Sacroiliac Joint Pain

Sachini Liyanage

Have you got pain in your lower back? Does the pain increase when standing up from a sitting position? Do you feel like your legs might buckle and aren’t supported by your body? Does this pain radiate to your buttocks, hips, pelvis or groin?

… If you answered yes to these questions, it’s quite possible that you may have sacroiliac joint pain.

What is the sacroiliac joint?

The sacroiliac joint (SIJ) connects the hip bones (iliac crests) to the sacrum which is the triangular bone between the lumbar spine and the tail bone. It acts as shock absorber between the upper body, pelvis and legs. Normally, the sacroiliac joint has very little movement and is reinforced by strong ligaments that hold everything together and helps with absorbing pressure.

What are the risk factors for developing pain?

• Gait issues such as leg length discrepancy or scoliosis which can lead to uneven pressure on one side of the pelvis
• Pregnancy or recent childbirth can cause the ligaments in the SIJ to relax and become loose, causing instability in the joint
• Repeated activity that puts stress on the joints including regular heavy lifting, labour intensive jobs, prolonged sitting or standing

Sacroiliac pain can come from 2 main biomechanical sources:

• Too much movement – This can cause the pelvis to feel unstable and lead to pain. Pain can radiate from the lower back to the groin area.
• Too little movement – This can cause muscle tension, pain and may inhibit movement. Pain is usually felt on one side of the lower back or buttocks and can radiate down the back of the leg.

Like most joints, your surrounding muscles act to stabilise your sacroiliac joints during stressful of vulnerable positions. Research has shown that contraction of the transversus abdominis muscle significantly stiffens and supports your sacroiliac joints. Research has also shown that your deep gluteal muscles are essential for controlling the stability of the hip. When these muscles are weak or lack endurance, your sacroiliac joints are potentially vulnerable to excessive movement, which can lead to SIJ hypermobility or instability and subsequent joint pain.

How does SIJ pain get diagnosed?

SIJ pain can mimic numerous other back and hip injuries such as pain radiating from the lumbar spine. SIJ pain is typically worse with standing and walking and improves when lying down, but not always. MRIs can show signs of SIJ inflammation or eliminate other potential pathologies, especially within the pelvis-hip complex. A thorough physical examination by your experienced physiotherapist is still one of the best methods to assess for SIJ pain or instability.

What can you do about SIJ pain?

Exercise is highly recommended for SIJ pain including lower abdominal muscle activation exercises and gluteal muscle exercises. Additionally, stretching of tight muscles within the hip-pelvis complex can sometimes help ease SIJ pain. Losing weight can also significantly decrease the forces that the SIJ has to sustain and increase the ability for your muscles to control your body weight through the SIJ complex.

Want help?

If you would like a thorough assessment and treatment plan for your SIJ pain or any other problems, don’t hesitate to give us a call on 9675 5586, we are always here to help you out!