Sacroiliac Joint Pain/ Dysfunction or Low Back Pain

| Posted on | 0 comments.
Sacroiliac Joint Pain/ Dysfunction or Low Back Pain

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.