AOCPMR 2024 Mid-Year Meeting-Pelvic Joint Dysfunction: An Underappreciated Cause of LBP - Orrin Mann, MD, MPH; Jason Holgers, DO; Tyler Kemnitz, DPT

Pelvic Joint Dysfunction: An Underappreciated Cause of LBP - Orrin Mann, MD, MPH; Jason Holgers, DO; Tyler Kemnitz, DPT

Video Transcription

Video Summary

The lecture discusses pelvic joint dysfunction (PJD) as an often overlooked cause of low back pain, emphasizing its clinical diagnosis and challenges due to mixed literature and lack of definitive imaging or tests. PJD involves dysfunction in the sacroiliac (SI) joints and symphysis pubis, leading to altered bone positioning, ligament injuries, and muscular consequences affecting pelvic stability. Case studies illustrate typical presentations, responses to osteopathic manipulative treatments, and the potential to rapidly relieve symptoms, even after years of pain. The speaker critiques overreliance on imaging and interventions like SI joint injections or surgery, highlighting the importance of physical exam and understanding pelvic biomechanics—specifically form and force closure of the SI joint. He describes the pelvis as the "basement" of the spine whose proper alignment influences lumbar spine health, introducing the concept of “Jenga syndrome” where pelvic realignment alleviates symptoms caused by spinal stenosis. The talk stresses systemic rather than compartmentalized evaluation, noting common symptoms such as non-radicular leg pain and groin/testicular pain related to PJD. The speaker encourages broadening clinical context, performing a quick 2-minute exam for PJD detection, and remaining open to osteopathic treatment approaches, as these can drastically improve patient outcomes in a substantial subset of low back pain sufferers.

Keywords

pelvic joint dysfunction

low back pain

sacroiliac joint

symphysis pubis

osteopathic manipulative treatment

pelvic biomechanics

Jenga syndrome

physical examination