Do you feel as though your pelvis is out of alignment? Perhaps one hip appears higher than the other, one side moves differently, or you regularly experience pain in your lower back, pelvis or hips. This is sometimes referred to as pelvic torsion.
The term “pelvic torsion” usually refers to a situation where the left and right halves of the pelvis do not appear to be perfectly aligned or move in unison. This does not automatically mean that anything is damaged or that the pelvis is permanently ‘out of alignment’.
A chiropractor can examine how the pelvis, the lower back, how your hips and the rest of your body function, and which factors may be linked to your symptoms.
What is pelvic torsion?
The pelvis consists of various bones and joints which together form a connection between the spine and the legs. In the case of pelvic torsion, one side of the pelvis appears to be positioned or moved differently from the other.
For example, one side may appear to be tilted slightly forwards or backwards. A difference in the height of the two sides may also be noticeable.
However, the body is never completely symmetrical. Minor differences between the left and right sides are common and do not necessarily cause any symptoms. Furthermore, the position of the pelvis can change when you stand, sit or move differently.
That is why it is important to look not only at the position of the pelvis, but also at how the body functions as a whole.
How does pelvic torsion occur?
There isn’t always a single clear cause for a difference in pelvic position or pelvic movement. Various factors may play a part, such as:
- uneven load;
- sitting or standing in the same position for a long time;
- differences in range of motion between the two hips;
- muscle tension around the lower back, buttocks and hips;
- a previous injury or operation;
- changes during or after pregnancy;
- the way someone walks or moves;
- the body’s adaptations to pain or overexertion.
The nervous system plays an important role in this. It controls the muscles and movements and helps the body to constantly adapt to posture, physical strain and the environment.
Pelvic torsion is therefore not always a permanent abnormality. What is visible during one examination may change when a person stands or moves. This is precisely where chiropractic can offer support. Targeted chiropractic adjustments aim to improve the mobility of relevant joints and provide the nervous system with new movement information. This can give the body more scope to organise movements differently and adapt better to physical strain.
The aim is not simply to “straighten” the pelvis, but to create conditions in which the lower back, pelvis and hips can work together more effectively.
What symptoms can be associated with pelvic torsion?
A difference in pelvic alignment does not automatically cause symptoms. The body is often able to cope well with minor differences.
If symptoms do occur, they may, for example, be related to:
- the lower back;
- the pelvis;
- the hips;
- the bottom;
- the groin;
- the knees;
- the legs or feet.
Some people also feel as though they are standing crookedly, putting more weight on one leg or moving less freely on one side.
The presence of these symptoms does not automatically mean that pelvic torsion is the cause. Similar symptoms can, in fact, be caused by various factors. That is why a physical examination is important.
Can pelvic torsion cause lower back pain?
An asymmetrical position or movement of the pelvis may be associated with lower back pain. However, this does not automatically mean that pelvic torsion is the cause of the back pain.
Back pain is often influenced by a number of factors. These include:
- physical strain;
- mobility and muscle function;
- sleep and recovery;
- stress;
- fitness;
- previous injuries;
- the duration and severity of the symptoms.
Simply checking whether the pelvis is straight or tilted is therefore not enough. It is important to also examine how the lower back, pelvis and hips work together during movement.
How is pelvic torsion diagnosed?
During a chiropractic examination, the focus is not solely on the visible position of the pelvis. The chiropractor assesses the functioning of the entire kinetic chain.
In this regard, the following, amongst other things, could be considered:
- the alignment of the pelvis and the spine;
- the mobility of the lower back;
- the movement of the pelvis and hips;
- differences between the left and right sides;
- muscle function and coordination;
- the way someone stands, walks and moves;
- factors that trigger or alleviate the symptoms.
During an initial consultation/first appointment, physical examinations and tests are carried out, a digital postural analysis is performed, your medical details and history are discussed, and you will receive an initial treatment (we refer to this as a adjustment). If another or underlying medical cause is suspected, further investigations or a referral may be necessary.
Can chiropractic treatment help?
A chiropractor cannot simply “put” a twisted pelvis back into place permanently. The pelvis and the surrounding joints are part of a moving and adaptable body.
However, a chiropractor can assess how the pelvis, lower back, hips and the rest of the kinetic chain are functioning. In doing so, they look at which factors may be linked to the symptoms.
Using targeted adjustments, the chiropractor focuses on the function and mobility of the relevant joints. The treatment provides the nervous system with new stimuli from the musculoskeletal system, to which the body can respond and may reorganise itself.
Throughout the treatment programme, the body’s response to the treatment is monitored. Where appropriate, the chiropractor may discuss additional advice to further support the nervous system and the body’s ability to adapt. This might include, for example, posture and daily strain, exercise, recovery, sleep or the gradual resumption of activities. If necessary, further investigations or a referral may be recommended.
The aim is not to make the body completely symmetrical. The focus is on improving function, making movement easier and reducing factors that may contribute to the symptoms.
You can do this yourself
Staying active is important for many back and pelvic problems. Which exercises are suitable depends on your symptoms and personal circumstances.
General points to bear in mind are:
- alternate between sitting, standing and walking at regular intervals;
- build up the movement gradually;
- avoid prolonged one-sided strain;
- Don’t constantly worry about maintaining a “perfectly straight” posture;
- allow the body sufficient time to rest and recover;
- Have any persistent or worsening symptoms checked out.
There is no single exercise that can correct every case of pelvic torsion. The appropriate approach depends on the cause of the symptoms and the findings during the examination.
When is it advisable to have a check-up?
Do you regularly experience pain in your lower back, pelvis or hips, and do you feel as though you’re standing crooked or moving differently?
In that case, a physical examination can help to provide a better understanding of what is going on. The aim is not only to determine whether there is a visible difference in pelvic alignment, but above all to investigate:
- where the difference might come from;
- how the pelvis and the surrounding areas move;
- whether the findings might be linked to your symptoms;
- which approach is right for your situation.
Contact a doctor if you experience severe pain following a fall or accident, a fever, unexplained weight loss, progressive loss of strength, numbness around the buttocks, or problems controlling your bladder or bowel movements.
Frequently asked questions
Is pelvic torsion the same as a misaligned pelvis?
The terms are often used interchangeably. A ‘misaligned pelvis’ usually refers to a general difference in pelvic position. Pelvic torsion more often refers to a difference in rotation or movement between the two halves of the pelvis.
Is pelvic torsion permanent?
Not always. The observed position of the pelvis can change due to posture, movement, strain and muscle tension.
Does pelvic torsion always need to be treated?
No. Minor differences between the left and right sides are common and do not always cause symptoms. Treatment is particularly relevant when there are symptoms or limitations in movement, and research indicates that modifiable factors may play a role.
Can you spot pelvic torsion yourself?
Sometimes one hip appears to be higher, or a difference in posture is noticeable. However, this does not necessarily mean that the cause has been identified, or that it is the cause of any symptoms.
Can a chiropractor correct a misaligned pelvis?
In our practice, we often see symptoms such as those described. It is too simplistic to say that a chiropractor can permanently realign the pelvis. However, a chiropractor can assess how the pelvis and surrounding areas are functioning and discuss an appropriate course of treatment or support.
