Sacroiliac Joint pain

Do you find yourself suffering from back pain? Does standing after a prolonged period of sitting give you back pain? You may be having SI joint problems.

What is the SI joint?

SIJ stands for Sacroiliac joint. These are joints on either side of the lower spine which function to carry your upper body weight when standing or walking and loading the weight on to your lower limbs. The two dimples on your lower back is where the SIJ is located and are referred to as lateral lumbar indentations.

What does the pain feel like?

The pain can be dull or sharp and although it can start at the SIJ, the pain can also radiate to the buttock, thighs, groin, and even the upper back. Majority of the time the pain is felt on only one side of the lower back.

What causes SIJ pain?

SIJ pain can be caused by numerous reasons.

  • OA or osteoarthritis can wear down the cartilage between the joints.
  • Ankylosing spondylitis or arthritis of the spine can cause additional problems.
  • Previous trauma or injury to the lower back such as a serious fall or a car accident can be a contributor.
  • Pregnancy is also a frequent source of SIJ pain due to the hormone relaxin which prepares you for labour.
  • Gait or the way one walks is one of the main causes of SIJ pain.

In all of these situations, the SIJ can either become inflamed or too mobile. The SIJ should remain stiff or rigid to support the pelvis and only allow a few degrees of movement. However, in some of these cases the SIJ starts allowing for either too much uncontrolled motion or extremely limited joint motion, resulting in SIJ inflammation and pain. When either of these things occur it is referred to as SIJ dysfunction.

What can you do?

The best way to decrease pain and increase support is to strengthen or stretch the muscles surrounding the SIJ. The main muscles surrounding the SIJ are the deep abdominal muscles (including the transverse abdominals and the oblique abdominals) and the deep gluteal muscle group. When these muscles are weak or lack endurance the SI joints are vulnerable to excessive movement which leads to SIJ hypermobility dysfunction and subsequent SIJ pain. If tightness is a problem then stretching to restore range of motion is necessary.

 

 

1st step: Pain relief and protection

  • Exercises to decrease stress on the inflamed structures
  • Electrotherapy involving ultrasound and IFC to decrease inflammation
  • Purchase an SIJ belt to help with support
  • Soft tissue massage to relax the muscles

2nd step: Strengthening and stabilization

  • Programs involving lower abdominal and hip strengthening exercises which will help support the SIJ

 

3rd step: Preventing reoccurrence

SIJ dysfunction has a tendency to return. The main reason for reoccurrence is insufficient rehab. This may mean that there is poor compliance with deep abdominal core and hip muscle exercises.

If you see a Registered Physiotherapist for a 6-8 week program involving electrotherapy, soft tissue release, deep abdominal core and hip stability exercises, you will find sustainable pain relief with a success rate of 90%.

References:

http://www.webmd.com/back-pain/si-joint-back-pain#1-2

http://www.physioworks.com.au/injuries-conditions-1/sacroiliac-joint-pain

http://www.healthline.com/health/sacroiliac-joint-dysfunction#overview1

 

How the SI joint is treated?