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Sacroiliac Joint (SIJ) Dysfunction

Sacroiliac Joint (SIJ) Dysfunction occurs when the sacroiliac joints of the pelvis become stiff or weak. The condition can develop at any age. Sacroiliac Joint (SIJ) Dysfunction is found in 25% of people who complain of low back pain. It is most often diagnosed in females.

The sacroiliac (SI) joints are formed by the connection of the sacrum and the right and left iliac bones. The sacrum is the triangular-shaped bone in the lower portion of the spine, centrally located below the lumbar spine. While most of the bones (vertebrae) of the spine are mobile, the sacrum is made up of five vertebrae that are fused together and do not move. The iliac bones are the two large bones that make up the pelvis. As a result, the sacroiliac (SI) joints connect the spine to the pelvis. The sacrum and the iliac bones (ileum) are held together by a collection of strong ligaments. There is relatively little motion at the sacroiliac (SI) joints specifically less than 4 degrees of rotation and 2 mm of translation at these joints. Most of the motion in the area of the pelvis occurs either at the hips or the lumbar spine. These joints do need to support the entire weight of the upper body when one is erect, which places a large amount of stress on them. This can lead to wearing of the cartilage of the sacroiliac (SI) joints and arthritis.

As with most other joints in the body, the sacroiliac (SI) joints have a cartilage layer covering the bone. The cartilage allows for some movement and acts as a shock absorber between the bones. When this cartilage is damaged or worn away, the bones begin to rub on each other, and degenerative arthritis (Osteoarthritis) occurs. This is the most common cause of Sacroiliac Joint (SIJ) Dysfunction. Degenerative arthritis occurs commonly in the sacroiliac (SI) joints, just like other weight-bearing joints of the body. Another common cause of Sacroiliac Joint (SIJ) Dysfunction is pregnancy. During pregnancy, hormones called relaxin are released in the woman’s body that allows ligaments to relax. This prepares the body for childbirth. Relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear. The additional weight and walking pattern (altered gait) associated with pregnancy also place additional stress on the sacroiliac (SI) joints. Any condition that alters the normal walking pattern places increased stress on the sacroiliac (SI) joints and is a risk factor for Sacroiliac Joint (SIJ) Dysfunction. This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle, or foot.

The signs and symptoms of Sacroiliac Joint (SIJ) Dysfunction pain start in the lower back and buttock and may radiate to the lower hip, groin, or upper thigh. While the pain is usually one-sided, it can also occur on both sides. Numbness or tingling in the leg or a feeling of weakness in the leg may also be experienced. Symptoms may worsen with sitting, standing, sleeping, walking, or climbing stairs. Often the sacroiliac (SI) joint is painful sitting or sleeping on the affected side. Some also may have difficulty riding in a car or standing, sitting, or walking too long. Pain can be worse with transitional movements (going from sitting to standing), standing on one leg, or climbing stairs.

Physical therapy can help with treating Sacroiliac Joint (SIJ) Dysfunction. The focus of treatment will be correcting Sacroiliac Joint (SIJ) Dysfunction. Treatment will include manual therapy as well as modalities such as therapeutic ultrasound therapy and electro therapy to manage the pain. Stretching exercises to improve muscle flexibility and movement, as well as strengthening exercises to provide stability to the sacroiliac (SI) and spinal joints will be prescribed by your therapist. Once strength and motion progresses, functional training will be introduced. If in doubt, please seek professional advice.

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