Sergio Marcucci
The sacroiliac joint (SIJ) is organized by articular surfaces between the sacral and iliac bones. It has different functions to connect the spine to the pelvic bone, allowing for better transmission of vertical forces from the spine to the pelvis and lower extremities. The first purpose of the SIJ is to provide stability, which is promoted partly by the muscles attached to the SIJ and is provided by multiple mechanisms, embracing the complex of ligaments fixed to the SIJ. The range of motion of SIJ is estimated around 2 to 4 degrees. Additionally, 35 muscles attach to the sacrum or innominate, which act in a combined effort with the fascial and ligaments, thus ensuring movement and simultaneously stability of the trunk and lower extremities. The SIJ also is an essential generator for pelvic and low back pain (LBP)in the differential diagnosis of referred map pain in the lower extremities. An increased prevalence of LBP and its related costs in the United States and the rest of the world. In Europe, the increase of adult patients with LBP is associated with sedentary activities as working with a computer behind a desk. Marcucci, Alexander, and Matthews observed in a pilot study composed of a sample with 20 patients having LBP or pelvic, and or lower extremities pain, after applying two different osteopathic release techniques on the posterior SIJ ligaments, a reduction of the pain in 18 patients, from which 12 had no pain anymore, 6 had only a reduction of the intensity of their pain. In two cases, the techniques did not provide any effect on the pain intensity. New insights of pelvic pain include cluneus nerve entrapment due to the over tension of muscle quadratus lumbarum in the differential diagnosis
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