SACRO-ILIAC JOINT (SIJ) PAIN

SACRO-ILIAC JOINT (SIJ) PAIN / DYSFUNCTION

Dysfunction in the sacroiliac (SI) joint often causes lower back and/or leg pain. Leg pain from the sacroiliac joint can be particularly difficult to differentiate from radiating leg pain caused by a lumbar disc herniation(sciatica) as they can feel quite similar, however, with sacroiliac pain there seems to be a particular pattern distribution of referred pain.



The sacroiliac joint is the joint whereby the spine attaches to the pelvis. The primary function of the sacroiliac joints is to absorb shock between the upper body and the pelvis and legs. Small movements at the SI joint also help with forward/backward bending. The joint is reinforced by a dense network of strong ligaments surrounding it, some of which extend across the joint in the back of the pelvis. This network of soft tissues provides support of this strong joint.


Causes:

Possible causes of sacroiliac joint pain and dysfunction:

  • Hypermobility, which can further result in instability in the sacroiliac joint. Pain from too much motion is typically felt in the lower back and/or hip, and may radiate into the groin area.

  • Hypomobility or restriction can often cause muscle tension, pain, and may inhibit mobility. Pain is typically felt on one side of the low back or buttocks, and can radiate down the back of leg.

As a result of the above the sacroiliac joint can become Inflamed which can be associated with SI joint pain. Other associated conditions can involve - infection, inflammatory arthritis (ankylosing spondylitis), rheumatoid arthritis or other systemic illnesses.

Symptoms:

- Low back pain

- Radiating leg pain

- Stiffness

- Pain on walking

- Pain on standing from a seated position

- Pain on turning at night

Sometimes, if inflammation is high this can causes irritation of local nerve roots, which can cause radiating pain.

Treatment

Most cases of sacroiliac joint irritation will often heal over a short period of time with the correct treatment and advice. Conservative treatment is often sufficient for healing of most cases of sacroiliac joint injuries, alongside corrective strengthening.


With degenerative wear and tear or sacroiliac joint arthritis, the lower back becomes very stiff and restricted. Concentrated spinal mobilisations performed by your osteopath are often very effected at reducing pain and restoring mobility.

  • The goal of conservative treatment is to provide pain relief, restore functional mobility as soon as possible with the long term goal of working preventative of reoccurrence of facet irritation.

  • Sacroiliac joint injuries can also be commonly exposed to ligamentous irritation and tearing - giving the prominence of buttock pain

  • ​Conservative treatment sometimes includes pain medications or NSAIDs like ibuprofen, naproxen alongside osteopathic treatment and physical therapy. Also, preventative exercise.

  • ​Manual therapy (osteopathy), physical therapy and acupuncture.

PLATELET RICH PLASMA (PRP) TREATMENT FOR SACROILIAC JOINT

Despite widespread use of steroids to treat sacroiliac joint (SIJ) pain, their duration of pain reduction is short. Platelet-rich plasma (PRP) has the potential to enhance tissue healing and studies have shown clinical benefits to be longer-lasting for effect on pain.


Steroid vs. Platelet-Rich Plasma in Ultrasound-Guided Sacroiliac Joint Injection for Chronic Low Back Pain - https://www.ncbi.nlm.nih.gov/pubmed/27677100

Exercises For Sacroiliac joint pain and dysfunction

It is important to stay 'relatively' active alongside appropriate rest for healing of sacroiliac irritation. Our SI joints respond to movement and mobility. This being said, it is very important to establish the extent of the damage caused initially. Dependant on the extent of the injury, will determine how much you can do to start with.


Only if advised to do so, when improvements are being made, it is important to do some low impact exercises under the guidance of your osteopath, such as:

  • Gentle walking

  • Lying knee hugs (single)

  • Gentle active mobility exercise, with gradual progression

General Exercises For Sacroiliac joint pain and dysfunction

SI joint exercises should focus on three key areas:

1) strengthening

2) stretching

3) aerobic conditioning

Dynamic core conditioning can provide pain relief because it will support the spine, keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.

Further specific exercises (below) can be adopted when tolerated

PLEASE FOLLOW LINK HERE FOR SPECIFIC SPINAL REHABILITATION FOLLOWING SACROILIAC (SI) JOINT PAIN / IRRITATION

www.dynamicosteopaths.com

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