Understanding Sacroiliac Joint Dysfunction: Causes, Symptoms, and Treatment
Understanding Sacroiliac Joint Dysfunction: Causes, Symptoms, and Treatment
This article contains product affiliate links. We may receive a commission if you make a purchase after clicking on one of these links.
In my previous posts about lower back pain, I talked about low back strains and sprains, sciatica, and herniated disks. In this blog post, we will explore sacroiliac joint dysfunction, what causes it, and how it can contribute to lower back pain.
I have treated a great number of patients who came complaining of lower back pain and thought that their symptoms were caused by a herniated or degenerated disk.
However, during the examination, it would become clear that their pain is caused by the inflammation of the sacroiliac joint. There are specific treatment approaches for dealing with sacroiliac joint problems, as opposed to treating pain dysfunction related to a herniated disk or lower back sprain.
You can see how important it is to understand what the sacroiliac joint is and how it works, to diagnose and treat it correctly.
What is the Sacroiliac Joint?
The sacroiliac joint (SI joint) is located at the base of the spine, where the sacrum (the triangular bone at the bottom of the spine) meets the ilium (the large, wing-shaped bone that makes up the pelvis).
The SI joint is responsible for providing stability to the pelvis and spine during standing, walking, and other weight-bearing activities.
It helps to distribute forces evenly across the pelvis, reducing stress on the lower back.
The SI joint also plays a role in shock absorption, helping to cushion the spine and pelvis from the impact of activities such as running and jumping.
It also allows for a small degree of movement, which can help to absorb shock and reduce stress on the spine.
What is Sacroiliac Joint Dysfunction?
Sacroiliac joint dysfunction occurs when there is a problem with this joint, either due to inflammation, degeneration, or abnormal movement. This can cause pain in the lower back, buttocks, hips, and thighs, and it can also lead to muscle weakness, stiffness, and instability.
What Causes Sacroiliac Joint Dysfunction?
Several factors can contribute to sacroiliac joint dysfunction, including:
1. Trauma: A fall, car accident, or another traumatic event can cause damage to the sacroiliac joint, leading to dysfunction.
Have you ever stepped down off a curb or a step without realizing that there was a step? I bet you had some discomfort in your buttock or lower back afterward. What happened is, you have jarred your sacroiliac joint and have created pelvic misalignment and, possibly, inflammation.
2. Pregnancy: The ligaments that support the sacroiliac joint can become stretched and weakened during pregnancy, leading to instability and dysfunction.
3. Arthritis: Arthritis can cause inflammation and degeneration of the sacroiliac joint, leading to pain and dysfunction.
4. Leg length discrepancy: A difference in leg length can cause uneven forces on the sacroiliac joint, leading to dysfunction.
5. Poor posture: Poor posture can cause abnormal forces on the sacroiliac joint, leading to dysfunction over time.
How is Sacroiliac Joint Dysfunction Diagnosed?
Sacroiliac joint dysfunction can be difficult to diagnose, as the symptoms can mimic other conditions, such as herniated discs or sciatica.
A physical therapist or another healthcare provider will typically perform a thorough evaluation that includes a medical history, physical exam, and imaging studies (such as X-rays or MRI) to rule out other conditions and confirm the diagnosis of sacroiliac joint dysfunction.
In addition to physical examination and imaging, injection of a local anesthetic into the sacroiliac joint may also be used as a diagnostic tool. If the injection provides temporary pain relief, it confirms the diagnosis of sacroiliac joint dysfunction.
Can Sacroiliac Joint Dysfunction be differentiated from pain caused by a Herniated Disc without an X-ray or MRI?
Herniated discs frequently cause lower back pain, and their symptoms can be similar to sacroiliac joint dysfunction. Therefore, differentiating between sacroiliac joint dysfunction and herniated discs can be challenging. However, there are some key differences in symptoms that can help differentiate between the two:
Sacroiliac Joint Dysfunction
Sacroiliac joint dysfunction typically causes pain in the lower back and buttocks.
The pain is often one-sided (although it is possible to experience soreness in both buttocks).
Pain may radiate down the back of the thigh but typically does not extend below the knee.
Pain is often worse while walking or standing.
A person may favor one leg while walking or standing, shifting the weight off of the painful side.
There may be tenderness over the sacroiliac joint when pressure is applied.
Herniated Disk
Herniated discs, on the other hand, typically cause pain that radiates down the leg. This pain is often referred to as sciatica.
The pain can be one-sided or bilateral, depending on the directions and size of the herniation, and can extend below the knee.
Pain is often worse with sitting, coughing, or sneezing, and may improve with walking.
There may be tenderness over the affected spinal level when pressure is applied.
Frequently, there is a noticeable shift, whereas the pelvis is shifted away from the painful side.
Simple Solutions to Treat Your SI Joint at Home
Let’s talk about how you can treat your SI joint at home.
First, let me emphasize that the best course of action is to seek treatment from a qualified health professional.
Your choices are:
Physical therapist
Chiropractic
Orthopedic doctor
Acupuncturist
Massage therapist
I have discussed these solutions in detail in my blog post “Effective Low Back Pain Treatment Solutions for Chronic Sufferers”
A knowledgeable physical therapist will evaluate your problem and proceed with the appropriate treatment. However, physical therapists can’t perform an X-ray or MRI (unless they work in a doctor’s clinic).
A chiropractor can send you out for an X-ray or do one in their clinic if they have imaging facilities. A good chiropractor will obtain x-rays before initiating the treatment, especially given the nature of chiropractic treatment which typically involves the manipulation of the spine and pelvic structures.
An orthopedic doctor will also order imaging. After that, an ortho doctor has several possibilities:
· inject your SI joint with medication
· prescribe pain meds (usually, an anti-inflammatory)
· refer you to a physical therapist
An acupuncturist will use acupuncture to address various points in the body and produce a reduction of symptoms in that way.
A good massage therapist will use different massage techniques to relax your muscles and work out muscle spasms.
If you can’t get to one of these professionals or if you want to try and fix the problem yourself, there are several treatments you can do at home.
First, the passive treatments to do if you got injured recently.
1. Rest
Get the weight off the affected side by lying down in the most comfortable position you can find. For some people, it would be on their stomachs. Others might find lying on their back more comfortable.
2. Ice
Putting a cold pack on the painful area might relieve inflammation and greatly reduce pain. I would not put heat on a fresh injury. Heat is good when the pain subsided and you feel mostly stiffness.
3. Use a pain-relieving ointment on the sore area.
4. Use Electrical Stimulation. Using TENS, with or without cold therapy, can help reduce pain.
Now I will describe an active approach to treating your SI joint.
This approach consists of several movements designed to align your pelvic area and take the pressure off the affected joint.
It is worth knowing that if one of your SI joints is inflamed, usually, it is the joint that is “loose”. It is not as stable, and the muscles and ligaments around it are not as strong. The other joint, on the opposite side, is usually very tight and does not allow the necessary mobility when you walk, run, or perform other activities. The main goal is to strengthen the weak side and loosen the tight side.
However, this will take time. There is a more immediate approach that involves performing several movements in sequence. In physical therapy jargon, it is called a “shotgun approach”.
The movements described below are done one after another in the following sequence.
Movement 1 – Knees to Chest
DOUBLE KNEE-TO-CHEST
Courtesy of HEP2GO
Lie down on your back with your knees comfortably bent.
Reach to your knees with both hands and bring both knees up to your chest until you feel the stretch in your lower back.
Hold the stretch for 3 seconds and gently return the legs to the initial position.
Repeat 3-5 times.
Alternate exercises for Movement 1 - Bridging
BRIDGE - BRIDGING
Courtesy of HEP2GO
Lie down on your back.
Bend your knees and place your feet flat on the floor.
Slowly lift your hips off the ground while tightening your buttock muscles.
Lift your buttocks off the surface to create a “bridge”.
Hold for 2-3 seconds and gently lower the buttocks.
Repeat 3-5 times.
Movement 2 – Hip Abduction
(Abduction is the action of moving your arm or leg away from the midline of the body)
SUPINE HIP ABDUCTION - ISOMETRIC
Courtesy of HEP2GO
Lie down on your back.
Bend your knees and place your feet flat on the floor.
Put a strong resistance band just above your knees (there are many resistance bands on the market; you have to get the strongest). OR you can use a belt as shown in the exercise illustration.
Push your knees apart against the resistance.
Hold for 2-3 seconds and return to the initial position.
Repeat 3-5 times.
Ideally, instead of using a resistive band, you would have a partner applying pressure to the outside of your knees and not allowing your knees to move. This is called “Isometric Contraction”. “Isometric” means there is an effort to move but the resistance is too great to allow the movement. To illustrate it, try to push your hand into the wall.
Movement 3 – Isometric Adduction
(Adduction is the action of moving your arm or leg towards the midline of the body)
· Lie down on your back. Bend your knees and place your feet flat on the floor.
· Put an exercise ball (about 15-18 inches in diameter) between your knees.
· Squeeze the ball as hard as you can.
· Hold for 2-3 seconds and release.
· Repeat 2-3 times.
If you have a partner, have them place their forearm between your knees with their hand on the inside of one knee and the elbow on the inside of the other knee. Then squeeze your knees together against their pressure.
Some people experience a “pop” around their pubic area. This usually means that your pelvic girdle got into a better alignment.
Rest for a few minutes, then slowly get up and take a few steps. You might feel a better weight distribution on your legs and the pain might subside.
After you feel better, you can do additional exercises to correct pelvic misalignment and prevent future sacroiliac joint issues.
1. Glute Bridge with Resistance Band:
Lie on your back with a resistance band looped just above your knees.
Bend your knees and place your feet flat on the floor.
Slowly lift your hips off the ground, squeezing your glutes and engaging your core.
Hold for a few seconds before lowering back down.
Repeat for 10-15 repetitions.
2. Clamshell with Resistance Band:
Lie on your side with your knees bent and a resistance band looped just above your knees.
Keeping your feet together, lift your top knee away from your bottom knee, keeping your feet touching.
Lower back down and repeat for 10-15 repetitions on each side.
3. Hip Flexor Stretch:
Kneel on one knee with your other foot flat on the ground in front of you.
Slowly shift your weight forward, keeping your back straight and your front knee directly over your ankle.
Hold for 30 seconds before switching sides.
4. Supine Piriformis Stretch:
PIRIFORMIS STRETCH - SUPINE
Courtesy of HEP2GO
Lie on your back with your knees bent and feet flat on the ground.
Cross your right ankle over your left knee, then gently pull your left knee towards your chest.
Hold for 30 seconds before switching sides.
I hope that you found the information in this blog post useful.
Please remember:
While the SI joint treatment solutions described above can be effective, there are times when medical attention is necessary.
You should seek medical attention as soon as possible if:
Your pain is severe and does not improve with rest and self-care
Your pain is accompanied by other symptoms such as numbness, tingling, or weakness in the legs
Your pain is the result of a fall, injury, or accident
Your pain is accompanied by losing control of your bowels or bladder
Stay healthy!
Disclaimer
Although we strive to provide the most accurate information possible, please note that all of the content found on ReliefSolutions4you.com, including text, audio, video, and/or other formats are provided for informational purposes only. The content on ReliefSolutions4you.com is not a substitute for professional medical treatment, advice, and/or diagnosis. Always seek out the advice of a physician or other qualified health provider when seeking information for a medical condition or before engaging in physical training. The information on ReliefSolutions4you.com is not to be taken as medical advice. Always consult with your physician when starting a new physical training regimen and/or diet.
