Are you having SI joint pain issues?
An injury of any kind, osteoarthritis, or any other underlying medical condition that affects the hips, pelvis, legs, or lower back can lead to issues with the Sacroiliac joint (SI), which can be extremely painful.
Sacroiliac joint pain varies. It can be sharp and intense and travel from the hips to the pelvis to the thighs and lower back. But other times, or for other patients, the pain can be less intense and limited to a smaller body area.
You may also experience a numb tingling sensation and feel like your legs are about the “give way” under your weight with sacroiliac joint issues.
Around 30% of patients may also suffer from pain in the lower back due to issues with the Si joints. We know that more than half the US population sometimes suffers from lower back pain.
It is one of the main causes of work-related disability. We believe that many of these patients may have undiagnosed sacroiliac joint issues contributing to their lower back pain.
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What Is The SI Joint?
The SI joint is actually two joints. They’re positioned where the ilium (the upper part of the hip and pelvis) and the sacrum (the large shield-shaped bone at the base of the spine) connect in the lower back.
The sacroiliac joints carry your body weight and help to distribute it evenly across the pelvis. They also connect your pelvis to your lumbar (lower) spine. It relieves pressure on the spinal cord and serves as a shock absorber.
The SI joint bones are unevenly shaped with edges that help them to remain aligned. The bones link together with durable ligaments and muscles for stability, and although it’s limited, they do allow some movement.
While the movement is minimal, the sacroiliac joints are essential for us to stay upright and help women in childbirth.
What Causes SI Joint Pain?
The is a layer of cartilage that serves as protection for the bones of the SI joint. For lubrication, there is fluid between the SI joint bones.
There are also nerve endings in the joint spaces that transmit pain signals (which may be what’s causing your pain). Alternatively, If there is a tear in the cartilage or the SI joint bones move out of alignment, it can also cause pain.
But in many cases, the cause of SI joint pain is sacroiliitis. Sacroiliitis is a painful condition where either SI joints become inflamed. This inflammation can develop for a variety of different medical reasons, including:
- Osteoarthritis: Older adults are more likely to experience wear and tear of cartilage joints that causes osteoarthritis, which can affect the body’s various joints, including the SI joint.
- Ankylosing spondylitis (AS): This autoimmune condition can lead to inflammatory arthritis affecting the joints and spinal vertebrae. Apart from it being painful, it may also lead to the growth of new bones that cause the spinal joints to fuse. Despite ankylosing spondylitis impacting the SI joint and causing pain, it may also affect other joints, including the organs. This is a chronic condition that can cause pain ranging from mild to intense.
- Gout: Also termed as “gouty arthritis .”An abnormal increase in uric acid levels in the body causes this painful condition. It affects the joints of the body and causes severe pain. While it usually manifests first in the big toe, it can impact all joints, including the SI joint.
- Injury: Any type of major trauma like an accident or severe fall may lead to an injury of the SI joint resulting in pain.
- Pregnancy: During pregnancy, the elasticity around the SI joint increases due to releasing a hormone called Relaxin. While it helps facilitate childbirth, it also reduces the joint’s stability, which can cause pain. In addition, during pregnancy, excess weight and increased body movement due to the baby’s weight can also cause pain in the SI joint. For this reason, pregnant women are more likely to go on to develop arthritic SI joints, with the risk higher for women who have multiple pregnancies.
- Gait: Having an incorrect or awkward gait (how you walk) can lead to SI joint issues. If for any reason, you walk abnormally, e.g., because you have fused hips, different leg lengths, etc., all of this can cause dysfunction of the SI joint. Also, some women that are pregnant may not walk normally. But after childbirth, their gait improves, and the Si joint pain disperses.
There are some seemingly harmless everyday activities that can aggravate already sensitive sacroiliac joints.
They include sitting for too long, balancing on one leg, walking up and down stairs, moving from sitting to standing, and running.
So, if you’re already suffering, it’s worth bearing in mind that these activities can make the pain worse.
How To Prevent SI Joint Pain
Some patients may suffer from SI joint pain because of chronic medical issues, so it may not be preventable in all cases.
However, staying physically active can reduce the risk of painful joints and may help delay the onset of medical issues like osteoarthritis in the SI joints.
Plus, making sure that you maintain a healthy weight can help in the prevention of the condition. Eating well, reducing stress, and staying hydrated can also help, as with most things.
What Are The Symptoms Of Sacroiliac Joint Problems?
The symptoms of issues relating to the Si joint different from person to person, but some of the most common symptoms are:
- Pain in the groin region
- Muscle weakness accompanied by numbness
- Lower back pain
- Experiencing pain when you stand from a seated position
- Consistent pain in the pelvic region, buttocks, and hips
- Pain that travels down to the upper legs and thighs
- Feeling like your legs cannot bear your body weight
- Burning and stiffness in the pelvic region
Do you have any of these symptoms?
How To Get Relief From SI Joint Pain
Physical therapy, therapeutic exercises, and massage combined can help treat sacroiliac joint pain and make the SI joint and the surrounding muscles stronger.
Ice packs can also help relieve inflammation and pain in that area of the body. You may find even more relief from your symptoms by alternating between hot and cold packs.
Some patients also say they find relief from using a “sacroiliac belt .”A sacroiliac belt is a type of compression worn around your hips to keep the SI joint stable to allow the joint and the surrounding tissue support to heal, reduce pain, and prevent further injury.
Some people love them. Some people say they don’t notice any difference in their symptoms.
Have you tried one?
Patients who don’t show improvement with exercise and physical therapy (normally due to an underlying medical condition) may require pain-killing medication.
Doctors may sometimes prescribe NSAIDS (anti-inflammatory drugs) like ibuprofen or oral steroids for a limited duration.
They may also suggest administering steroid injections directly into the joint or even muscle relaxants to treat SI joint issues.
If you have ankylosing spondylitis, they may use TNF inhibitors. In some cases, radiofrequency ablation deactivates the pain-causing nerves or, as a last resort, surgery.
Surgery is usually only used as the last remaining option for treating chronic SI joint pain when all other forms of treatment have been unsuccessful in relieving symptoms and managing pain.
Their surgical process is known as SI joint fusion, where tiny screws and plates keep the SI joint bones held together until they fuse or combine.
While surgery is generally successful in treating the condition and relieving symptoms, it restricts the range of motion of the SI joint.
But we always recommend a physical therapy first strategy to prevent unnecessary use of medication with negative long-term health effects and to prevent surgery.
In most cases, physical therapy treatment effectively reduces pain and increases functionality in the SI joint.
We use stretching and strengthening exercises on the surrounding muscles and connective tissues, massage, and hands-on joint and tissue manipulation to get you moving well again without pain.
If you’re not sure whether your issues are related to the SI joint, we can also quickly diagnose the root cause and shed some light on exactly what is happening inside your body and causing the pain.
If you have sacroiliac joint pain now, the good news is that we can offer you a free 20-minute consultation at the Intecore Physical Therapy clinic to find out what’s going on (or not going on) with your sacroiliac joint and find out whether physical therapy is the right choice for you. You can book yours here.
