Sacroiliac Joint Dysfunction (SI Joint)
What are the sacroiliac (SI) joints?
The sacroiliac (SI) joints are formed by the connection of the sacrum and the right and left iliac bones (pelvis). The iliac bones are the two large bones that make up the pelvis. As a result, the SI joints connect the spine to the pelvis. The sacrum and the iliac bones (ileum) are held together by a collection of strong ligaments. There is relatively little motion at the SI joints. These joints do need to support the entire weight of the upper body when we are erect, which places a large amount of stress across them. This can lead to wearing of the cartilage of the SI joints and arthritis.
What is sacroiliac joint dysfunction?
There are many different terms for sacroiliac joint problems, including SI joint dysfunction, sacroiliac joint disease, SI joint syndrome, SI joint strain, and SI Joint inflammation. Each of these terms refers to a condition that causes pain in the SI joints from a specific cause.
- Lower back pain (below L5)
- Sensation of lower extremity: pain, numbness, tingling, weakness
- Pelvis / buttock pain
- Hip / groin pain
- Feeling of leg instability (buckling, giving way)
- Disturbed sleep patterns due to pain
- Disturbed sitting patterns (unable to sit for long periods, sitting on one side)
- Pain going from sitting to standing
The Sacroiliac (SI) joint and Low Back Pain (LBP)
As with other joints in the body, the sacroiliac (SI) joint can become damaged, can suffer from wear and tear, or the ligaments supporting the joint may be stretched or injured. This may result in altered function of the SI joint (SI joint dysfunction) which may result in pain in the buttocks, lower back, groin and even leg pain. SI joint dysfunction and associated pain can be caused by a specific traumatic event (disruption) or can develop over time (degeneration).
Trauma (common events that may cause SI joint disruption)
- Motor vehicle accident
- Fall on buttock
- Lifting and/or twisting
- Natural childbirth
Degeneration (common causes of SI joint degeneration)
- Previous lumbar surgery (e.g., lumbar fusion of the L3/L4, L4/L5, or L5/S1)
- Stresses to the SI joint due to leg length differences, joint replacement, or scoliosis
- Pregnancy – chronic lower back pain during pregnancy and/or after giving birth (Post-partum Pelvic Girdle Pain, frequently described as PGP or PPGP)
- Previous iliac crest bone graft (ICBG)
- Prior infection of the SI joint
Pain in the lower back and buttocks may be caused by the SI joint, hip, spine, or a combination of these structures. It is important that your physiotherapist thoroughly evaluate ALL potential pain sources during a lower back pain exam. Carefully review the typical symptoms of SI Joint pain.
Physiotherapy treatment will consist of reducing inflammation, restoring normal range of motion, reducing pain, increasing strength and improving posture. Here at Swinton Physiotherapy we would use a range of techniques from, mobilisations, manipulation, soft tissue therapy, postural education and advice, acupuncture and a home exercise programme.