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The Connection Between the Sacrum and Headaches

by Jonathan Sampson, M.C.S.P., P.T.

Have you ever wondered how the sacrum can cause headaches?
The sacrum is the large triangular bone, made up of five fused vertebrae, situated below the lumbar spine and above the coccyx. It is wedged between the two innominate bones to form the pelvis. The articulation of the sacrum and an innominate bone is called the sacroiliac joint.

The sacroiliac joints are extremely strong but should allow a small amount of movement of the sacrum. This movement is essential for normal functioning of the spine and skull, allowing for compensation for irregularities in the ground as a person walks or runs and to maintain correct alignment of the head over the spine. Loss of movement in the sacroiliac joints or sacrum creates mechanical changes in the upper cervical spine and skull.

How? The sacrum is directly connected to the foramen magnum (the opening in the base of the skull), where the brain leaves the skull and becomes the spinal cord, and to the atlas and axis (1st and 2nd vertebrae) by the meninges. The meninges are three layers of membranes which surround and protect the brain and spinal cord. They are attached to bone at the foramen magnum and again at the sacrum but float freely within the spinal column in between. If the sacrum is twisting as you move, rather than following a normal movement pattern, this will create a very slight tensioning of the meninges which can then lead to dysfunction of the joints between the skull, atlas and axis (i.e., if the sacrum is moving into a left, anterior or posterior, torsion [twist] it is common to find the atlas rotated to the left also.)

It is very common to find movement abnormalities between the skull, atlas and axis in people who suffer from headaches. These movement abnormalities cause tension on the joints, the muscles and surrounding connective tissue which can lead to pain. It is also very common to find dysfunctions of the sacrum and sacroiliac joints in the same people. If the upper cervical dysfunctions are not treated in conjunction with the sacrum and sacroiliac joint dysfunctions they are very likely to reoccur along with the headaches.

Tensioning of the meninges is also thought to change the normal rhythmical movement of the joints of the skull known as the craniosacral rhythm. Osteopathic and physical therapy research has shown the connection between abnormal movement of the skull and pain.

Physical therapy can help to regain normal movement of your sacrum, sacroiliac joints, spine and skull using various forms of manual therapy followed up by appropriate exercises to help maintain the regained movement or further improve the joint mobility.

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Southside Physical Therapy Inc.
364 SE Wilson Ave.
Bend, OR 97702
Phone: 541.388.2681
Fax: 541.388.9236

Clinic Hours:
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8 a.m. to 6 p.m.
Other hours may be available by appointment