What is sacroiliac joint pain?
The sacroiliac joints (SIJ) connect your pelvis to your lower spine. The function of the SIJ is to provide stability and lessen the forces to the legs. It acts as shock absorbers for your spine during weight bearing activities. The strong ligaments that make up the SIJ limits the movement at the pelvis. The SIJ can become an issue when there is excessive stiffness (hypomobility) or excessive movement (hypermobility) in the joint. In specific population, genetics can play make a person more susceptible to develop pain at the SIJ. People can innately have a stiffer or more lax SIJ. Pregnant woman can often experience pelvic girdle pain due to biomechanical and hormonal changes to the body. These factors can increase laxity in the SIJ ligaments which can make it more prone to these issues. Furthermore, a large spike in weight bearing activity can also irritate the SIJ. For example, a sedentary office worker going to a long hike over the weekend. These specific population who have underlying muscular weaknesses due to their sedentary behaviour are more prone to develop this condition.
Common signs and symptoms of sacroiliac joint pain involve:
- Localised pain at the lower back or hips
- Difficulty walking and standing for prolonged periods
- Difficulty getting out of the car
- Pain at the lower back or hips when sitting in a crossed legged position
- Pain when lying on the side in bed
How is SIJ pain diagnosed?
The diagnosis of SIJ pain is often difficulty because it can present many similarities with other lower back and hip injuries. This is why it is important to seek out advice from a health care professional. A physiotherapist will be able to conduct a variety of test to reveal the primary cause of the your pain. This involves a comprehensive patient history and physical examination. The role of diagnostic imaging is not usually required due to their poor correlation to symptoms. However, scans may be required if symptoms do not improve over the course of treatment.
How can physiotherapy help?
The aim of physiotherapy is to reduce inflammation to the site of injury and provide rehabilitation exercises to help build strong muscles to support the SIJ. This would usually involve specific glute strengthening and core exercises to help support the pelvis throughout our daily activities. Physiotherapist can also use of progressive motor control and stabilisation exercises to help train pelvic stability for patients who have excessive laxity in their SIJ. If the SIJ pain is severe then an SIJ belt or physiotherapy taping technique can be used to offload the SIJ to help provide comfort for the patient. Don’t let SIJ prevent you from enjoying your daily activities and hobbies. Contact one of our friendly physiotherapists today for a comprehensive assessment and individualized rehabilitation program.
References:
- Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 2008;17(6):794–819. doi: 10.1007/s00586-008-0602-4.
- Wu WH, Meijer OG, Bruijn SM, et al. Gait in pregnancy-related pelvic girdle pain: Amplitudes, timing, and coordination of horizontal trunk rotations. Eur Spine J 2008;17(9):1160–69. doi: 10.1007/s00586-008-0703-0.
- Pelvic Obstetric & Gynaecological Physiotherapy. Pregnany-related pelvic girdle pain (PGP) – For health professionals. UK: POGP, 2015; p. 1–10.