SI Joint Dysfunction

Sacroiliac Joint Dysfunction

What is it?

What are the signs and symptoms?

Single sided low back pain around the top of the buttocks
Symptoms sometimes referring into the buttock, groin and thigh.
Occasionally, pain may be felt on both sides of the lower back.
Symptoms often exacerbated with activities involving lower back or hip movements, e.g. rolling over in bed, putting on or taking off their shoes and socks, walking up and down stairs, or with running.
Tenderness is usually felt over the sacroiliac joint upon palpation.
Sacroiliac joint dysfunction may also be associated with asymmetry of the pelvis due to muscle tightness, joint stiffness, or joint laxity associated with pregnancy.

How is it diagnosed?

A thorough subjective and objective examination from a chiropractor is usually sufficient to diagnose a lumbar facet joint sprain. Further investigations such as X-ray, MRI scans or CT scans can be helpful in assisting diagnosis.

How is it treated?

Most patients with sacroiliac joint dysfunction will have a full recovery with a chiropractic treatment program. One of the key components is that the patient rests sufficiently from any activity that increases their pain until they are symptom free.

Regular icing in the initial phase of the injury may help to reduce inflammation. Chiropractic is important to assist healing and to correct any factors contributing to the development of the injury. It is also important to perform early movement and strength exercises to prevent any stiffness and weaknesses developing, and also to ensure the sacroiliac joint is functioning as it should.
Generally, sitting for prolonged periods should be avoided. However, if inevitable, optimal sitting posture is important to minimize stress on the sacroiliac joint.

What is the prognosis?

The recovery time for sacroiliac joint dysfunction will vary from patient to patient depending on compliance with chiropractic. With ideal treatment, patients may be pain free in as little as several days, although typically this may be expected to take 2 – 3 weeks. It is important to note, however, that injured tissue takes approximately six weeks to restore the majority of its strength in ideal healing conditions. Care must therefore be taken when returning to activity during this period.

What factors contribute to its development?

• muscle imbalances
• leg length differences
• muscle weakness or tightness
• biomechanical abnormalities
• poor posture
• lumbar spine stiffness
• a sedentary lifestyle
• poor core stability
• inappropriate lifting technique
• being overweight
• a lifestyle involving large amounts of sitting, bending or lifting

The pelvic girdle changes associated with pregnancy may also contribute to the development of sacroiliac joint pain.

What treatments are involved?

What other interventions are there?

• soft tissue massage
• mobilization
• manipulation
• correction of any leg length discrepancy
• dry needling
• education
• activity modification advice
• biomechanical correction
• ergonomic advice
• exercises to improve flexibility, strength, posture and core stability

What products will help?

The sacroiliac joint is the joint in the lower part of the back which joins the tail bone (sacrum) to one of the pelvic bones (ilium). There are two sacroiliac joints – one on either side of the spine. The sacroiliac joints transfer weight from the spine to the pelvis and allow some movement to occur.
During certain movements of the spine and hips, stretching or compressive forces are placed on the sacroiliac joints and surrounding ligaments. If these forces are excessive and beyond what the sacroiliac joint can withstand, injury to the sacroiliac joint may occur.
This can be from bending, sitting, lifting, arching or twisting movements of the spine, or, from weight bearing forces associated with running or jumping. Injury to the sacroiliac joint may occur as a result of trauma or due to repetitive or prolonged forces over time.

Despite appropriate chiropractic management, a small percentage of patients with sacroiliac joint dysfunction don't improve and may require other intervention. This may include pharmaceutical intervention, investigations such as an X-ray, bone scan, CT scan or MRI, blood tests or assessment from a specialist. A corticosteroid injection into the sacroiliac joint may sometimes be used to help alleviate symptoms. The treating practitioner can advise on appropriate management and can refer to the appropriate medical authority if it is warranted clinically.