The sacroiliac joint or SI joint connects the spine to the pelvis. It is formed by the connection of the sacrum, the triangular shaped bone in the lower portion of the spine, to the right and left iliac bones. The iliac bones are the two large bones that make up the pelvis. The sacrum and iliac bones are held together by a collection of strong ligaments where there is relatively little motion. When we are erect the SI joint needs to support the entire weight of the upper body acting as a shock absorber between the bones.
Pain in the sacroiliac joint can be caused by trauma, such as a fall, sudden jarring from a jump, the normal aging process of osteoarthritis, pregnancy, or any condition that alters the normal walking pattern placing increased stress on the SI joints. Pain is often experienced unilaterally in the lower back or back of the hips. Pain may radiate to the groin and thighs. Symptoms will typically worsen with standing, walking, or single leg standing on the involved side. A history of sharp pain that will awaken you while turning in bed will also occur.
Some suggestions to avoid stress to the SI joint are sleeping with a pillow between the legs; keeping the legs and hips parallel and as symmetrical as possible when moving or turning in bed as well as in and out of the car. When standing, stand symmetrically with the weight of your body evenly distributed through both legs. Sit down to get dressed, especially when putting on underwear or pants to avoid single leg weight bearing. Moving slowly without sudden movements and avoidance of bending forward at the waist will help minimize stress to the painful joint. Always sit with good posture with a lumbar roll behind you.
Physical Therapy can be very beneficial for pain relief. Initially in the acute phase, the use of modalities such as electric stimulation, ice, and ultrasound may help reduce the inflamed joints. Pain in the SI joint is often related to either too much or not enough motion in the joint. Tight or shortened muscles need to be stretched such as the hamstrings and piriformis. The muscles that are found to be weak need to be strengthened, emphasizing the pelvic stabilizers, lumbar spine, and hip joints to eliminate trunk and lower extremity muscle imbalances as well as correcting any walking abnormalities. A sacroiliac belt is a device that wraps around the hips in order to stabilize the SI joints may also prove beneficial.
If you are suffering from sacroiliac joint pain and would like to consult with a physical therapist, just ask your physician to refer you to a qualified practitioner. We would be happy to assist you achieve pain relief.
Contraction of the transversus abdominis has been proven effective to significantly decrease the laxity of the sacroiliac joint. To perform a transversus abdominis isometric simply lay on your back or stomach with your spine in the neutral position. Draw in the lower portion of your abdomen up and in towards the spine without moving your trunk or pelvis. Make sure you breathe normally and do not hold your breath while performing this exercise. Hold the contraction of your stomach for 10 seconds then relax.
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