Sacroiliac Joint Dysfunction
SIJ dysfunction refers to a condition involving the sacroiliac joint (SIJ), which is located in the pelvis and connects the sacrum (the triangular bone at the base of the spine) to the iliac bones (the large bones of the pelvis). This joint is responsible for transferring the weight of the upper body to the lower body and allows for a small amount of movement necessary for walking and other activities.
SIJ dysfunction occurs when there is abnormal movement or alignment of the sacroiliac joint, leading to pain and discomfort in the lower back, buttocks, hips, and legs. The exact cause of SIJ dysfunction can vary and may include factors such as trauma, pregnancy, arthritis, inflammation, muscle imbalance, or repetitive stress.
Common symptoms of SIJ dysfunction include:
Pain in the lower back, buttocks, hips, and groin area.
Pain that may radiate down the back of the thigh or into the lower leg.
Pain aggravated by activities such as walking, standing, or climbing stairs.
Stiffness or difficulty moving the lower back or hips.
Pain that worsens with prolonged sitting or lying down.
The Fortin Finger Test: When asked where your pain is, you point straight to a point which is within 1cm of the SIJ
Anatomy of the Sacroiliac Joint:
The sacroiliac joint connects the sacrum, the triangular bone at the base of the spine, to the iliac bones of the pelvis. This joint plays a crucial role in stability and load transmission between the spine and lower extremities. Its unique structure allows for minimal movement necessary for activities like walking and bending.
Several factors can predispose individuals to sacroiliac joint (SIJ) dysfunction. These precursors include:
Trauma: Injury to the pelvis, such as a fall or impact, can disrupt the normal alignment and function of the sacroiliac joint, leading to dysfunction and pain.
Pregnancy: Hormonal changes during pregnancy, particularly the release of relaxin hormone, can increase the laxity of ligaments surrounding the SIJ, potentially leading to instability and dysfunction.
Muscle Imbalances: Weakness or imbalance in the muscles surrounding the pelvis and SIJ can affect joint stability and contribute to dysfunction.
Joint Hypermobility: Some individuals naturally have hypermobile joints, including the SIJ, which can increase the risk of dysfunction, especially when coupled with inadequate muscle support.
Arthritis: Inflammatory conditions such as ankylosing spondylitis or osteoarthritis can affect the sacroiliac joint, leading to pain, stiffness, and dysfunction over time.
Repetitive Stress: Activities or occupations that involve repetitive movements or prolonged standing can place excessive stress on the SIJ, increasing the risk of dysfunction.
Poor Posture: Improper posture, such as slouching or sitting with poor spinal alignment, can contribute to SIJ dysfunction by placing uneven pressure on the joint and surrounding structures.
Leg Length Discrepancy: Variation in leg length can result in asymmetrical loading of the pelvis and SIJ, potentially leading to dysfunction and pain.
Triggers and Aggravators:
Several factors can exacerbate SIJ dysfunction:
Prolonged sitting or standing
Lifting heavy objects incorrectly
Repetitive movements that strain the SIJ
Poor posture or biomechanics
Sudden movements or trauma - like falling onto your buttocks
Inflammation
Twisting and lunging motions - such as vacuuming
Whiplash
Relevance in Pregnancy:
Pregnancy induces hormonal changes that affect the ligaments and joints, including the SIJ. As the body prepares for childbirth, increased laxity in ligaments can lead to SIJ dysfunction. Pregnant women commonly experience lower back pain due to the altered biomechanics and increased stress on the SIJ and surrounding structures.
Tips to Reduce Pain and Discomfort:
Maintain Proper Posture: Practice good posture while sitting, standing, and walking to reduce stress on the SIJ.
Strengthen Core Muscles: Engage in exercises that strengthen the core muscles to provide support and stability to the SIJ.
Use Proper Lifting Techniques: Bend your knees and keep your back straight while lifting heavy objects to prevent strain on the SIJ.
Apply Heat or Ice: Alternate between heat and ice therapy to alleviate pain and reduce inflammation in the affected area.
Consider Supportive Devices: Utilize supportive belts or pillows to provide additional support to the lower back and pelvis.
Avoiding Flare-ups:
Practice gentle stretching exercises to improve flexibility and reduce tension in the muscles surrounding the SIJ.
Avoid activities or movements that exacerbate pain and discomfort.
Maintain regular strengthening exercises prescribed by our expert osteopaths
Regular osteopathic visits to maintain alignment and health
Managing Flare-ups:
Rest and avoid strenuous activities to allow the SIJ to heal.
Apply topical analgesics or anti-inflammatory gels to alleviate pain and discomfort.
Consider gentle osteopathic manipulative techniques to realign the SIJ and relieve tension in surrounding tissues.
Gentle fascial release incorporated with appropriate breathing.
Is it SIJ dysfunction or instability?
Sacroiliac joint (SIJ) dysfunction and instability are distinct conditions involving the SIJ but differ in their underlying mechanisms and clinical presentations. SIJ dysfunction typically involves issues related to joint function, such as inflammation, irritation, or abnormal movement within the joint, leading to pain and discomfort primarily localized in the lower back, buttocks, and hips. It often results from factors like trauma, arthritis, muscle imbalances, or pregnancy.
In contrast, SIJ instability refers to excessive or abnormal movement within the SIJ, often due to ligament laxity or weakness, which can result in a feeling of instability, pain, and difficulty with weight-bearing activities. While SIJ dysfunction primarily focuses on problems related to joint function and movement, instability involves a lack of proper support or control of the joint, leading to abnormal movement and potential misalignment.
Treatment approaches for these conditions may overlap but can also be tailored to address the specific underlying issues, whether they involve dysfunction, instability, or a combination of both, so it’s important to have a full and comprehensive assessment with one of our expert pelvic osteopaths to have a personalised approach.