain below L5 pattern, and the named predisposing factors.
Get The Pelvis Examined Properly
Call and describe where it sits and what makes it worse, or book online and pick a time.
3825 W Green Oaks Blvd, Suite 710, Arlington, TX 76016. Appointments only.