The human body has two sacroiliac (SI) joints. The SI joint is the joint that links the iliac crest in the hip (pelvis) to the sacrum (lowest part of the spine just above the tailbone). It transfers weight and forces between your upper body and your legs. It also acts as your spine’s shock absorber by keeping impact forces from reaching your spine and injuring it during your day-to-day activities.
What is SI joint pain?
SI joint pain is a pain in one or both of your SI joints that can be due to either too much or too little movement in the joint. SI joint pain can sometimes cause lower back and/or leg pain making it very difficult to differentiate it from radiating (radicular) leg pain caused by lumbar disc herniation (sciatica). It is estimated that the sacroiliac joint is responsible for 15% to 30% of lower back pain cases.1
What causes SI joint pain?
SI joint pain can be caused by a trauma to the lower back, hip or buttocks, such as an automobile accident or a fall. It can also be caused by:
- Pregnancy and childbirth due to the widening and stretching of the sacroiliac joints during childbirth, arthritis and infection in the sacroiliac joint (osteomyelitis).
- A procedure, such as lumbar spinal fusion surgery.
- Repetitive SI joint stress from such activities as repeated heavy lifting or manual labor, prolonged sitting or standing and prolonged intense physical activity.
Inflammation of the SI joint resulting from any of these traumas or life events can lead to a condition called sacroiliitis. Sacroiliitis is also often the first symptom of systemic inflammatory diseases including systemic lupus erythematosus (SLE) – commonly known as “lupus” – and spondyloarthropathies like ankylosing spondylitis, psoriatic arthritis, reactive arthritis and rheumatoid arthritis (RA).
SI Joint Pain Symptoms
SI joint pain symptoms can include one or more of the following:
- Hot, sharp, stabbing sciatica-like pain that starts in the buttocks and radiates down the back of the thigh but typically does not extend past the knee. Sometimes, however, it can extend to the ankle or foot.
- Numbness, tingling and/or lower extremity weakness.
- Reduced range of motion in the lower back, hips, pelvis and groin.
- Worsening pain when the joint is stressed with such activities as prolonged standing, climbing stairs or jogging, or lying on the affected side.
- Pelvic and/or lower back instability that causes the pelvis to feel as it will buckle or give way when standing, walking, or moving from standing to sitting.
- Sleep disturbances.
- Painful to sit for long periods of time.
- Painful when transitioning from a sitting to a standing position.
Treatment for SI Joint Pain
The good news is that SI joint pain can typically be treated using nonsurgical methods, including physical therapy, manipulation and exercise. Treatment may include manual therapy and manipulation along with stretching and strengthening exercises. Contact us to find out how you can manage your SI joint pain without having to rely on drugs or invasive epidural steroid shots.
Resources:
- Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013 Jan; 13(1):99-116.
