What is this Sacroiliac joint Pain (SIJ)?
The sacroiliac joint refers to the joint between the pelvis and sacrum which is situated just off to the side of the tailbone. Pain in this area can be focal or felt in the lower back or the hip, although presentations of pain can vary greatly between people. Pain is typically caused by an inflammatory process that may have been due to a traumatic event or developed overtime as a result of altered movement patterns and postures particularly in sitting, standing and twisting (Cohen et al. 2013). This can cause inflammation and pain to the many ligaments around the SIJ, or bony changes.
Conditions that may be related to Sacroiliac joint Pain
People who suffer from lower back pain can have involvement from the sacroiliac joint, approximately 15-30% of people who experience lower back and buttock pain is attributed to the SIJ (Adhia et al. 2016).
Pain that may present similarly to SIJ pain includes hip pain as a joint that sits close to the SIJ and can share some aggravating movements. Although, functional assessments such as hip movement and tests for hip-related pathology can assist in understanding what is causing pain (Polly, 2017).
Common symptoms / signs
Individuals with SIJ pain typically have a focal pain at the SIJ and buttocks area, although may feel pain that refers to the lower back and down the thigh. This pain can be aggravated by prolonged sitting and may feel like a sharp, stabbing pain. Some movements that may also aggravate pain include bending forward, climbing stairs or standing on one leg.
How is Sacroiliac joint Pain treated?
Physiotherapy treatments are aimed to minimis pain levels through joint mobilisations, soft tissue work and the use of heat or cold therapies. Individuals may be advised to change activities or postural positions that can aggravate pain. Exercise is important to include in the treatment program to reduce recurrent symptoms and improve mobility. These typically consist of core exercises and gluteal muscles aimed to improve the stability at the SIJ as these muscles attach to around the SIJ and can support this joint to move with minimal pain. Particularly for those who experience SIJ pain that may be caused by increased joint laxity (Falowski et al. 2020).
Risk factors of this condition include:
- Pregnancy causing joint laxity and change in posture
- Leg length discrepancy
- Hypermobility / hypomobility
- Gait abnormalities
- Scoliosis
References
Adhia, D. B., Milosavljevic, S., Tumilty, S., & Bussey, M. D. (2016). Innominate movement patterns, rotation trends and range of motion in individuals with low back pain of sacroiliac joint origin. Manual therapy, 21, 100-108.
Cohen, S. P., Chen, Y., & Neufeld, N. J. (2013). Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert review of neurotherapeutics, 13(1), 99-116.
Falowski, S., Sayed, D., Pope, J., Patterson, D., Fishman, M., Gupta, M., & Mehta, P. (2020). A review and algorithm in the diagnosis and treatment of sacroiliac joint pain. Journal of Pain Research, 13, 3337.
Polly, D. W. (2017). The sacroiliac joint. Neurosurgery Clinics, 28(3), 301-312.