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Sacroiliac Joint Pain/ Dysfunction or Low Back Pain

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Category: BACK

Sacroiliac Joint Pain/ Dysfunction or Low Back Pain

Posted on by Admin

Description/ Introduction:

The sacroiliac joints (SIJs) play a crucial role in transferring the body’s weight load from the upper torso to the lower limbs. It ranks as one of the most frequent contributors of long-standing low back pain, with around 15%–30% of individuals suffering from back pain experiencing discomfort stemming from these joints.

Pain and stiffness arising in the SIJ are referred to as SIJ dysfunction. This occurs due to abnormal motion and malalignment of the joint stemming from either hyper (excessive) or hypo (limited) mobility.

Causes of SIJ pain:

Joint dysfunction can occur in either traumatic or non-traumatic conditions such as:

Traumatic Causes:

  1. Fall,
  2. Motor vehicle collision,
  3. Myofascial pain
  4. SIJ Ligament sprain
  5. Improper lifting activities, and
  6. Pregnancy (due to increased laxity of ligaments)

Atraumatic /Pathological Causes:

  1. History of lumbar fusion surgery,
  2. Cumulative injuries,
  3. SIJ Arthritis,
  4. Scoliosis (sideways curve of spine),
  5. Inflammatory Arthropathy (swelling in the joint),
  6. Infection

Other Factors:

  1. Appendicitis,
  2. ovarian cysts or torsion, and
  3. pelvic inflammatory disease.

Risk Factors of SIJ pain

Some of the risk factors which may predispose individuals to having SIJ pain are as follows:

  • Obesity,
  • Sedentary lifestyle
  • Leg length discrepancy (one leg longer/shorter than the other),
  • Gait (walking) abnormalities,
  • Persistent strain or low-grade trauma (e.g., while jogging),
  • Muscular weakness
  • Scoliosis.

Clinical Signs and Symptoms of SIJ pain:

  • Pain and stiffness/Discomfort in the lower back, buttocks, and/or radiating pain to the upper leg and/or groin area.
  • Difficulty in bending,
  • Numbness/ tingling in legs,
  • Difficulty sleeping,
  • Difficulty in sitting or standing for long duration,
  • Difficulty in transitioning from sitting to standing,
  • Difficulty in stair climbing, running.

Other Injuries Mimicking pain similar to SIJ:

SIJ dysfunction is not the sole culprit behind all cases of lower back pain. Other prevalent causes of lower back pain may encompass conditions such as piriformis syndrome, issues with the dorsolumbar fascia and musculature, lumbar disc herniation (bulge), lumbar facet arthritis, and pain referred from neurological sources. It is crucial to accurately identify and address the underlying cause of pain and discomfort.

At ‘Physio Asia,’ we conduct thorough evaluations and provide specialized treatment approaches for lower back conditions. Our goal is to alleviate your pain and minimize the likelihood of future episodes.

SIJ Pain Management

The primary approach to addressing SIJ dysfunction in the early stages involves conservative management, which includes physical therapy. The Physiotherapy treatment may involve the following:

  • Posture correction
  • Manual joint mobilization
  • Soft tissue release/Massage
  • Specialized exercise protocol focussing on overcoming muscular imbalances
  • Core strengthening program
  • Low level laser therapy
  • Ultrasound therapy
  • Shortwave diathermy
  • Supportive Braces (SIJ Belt) to stabilize the joint in cases of instability

Prevention Strategies to overcome SIJ pain or Back pain:

  • Stay physically active by engaging in exercises like swimming and walking, and incorporate daily stretching routines to ward off stiffness. Additionally, maintain a healthy diet.
  • Steer clear of prolonged static positions, whether it’s sitting or standing, and prioritize good posture when using computers, playing games, or watching television.
  • Avoid bending and lifting from your back, ensure you bend at your hips and knees while keeping the object closer to your body
  • Opt for a supportive and firm mattress for sleeping, and consider placing a pillow under your knees to enhance your sleeping posture.

References:

  • Gartenberg A, Nessim A, Cho W. Sacroiliac joint dysfunction: pathophysiology, diagnosis, and treatment. Eur Spine J. 2021 Oct;30(10):2936-2943. doi: 10.1007/s00586-021-06927-9. Epub 2021 Jul 16. PMID: 34272605.
  • Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV. Sacroiliac Joint Pain and Its Treatment. Clin Spine Surg. 2016 Mar;29(2):42-8. doi: 10.1097/BSD.0000000000000359. PMID: 26889985.
  • Chuang CW, Hung SK, Pan PT, Kao MC. Diagnosis and interventional pain management options for sacroiliac joint pain. Ci Ji Yi Xue Za Zhi. 2019 Sep 16;31(4):207-210. doi: 10.4103/tcmj.tcmj_54_19. PMID: 31867247; PMCID: PMC6905244.

Physiotherapy for Sciatic Nerve Pain or Sciatica in Singapore

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Sciatica is a common presentation of patients with back pain in Singapore. Though according to health hub about 80% of adult population may suffer from Back pain in Singapore, with varying degree at some time in their life, 10% may present with Sciatica or pain that travels down the leg.

Sciatica Nerve is a spinal nerve that follows a long path from the lower two levels of spine L4-5 and L5-S1, through the buttock, down the back of the thigh and leg, and finally ends in the foot. Pain may increase with sneezing, coughing, lifting or sitting.

It’s a cramp-like pain that can be sharp or burning pain anywhere from the lower back and hip, and going down the back of one leg or foot.

There may be:

  • Pins and needles
  • Numbness and Tingling
  • Weakness of the leg and foot

 

Sciatica can be due to a Spinal disc compression or slip disc or from Muscles of the buttock pressing the nerve like in piriformis syndrome and also Spinal stenosis.

Physio Asia Singapore has been successfully treating patients with Sciatica with specialized Physiotherapy including:

 

 

Try these to prevent back pain and sciatica

  • Exercise and be active, swimming, walking are good activities and stretch every day to prevent stiffness and eat a healthy diet
  • Avoid static positions like prolonged sitting or standing and practice good posture when using computers/games or watching television
  • Proper bending and lifting postures by bending your hips and knees to use the power in your legs
  • use a supportive and firm mattress and a pillow under the knees to sleep

Back Pain Physiotherapy in Singapore

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Low back pain https://physioasia.com/back-pain/ is one of the most common afflictions in our society. Back pain ranges from mild pain (with activities) to extreme pain (that cannot seem to find a comfortable position to be in), from a sharp catching pain to dull ringing ache, from centralized pain at the lower back to radiating pain and even numbness, pins and needles down the legs.


It is important to be able to differentiate between these presentations and manage the pain accordingly. The following sequence of therapy helps with long term pain

  • Mobilisation or manual therapy: Significant effect to restore restricted mobility between the spinal vertebrae. This aids to reduce pain, muscle spasm and stiffness.
  • Spinal Decompression therapy:
  • This Technique utilizes slow sustained Decompression (Pull) force on the Disc – for disc herniation – to facilitate the healing of the ruptured or prolapsed disc.
  • Scores Back Care Program – A Core Stabilization program:
  • Many patients may feel better after initial back pain with traditional treatment but their symptoms can return within a few days. As a side effect of the recurrent back pain, core muscles become weak and do not get activated as efficiently resulting in loss of appropriate back curvature and thereby causing increased stress on the spine.
  • SCORES use a combination of Real-time Ultrasound to see the core muscles in action, and with Achievo Stabiliser one learns the correct activation of these muscles thereby preventing Back pain.