This blog will delve into what the Sacroiliac joint is and why it can become painful. Common causes, typical symptoms and management of sacroiliac pain will all be discussed allowing you to feel more confident surrounding your injury. We also will explain when may be a good time to seek additional help with a physiotherapist.
What is Sacroiliac pain?
Sacroiliac pain comes from the sacroiliac joint (SIJ) – which connects the sacrum (bottom of your spine) to the ilium (part of your hip bone). The main function of this joint is to provide stability and allow the lower limb to move with force. Pain can occur when the joint is inflamed, stiff or moves irregularly. SIJ pain accounts for a small percentage of back pain.
The SIJ is a synovial joint, however unlike other synovial joints they have limited range of movement with flexion and extension only moving the joint around 3 degrees.
SIJ pain can be caused by:
- Trauma – Injuries from falls, motor vehicle accidents or heavy lifting/twisting can cause the SIJ to get inflamed or damaged.
- Repetitive stress – Activities like running, high impact classes or manual jobs can put excess pressure on the joint over a period of time.
- Muscle imbalances – Weaknesses in the surrounding muscles, such as the core and the glutes may lead to the SIJ becoming vulnerable to excessive movements.
- Medical conditions – Conditions such as osteoarthritis, inflammatory arthropathies and pregnancy can all cause or contribute to SIJ pain. For example, the additional weight during pregnancy will alter a person’s gait and therefore stress the SIJ.
Symptoms of SIJ pain
Symptoms can include:
- A dull pain in the lower back that may refer down to the buttock or legs
- Pain when running, walking, standing or climbing stairs
- Tenderness over the back of the pelvis (back dimples)
- Stiffness in the mornings or after prolonged activity
- Reduced mobility in the lower back and/or hips
Managing SIJ pain at home
Home management of SIJ pain should focus on reducing inflammation, easing muscle tension and improving stability and strength around the joint. Some examples of these are:
- Ice or heat – Ice or heat can be applied to the painful area. Ice would be suitable for reducing inflammation whereas heat would be beneficial for relaxing any tight/ inflamed muscles. Basic guidelines state that ice should be used in the acute phase (24-48 hours after injury) and heat should then be used any time after 48 hours.
- Gentle stretching – Stretching can reduce symptoms and release any tight muscles around the area. Some stretches that target the sacroiliac joint are the knee to chest stretch, the lying figure 4 stretch and wide knee child’s pose.
- Movement – It is important to keep up gentle movement, activities like going on gentle walks, standing often and light mobility work all help the joint to stay moving and avoid stiffening up further.
- Strengthening – Strengthening the core, glute, lower back and hip will be beneficial and a long-term solution for SIJ pain. Strengthening the muscles surrounding the SIJ will allow the pelvis to stay stable and reduce excess stress on the joint. A few exercises to try are glute bridge, clam shells, dead bugs and lying leg rotations.
- Activity modification – It is good to note, that any activity that causes pain should try to be modified, especially if the injury is painful and acute. For example, if running is causing pain, reduce the distance you run for, reduce the pace and think about shorter stride lengths. If sitting causes SIJ pain, you could try a different chair, add lumbar support, sit with your legs at 90 degrees and avoid crossing your legs. Some things are unmodifiable, but trying to adjust may reduce pain.
When to see one of our physios
If pain is persisting, it would be a good idea to book in with a physiotherapist. An Initial Assessment will include a thorough subjective assessment with tests such as the compression, distraction, thigh thrust and sacral thrust to determine if your back pain is related to the SIJ. A clinician will also provide you with an individualised exercise plan to get you back to doing what you love.
If you would like to speak to a physiotherapist then please get in touch. Book an appointment with a physio online.
