The Sacroiliac joints connect the sacrum (the wedge shaped bone at the bottom of the spine) to the iliac bones (the two bones that make up the pelvis). These joints support the weight of the body when we are upright. To provide the stability required , there is only a small amount of movement at this joint.
A trauma such as landing heavily on one buttock or one foot can cause a shearing force at the Sacroiliac joint which can cause pain. A one sided postural habit such as always leaning to one side or a leg length discrepancy can also cause the sacroiliac joints to become dysfunctional.
These joints also under go changes in females during pregnancy due to an increased laxity on the surrounding ligaments, and a change in position in preparation for labor. This can also often lead to dysfunction and pain.
Patients with this condition usually experience one sided low back pain around the top of the buttock with symptoms sometimes referring into the lower buttock, groin or thigh. Symptoms are generally exacerbated with activities that involve lower back or hip movements for example, walking up and down stairs or running. Tenderness is usually felt on firm palpation of the sacroiliac joint. Sacroiliac joint dysfunction may also be associated with asymmetry of the pelvis due to muscle tightness, joint stiffness, or joint laxity.
Treatment for Sacroiliac Joint Pain
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and decrease the likelihood of injury recurrence. Treatment may comprise:
- Joint mobilisation
- Joint manipulation
- Spinal and pelvic realignment
- Dry needling /acupuncture
- Deep tissue massage/myofascial release
- Exercise programs to stretch, self treat and improve proprioception, balance, strength and core stability
- Biomechanical Assessment
- Neural mobilisation
- Education / training advise/ phased return to exercise
- Activity modification advice
- Orthotic/Insole advise
- Ice or heat treatment
- Clinical Pilates
- Injection advice