Low Back Pain with Balance Problems

Did you fall recently? Do you have low back pain? Do you sometimes feel that you are walking on an uneven surface even though the floor is level? Do you sometimes misjudge distance while walking into another room and bump your shoulder on the door jam? Do you get very fatigued or even exhausted much earlier in the day? You might be suffering from a condition known as an…..Upslip.

What is an Upslip?

An upslip, or superior ilium, is a condition where one ilium (pelvis bone) is slightly higher than the ilium on the opposite side. They commonly occur from bending, rotating and lifting. When a person bends and twists to their left the upslip will occur on the right side. They also happen in motor vehicle accidents and when people fall and land on one buttock.

Symptoms of an Upslip

Do you feel as if you are walking on uneven ground, even though you know the floor is level? Does it hurt to sit too long? Do you sometimes misjudge distance, while walking through an open door, and bang your shoulder into the door jamb? Do you feel off balance and frequently have to catch yourself to keep from falling? Have you noticed yourself “running out of steam” much earlier in the day since having an accident or a fall?  I call this an early “fatigue point” could mean that a person is working harder, to maintain balance, because of an upslip.

Brain and muscle work together to produce the effort needed to maintain one’s balance. Because balance is a function of the autonomic nervous system, people aren’t consciously aware of the processes involved. If you answered yes to any of these questions, you may be suffering from an upslip.

Because the sitting bones (ischial tuberosities) are also uneven, people who suffer from an upslip condition typically experience sacroiliac pain while sitting, usually on the affected side, but in a small percentage of cases, on the opposite side

Two things happen to your anatomy when you have an upslip condition:

  1.  The sacrum (the base upon which the lumbar vertebrae are stacked) becomes unleveled. Extra stresses are applied to the sacroiliac joints which causes pain.
  2.  A functional short leg is formed because as the ilium moves upward it takes the leg along with it. A functional short leg leads to balance problems. When one leg is shorter than the other one, it feels as if you are walking with one shoe on and one shoe off. This is what gives you the feeling of walking on uneven ground. This unevenness can cause you to run into door jambs as you enter another room.

Correcting an Upslip

Physical therapists, skilled in manual therapy, are able to quickly assess your condition by observing your bony landmarks. They’ll look for an elevated ilium bone while you’re standing, sitting and lying in the supine (on your back) position. A functionally short leg will be apparent on the side of the elevated ilium.
The manual physical therapist will know how to correct the condition. After making the correction they will look for one of two possible secondary pelvic torsions. These too will be corrected.
The correction is often accomplished on one visit but sometimes the upslip returns. A couple of reasons for the return include:
  1. The patient continues to do the activities that caused it in the first place –  like continuing to bend, rotate and lift, or
  2. By having weak core muscle strength. I have found that strengthening the core muscles has been very useful in preventing recurring upslips. Your physical therapist will make suggestions on how to strengthen your core muscles.
If you suffer from any of the symptoms listed above, talk with your doctor. After he conducts a preliminary exam he may refer you to a physical therapist that’s skilled in manual therapy, to correct the condition. You may want to call physical therapists in your area and ask them if they are familiar with upslips and if they are skilled in manual therapy techniques.

Author: Tom LeBlanc, PT Certified Preceptor

TomLeBlancPT.com Tom LeBlanc, PT has enjoyed helping, encouraging and empowering individuals to Optimal Health and Function for over 40 years. As a physical therapist he has worked in Acute Hospitals, Rehab Centers, Outpatient Clinics, Geriatrics, in his Private Practice, and in the Home Health Environment where he is currently working at Encompass Home Health and Hospice. One of his passions is helping people to understand the importance of Good Hydration as a means to Optimal Health.

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