Twenty-two years ago after a morning jog followed by my usual yoga limbering, a pattern of over 10 years, I developed excruciating left buttocks and sciatic pain. Finally the following morning I saw an Osteopathic physician who diagnosed a sacral shear. It took him 45 minutes to correct the shear, with immediate relief of the pain. I became interested in this double rotation of the sacrum and quickly learned that a significant percentage of my chronic pain patients, many of whom had had unsuccessful back surgery, often with a fusion, had an undiagnosed sacral shear. Incidentally, there also is a rotation in only one direction and this is called sacral torsion.
Since then I have reduced this very significant, painful condition in scores of patients, including family members, staff, friends, patients and attendees at various workshops. In many workshops of several hundred individuals, 10% of the attendees ask to be checked and treated. Almost all who come forward in these situations have an undiagnosed sacral shear or torsion. On at least two occasions, patients with clearly ruptured discs have also had sacral shear, with total relief of pain when the shear is reduced.
In this regard, it is worth noting that at least 30 percent of individuals with NO back or sciatic pain have evidence of ruptured discs on MRI. The indication for surgery for a ruptured disc is unequivocal nerve pressure; even then, if the neurological damage is only slight numbness and not significant weakness, Intervertebral Differential Dynamic therapy is indicated.
The biggest problem in receiving a diagnosis and proper treatment is that, in general, it is only the 10% of Osteopaths (D.O.) who do Osteopathic Manipulative Therapy who treat this condition. My experience is that many of my patients have had many unsuccessful Chiropractic adjustments which have not addressed the sacral shear. It seems that sacral shear is not a diagnosis known by M.D.'s or D.C.'s.
The important message of this newsletter is:
If you fall on your buttocks, slip and twist, etc. and have significant buttocks pain, with or without sciatic pain, insist on seeing an Osteopathic Physician who does OMT. I have traveled 150 miles for proper treatment and it is worth it! When my own sacral shear recurred for the third time, I had prolotherapy, a technique of injecting a sclerosing agent to increase ligamentous scar. That was almost 5 years ago and stopped the recurrent rotation of the sacrum. This latter requires an expert and may be available in the hands of only a few competent Osteopaths.