Sacroiliac joint dysfunction is a broadly defined condition that most commonly involves sensitised or painful sacroiliac joints (SIJ) and surrounding musculature and ligaments. The SIJ connects the pelvis to the sacrum at the bottom of the spine and as such, is critical in transferring load between the spine and legs.
Falls, pregnancy, or repetitive unbalanced loading during activities can cause excessive or reduced compression to occur in the region, leading to SIJ instability and dysfunction. SIJ pain can be quite disabling and significantly reduce function and quality of life.
Symptoms
Patients often present with pain in the lower back/gluteal region, most commonly on one side, but there can be pain referred to other areas such as the thigh or lower leg. Common aggravating activities for SIJ dysfunction include:
- Weight bearing activities – walking, running.
- Rolling over in bed.
- Bending forwards.
- May be aggravated by sitting with legs crossed or lying on your side.
Diagnosis
Although diagnosis of sacroiliac joint dysfunction is difficult as it has similar traits to lower back pain, an experienced musculoskeletal physiotherapist can help differentiate the condition through:
- a clinical examination that includes locating pain around the SIJ ligaments.
- pain provocation tests.
- active load transfer tests.
- the absence of other signs of involvement from the lumbar spine.
X-rays or MRI have limited use, but ‘SPECT’ CT scans may be used in severe or chronic cases.
Management
Much like the diagnosis, treatment involves a combination of techniques to achieve best results:
- Ice or anti-inflammatories to help settle inflammation if there is any present.
- Manual therapy techniques to release tight musculature.
- A progressive functional exercise program to build control and strength through the lower back and pelvis.
- Compression gear such as a pelvic belt may help give support and relieve pain.
Physiotherapy has positive outcomes for sacroiliac dysfunction to help relieve pain and improve function, but a continuation of functional rehabilitation is critical to prevent reoccurrence in the future.
Don’t let SIJ pain disrupt your daily life, book now with one of the experienced physiotherapists to get a plan to get you back In Balance and doing the things that you love!
