Patient: Mrs Bratlett, 36 years old female, housewife, overweight and six months pregnant with third child.  Patient referral.

Date of First Visit:  19 April 2001

Chief Complaint:  Pain in the buttock and the groin on the right side. 

History of Present Condition:  First appears to be just pain, with the pain traveling down to the knee on the inside of the leg.  Symptoms progressed within a few weeks to the point that patient cannot stand up or walk.  Impossible to put weight on the right leg. Hospital doctor said there is nothing they can do for her, except give her a pair of crutches.  She has been suffering this condition for 3-4 weeks.

Examination:  Found tenderness in the lower back (point UB25, UB26, GB30).   Obvious tenderness on the Sacro-iliac area.   Patient has no power to move or lift the right leg.  Turning the right leg creates pain in the right side of the groin.  Sitting up is no problem.  When standing, she cannot put the right foot down.

Conclusion:  This is a typical problem for those who are overweight or pregnant because of the pressure caused by excessive weight.  Physiological changes in the pelvic region due to pregnancy causing bone fatigue, which results in the Sacro-iliac joint moving out of its position. 

 Diagnosis:  Semi-dislocation of the Sacro-iliac joint.

 Principle of Treatment:   To correct the alignment of the Sacro-iliac joint and release the pain.

 Points selected: UB26, UB25, UB54, GB30, UB29.

 Treatment Method:  Push the back from the top down to the buttocks for one minute.   Massage, press and knead the buttocks with gentle pressure to begin with.  Press and knead on the effected side where the tender spots are located for about three minutes.  Press and knead the above points for one minute each.

 Manipulation: 

For posterior dislocation. Patient lying on the healthy side with the healthy leg straight. Stand behind the patient, slowly and gently bend the effected knee with the right hand pulling it backward towards the buttock, at the same time with the entire palm of the left hand press and slightly push on the lower back of sacrum area. Repeat for a total of three times.  Or, use the manipulation of sideways stretching the effected leg. For anterior dislocation.  Patient lying on the healthy side with the effected leg bent.  Stand in front of the patient and with the right hand gently push the shoulder back, while with the left forearm press on the hip and gently push it towards yourself. 

After the tenth session, the pain was 80% gone.   The patient was able to walk without crutches.  When patient came into the late stages of her pregnancy, treatment was temporarily terminated.  After the birth, the problem worsened; both sides were effected.  Neither leg could be placed on the ground and the patient returned for treatment in a wheelchair.  After another course of treatment with the same method applied to both sides, the patient fully recovered and was able to walk normally.  Patient continued treatment on a monthly basis (once a month); the Body Maintenance Treatment was applied.