The Pelvis and The Emotions
Low Back and Pelvic Pain—- Is There a Connection to Emotional Stress?
By William H. Koch, DC first published in The American Chiropractor, Dec 2017
As chiropractors we are all aware of the neurological supremacy of the cervical spine. And while we usually associate emotional imbalance with cervical subluxations, it is important that we not overlook the intimate link between pelvic and emotional balance. The connection is very real. Sometimes an unbalanced pelvis causes great emotional distress. And sometimes, perhaps even more often, emotional upset and stress causes acute low back and pelvic pain.
If you read my article on The Pelvic Imperative, you know I place a high degree of importance on balancing the pelvis as a prerequisite to all other spinal correction. I have found that without a balanced pelvis or foundation, no other corrections will hold.
Every chiropractor has patients who come in with acute, severe low back pain, very upset, not knowing why or how it happened.
“Doc, I don’t understand. All I did was bend over to brush my teeth and it felt like I got kicked by a mule. Now I can’t straighten up, can hardly move, it hurts like heck. And on top of that I feel like the world is caving in on me, I’m out of control and can’t do anything about anything! I can’t figure out why this thing has me so upset I can hardly think straight. What’s going on with me?”
Not only do they not understand why their back suddenly went out, but they can’t figure out why they got so upset and lost their usual emotional control. In other words, they are suddenly and completely “out of balance.”
Of course, we all know that the little thing that “suddenly” happened to cause their crippling pain is often just the proverbial “straw that broke the camel’s back.” Usually they have had some structural instability or subluxation for a long time but had been compensating well enough to deny to themselves there was a problem. Until that “little thing,” that final straw landed on the weak foundation triggering an acute episode of severe sacroiliac pain.
And when this happens it can be very emotionally upsetting to the patient. When one of my patients comes in upset because they are in so much pain and cannot figure out how it happened or why it happened, I know that the most important thing I can do is to spend a few minutes with them to explain what has happened and why they are having such a surprising emotional reaction.
I explain that the low back and pelvis is the body’s foundation. Our physical strength, ability to walk, run, work and defend ourselves is dependent upon the strength of that foundation and that if our foundation is knocked out of balance it can destabilize our emotions, too.
There is a correlation between pelvic imbalance resulting from sprain/strain injury and emotional distress. Specifically, when the sacroiliac joint is sprained and strained, there is alteration of the weight bearing ability of that joint and consequently of the overall body balance and stability. The severity of this condition ranges from mildly to severely painful. In its early stage it may only involve the sacroiliac joint, but with time and increased severity it can extend to all seven pelvic joints, causing widespread low back, pelvic, hip and leg pain.
Since the pelvis is the weight bearing foundation of the whole body, any imbalance or failure of this complex joint system will result in an overall loss of strength and stability of the entire musculoskeletal system.
On a subconscious level, probably as one of our instinctive survival mechanisms, when our basic physical foundational support fails us it can cause us to feel weak, helpless and vulnerable. That translates into anxiety and even depression if it goes on for very long.
On a primal emotional level this condition is perceived as weakness, vulnerability, and an inability to defend, protect and provide for ourselves and those who depend upon us. This causes insecurity and stress on a deep emotional level. Our ability to survive and thrive in either a primitive or modern environment is dependent on our strength and mobility.
These are common emotional reactions to injury and pain especially of the lower back, pelvis and sacroiliac.
On a neuro-physiological level, the pain and weakness associated with sacroiliac/pelvic injuries can cause a shift from our normal autonomic “rest and digest” or parasympathetic state to the emergency “fight/flight” or sympathetic state. This is very uncomfortable for even a short period of time. But when it is prolonged it produces a severely stressful conflict between our need to protect ourselves and our ability to do so.
The physical pain associated with a sprain/strain injury to the pelvis can be excruciating, sometimes even greater than the pain of a herniated disc. The good news is that when the proper and precise chiropractic correction of the pelvis is made, this condition can be resolved quickly and efficiently.
It is always gratifying to see how quickly a patient can feel better with a renewed sense of wellbeing when pelvic function is restored. The speed with which this can happen cannot be explained by the reduction of pain alone, but also by a shift out of the “fight/flight” mode back to our normal, relaxed, “rest and digest” state where we can look at our world more objectively.
What I have just described is known as a somato-psychic reaction in which our physical state affects our emotional state. The physical imbalance caused the emotional symptoms.
Conversely, our emotional state can also have a powerful physical affect known as a psycho-somatic reaction. Psycho-somatic reactions are often mistakenly thought to be a form of neurotic behavior. It is frequently dismissed as being “all in your head.” But, psycho-somatic reactions are very real and should not have a negative connotation.
Quite frequently an acute emotional upset can knock out the low back/pelvis/sacroiliac as quickly and severely as a major physical jolt.
I remember a personal incident that illustrates this well. One afternoon while I was doing paperwork in my back office I was jolted by a tremendous crash that shook the building. I ran to the front of the building and found a Pontiac had crashed through the front wall of my office, crushing my consultation desk and destroying my Zenith Hylo table. Had I been sitting at my desk or adjusting a patient at the time, I and the patient would probably have been killed. The impact of this shock was immediate and dramatic. Within moments, without any physical exertion, I experienced severe sacroiliac pain that almost brought me to my knees.
Many types of traumatic stress can cause this type of reaction. Accidents, a cancer or other potentially fatal disease diagnosis, worry about family members who are somehow endangered, death of a loved one, divorce, extreme financial distress, a job loss or other major change in life circumstances, and natural disasters are all potential triggers.
After spending almost 20 years in active hurricane areas of the tropical Atlantic and living through too many hurricanes to count, I have definitely found a post hurricane increase in sudden, crippling, extreme low back pain, usually involving sacroiliac slippage and separation.
At this time of extreme turmoil in the world, with ongoing violent political protests, the constant threat of terrorist attacks, the imminent threat of war with enemies in North Korea, Iran, and elsewhere, frequent, unpredictable mass shootings or vehicles running down groups of pedestrians, a historically high number of deadly and disastrous hurricanes, flooding, tornadoes, earthquakes, and fires, the country is under assault from all directions and severe stress is epidemic. Because of this, chiropractors across the country may notice a huge increase in emotion driven pain disorders, especially involving the very low back and sacroiliac.
We as chiropractors are in a unique position to provide essential support for emotion driven conditions. When emotional trauma is sudden and acute and we address the problems right away, often we can obtain quick and lasting results by achieving pelvic balance and good cervical alignment. When traumatic stress is ongoing and life altering, structural imbalance and pain may become chronic and recurrent. In chronic cases with ongoing stress we must recommend the patient address the emotional issues through counseling, meditation, yoga, tapping (EFT), hypnosis or other means of stress management in addition to continuing chiropractic care.
With a little detective work, an understanding of the dramatic effect emotions can have on our bodies and some good chiropractic care, we can help our patients with psychosomatic as well as somato-psychic disorders.
