Do you have pain in your lower back, buttocks, or legs? Does the pain get worse when you stand up from sitting or when you climb stairs? You might have a condition called sacroiliac joint dysfunction. This problem occurs when there’s too much or too little movement in the sacroiliac joints, which connect your spine to your pelvis.
As a chiropractor in Ashland, OR, I’ve helped many patients find relief from sacroiliac joint pain. In this article, we’ll explore what causes sacroiliac joint dysfunction, common symptoms to watch for, and the treatment options that can help you feel better.
What is the Sacroiliac Joint?
The sacroiliac joint is where your spine meets your pelvis. There are two sacroiliac joints, one on each side of your body. These joints are surrounded by strong ligaments that help keep your spine and pelvis stable. The sacroiliac joints allow a small amount of movement, which helps absorb shock when you walk or run.
What Causes Sacroiliac Joint Dysfunction?
Sacroiliac joint dysfunction happens when the joint moves too much or too little. Some common causes include:
• Leg length difference: If one of your legs is slightly longer than the other, it can put uneven stress on your sacroiliac joints.
• Pregnancy: The hormones your body releases during pregnancy can loosen the ligaments around your sacroiliac joints, making them less stable. The added weight of the baby can also strain these joints.
• Injury: A fall, car accident, or other trauma can damage the sacroiliac joints or the ligaments surrounding them.
• Arthritis: Conditions like osteoarthritis, ankylosing spondylitis, and psoriatic arthritis can cause inflammation and pain in the sacroiliac joints.
• Muscle imbalance: Weak or tight muscles in your hip, thigh, or core can change the way your sacroiliac joints move.
What Are the Symptoms of Sacroiliac Joint Dysfunction?
The symptoms of sacroiliac joint dysfunction can vary from person to person. Some common signs include:
• Pain in your lower back, buttocks, or back of your thigh
• Pain that gets worse with standing, walking, or climbing stairs
• Stiffness or a feeling of locking in your lower back or pelvis
• Numbness, tingling, or weakness in your leg
• Pain that shifts from one side of your back to the other
The pain from sacroiliac joint dysfunction tends to be worse on one side of your body. It may start in your lower back and radiate down into your buttocks, groin, or back of your thigh. Many people find that their pain gets worse after sitting for a long time, standing on one leg, or sleeping on the affected side.
How is Sacroiliac Joint Dysfunction Diagnosed?
Diagnosing sacroiliac joint dysfunction can be tricky because the symptoms are similar to other conditions like herniated discs, hip problems, or sciatica. To figure out if your sacroiliac joint is the source of your pain, your healthcare provider will start by asking about your symptoms and medical history. Then they will do a physical exam to check the movement and tenderness of your sacroiliac joints.
There are several tests that can help identify sacroiliac joint problems:
• Distraction test: While you lie on your back, your provider will press down on the front of your hip bones. If this causes pain in your sacroiliac joint, it suggests the joint may be inflamed.
• Thigh thrust test: While you lie on your back with your hip and knee bent, your provider will push your knee toward your chest. Pain in your sacroiliac joint during this test can indicate a problem.
• FABER test: While you lie on your back, your provider will have you bend your knee and rotate your hip out to the side. Pain during this movement can be a sign of sacroiliac joint dysfunction.
X-rays, MRIs, or CT scans are usually not needed to diagnose sacroiliac joint dysfunction. However, your provider may recommend imaging tests if they suspect arthritis, a fracture, or another condition could be causing your pain.
How is Sacroiliac Joint Dysfunction Treated?
Treatment for sacroiliac joint dysfunction usually starts with non-surgical options. The goal is to relieve pain, restore joint movement, and improve your strength and flexibility. Treatment may include:
• Chiropractic adjustments to restore joint mobility
• Massage or trigger point therapy to relax tight muscles
• Stretching exercises for your hips, buttocks, and lower back
• Strengthening exercises for your core and pelvic muscles
• Ice or heat therapy to reduce pain and inflammation
• Sacroiliac support belt to stabilize the joint
If your pain is severe, your provider may recommend a steroid injection into the sacroiliac joint. This can help reduce inflammation and pain for several months. Surgery is rarely needed for sacroiliac joint dysfunction.
In addition to medical treatment, there are things you can do at home to ease your symptoms:
• Avoid activities that make your pain worse, like sitting for long periods or climbing stairs
• Use a pillow between your knees when sleeping on your side
• Apply ice or heat to your lower back and buttocks
• Take over-the-counter pain relievers like ibuprofen or acetaminophen
With the right treatment and self-care, most people with sacroiliac joint dysfunction can find relief from pain and return to their normal activities.
Conclusions
Sacroiliac joint dysfunction is a common cause of lower back and leg pain. It happens when there’s too much or too little movement in the joints that connect your spine to your pelvis. Pregnancy, leg length differences, injuries, and arthritis are some of the most common causes.
If you’re struggling with low back pain that radiates into your buttocks or legs, don’t ignore it. See a healthcare provider who can diagnose the cause of your pain and recommend a treatment plan. With chiropractic care, exercises, and other conservative treatments, you can find relief from sacroiliac joint pain and get back to enjoying your life.
References:
1. Laslett M. Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint. J Man Manip Ther. 2008; 16(3): 142–152.
2. Bernard TN Jr, Kirkaldy-Willis WH. Recognizing specific characteristics of nonspecific low back pain. Clin Orthop Relat Res. 1987 Apr;(217):266-80.
3. Vleeming A et al. The function of the long dorsal sacroiliac ligament: its implication for understanding low back pain. Spine. 1996 Mar 1;21(5):556-62.
4. Visser LH et al. Treatment of the sacroiliac joint in patients with leg pain: a randomized-controlled trial. Eur Spine J. 2013 Oct;22(10):2310-7.
5. Kurosawa D et al. Referred pain location depends on the affected section of the sacroiliac joint. Eur Spine J. 2015 Mar;24(3):521-7.
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