There are two small sacroiliac joints located at the base of the back. They are located between the sacrum (the large triangular bone at the base of the back) and the pelvis. The sacroiliac joints do not move very much but they are critical to transferring forces between the upper and lower body. Sacroiliac joint pain is usually due to mechanical overload of the joint. This may be due to a sudden excessive traumatic force or long term repetitive strain. Long term repetitive strain can be caused by misalignments such as a twisted pelvis or a leg length difference.
During pregnancy hormones are released that relax the ligaments of the body to allow the pelvis to change shape to permit childbirth. This increased flexibility and the change of shape during pregnancy can cause sacroiliac joint pain. Less commonly inflammatory joint diseases such as ankylosing spondylitis may cause sacroiliac joint pain.
Symptoms
- Pain at the base of the spine on one side only.
- Pain may be both dull and sharp in character.
- Pain usually worse in the morning for up to 30 minutes
- Pain may radiate (spread) into the buttock, groin or leg
- Spasm in muscles of the lower back and buttock on affected side.
- Pain is aggravated by
- Turning in bed
- Abducting the hip (swinging the leg out to the side) for example when getting in or out of a car.
- Walking as the heel hits the floor on the affected side
What you can do
- Cold therapy
- Rest - avoidance and reduction of aggravating activities
- Employ correct posture and body use to avoid overloading area
- Anti inflammatory medication – speak to your doctor or pharmacist about a suitable product
What we can do
- Diagnostic tests to incriminate sacroiliac joint
- Questioning to eliminate inflammatory joint disease as a cause of pain
- Manipulation of affected joint to open up the sacroiliac joint and break down scar tissue formation that may restrict joint movement
- Massage to relieve spasm in overlying muscles and therefore decrease pain
- Pumping techniques to remove inflammation from around the joint (foraminal gapping, reinforced flexion and traction)
- Reduce mechanical load on affected area by
- Improving alignment of spine and pelvis including assesement of leg length difference
- Mobilising and stretching joints to increase movement in adjacent areas of the spine to reduce loading on affected joint
Further treatment options
- Corticosteroid injection into the facet joint to reduce inflammation.
- Radiofrequency denervation’. A technique that destroys the nerve supply to the joint using ionizing radiation
Tags: back pain, low back pain
