Therapies and Treatments for Sacroiliac Pain
Sacro Occipital Technic®, Reflex Pain Treatment, Physical Therapy/Exercises, Shockwave Therapy, Myofascial Release
What is Sacroiliac Pain?
Sacroiliac (SI) pain refers to discomfort and pain experienced in the sacroiliac joint, which is located in the lower back where the sacrum (the triangular bone at the base of the spine) connects to the iliac bones (the large pelvic bones).
The sacroiliac joint is essential for stability and shock absorption, allowing for movement between the spine and pelvis while bearing the weight of the upper body.
A sacroiliac hypermobility or instability due to the overstretching or sprain of the ligaments overlying them (the sacroiliac ligaments) can cause the piriformis muscle to either become contracted or stretch pulled leading to a compression of the sciatic nerve.
This often creates pain in the buttock(s) that can radiate down the back of the thigh to the knee. In 2-4% of the population it can radiate to the foot. Another radiation pattern for sacroiliac pain is a C-type pattern wrapping around the hip to the front of the hip.
This will also cause pressure and aching in the lower spine most commonly felt when first waking up (tends to “settle out” within 20 or 30 minutes of walking around), after picking up heavy objects, prolonged sitting and/or standing, and an hour or so after stretching the piriformis muscle.
What causes Sacroiliac Pain?
Sacroiliac pain can be caused by various factors with some people being structurally predisposed to injury depending upon the shape of the joint. Some factors are:
- Trauma or Injury: Direct trauma to the sacroiliac joint, such as a fall, car accident, or sports injury, can lead to inflammation, strain, or ligamentous injury, resulting in pain and discomfort.
- Pregnancy: Changes in hormone levels and increased joint laxity during pregnancy can affect the stability of the sacroiliac joint, leading to SI pain, especially in the later stages of pregnancy. Women having multiple children are more susceptible to a greater degree of hypermobility/instability of this joint. This is worsened by weaker core musculature.
- Degenerative Changes: Wear and tear on the sacroiliac joint due to aging, repetitive stress, or degenerative conditions such as osteoarthritis or ankylosing spondylitis can cause inflammation, stiffness, and pain.
- Muscle Imbalances: Muscle imbalances or weakness in the muscles surrounding the sacroiliac joint, such as the gluteal muscles, transversus abdominis, or hip flexors, can alter joint mechanics and contribute to SI pain.
- Joint Dysfunction: Malalignment or dysfunction of the sacroiliac joint, such as subluxation or hypermobility, can cause abnormal movement patterns and result in pain and instability.
- Inflammatory Conditions: Inflammatory conditions such as sacroiliitis (inflammation of the sacroiliac joint) or spondyloarthropathies (a group of inflammatory joint diseases) can cause SI pain as part of their symptomology.
- Piriformis Syndrome: Irritation or compression of the sciatic nerve by the piriformis muscle, which runs near the sacroiliac joint, can cause referred pain in the lower back and buttocks. This is usually secondary to a hypermobility or instability of the sacroiliac joint, or sprain of the sacroiliac ligaments. If the person is genuinely a stiff individual then the muscle can be shortened as a result of general inflexibility leading the SI joint dysfunction and piriformis syndrome.
- Leg Length Discrepancy: Significant differences in leg length can alter pelvic alignment and mechanics, potentially leading to SI joint dysfunction and pain.
- Overuse or Repetitive Movements: Engaging in activities that involve repetitive or excessive movement of the lower back, pelvis, or hips, such as heavy lifting, running, or prolonged sitting, can strain the sacroiliac joint and surrounding structures, leading to pain.
- Psychosocial Factors: Psychological factors such as stress, anxiety, or depression can exacerbate pain perception and contribute to the chronicity of SI pain symptoms.
FAQs for Sacroiliac Pain
What is Sacroiliac (SI) Pain?
Sacroiliac pain refers to discomfort or pain experienced in the sacroiliac joint, located in the lower back where the sacrum (triangular bone at the base of the spine) connects to the iliac bones (large pelvic bones). SI pain can vary in intensity and may be felt on one or both sides of the lower back, buttocks, hips, or groin.
What causes Sacroiliac Pain?
Sacroiliac pain can be caused by various factors, including trauma or injury, pregnancy-related changes, degenerative conditions, muscle imbalances, joint dysfunction, inflammatory conditions, piriformis syndrome, leg length discrepancy, overuse or repetitive movements, and psychosocial factors such as stress or anxiety.
How is Sacroiliac Pain diagnosed?
Diagnosis of sacroiliac pain typically involves a thorough medical history review, physical examination, and possibly imaging tests such as X-Rays, MRI, or CT scans to rule out other potential causes of lower back or hip pain. Diagnostic tests such as SI joint injections or provocative maneuvers may also be used to confirm the diagnosis.
What are the symptoms of Sacroiliac Pain?
Symptoms of sacroiliac pain may include discomfort or pain in the lower back, buttocks, hips, or groin, which may worsen with certain movements or activities such as standing, walking, or climbing stairs. Pain may be dull, achy, or sharp and may radiate into the legs or groin.
Is Sacroiliac Pain the same as lower back pain?
While sacroiliac pain is located in the lower back region, it specifically refers to discomfort or pain arising from the sacroiliac joint. Lower back pain, on the other hand, can have various causes, including muscle strain, lumbar disc herniation, spinal stenosis, or facet joint dysfunction, among others.
Can Sacroiliac Pain be prevented?
While it may not be possible to completely prevent sacroiliac pain, certain measures can help reduce the risk of developing symptoms. These may include maintaining good posture, practicing proper body mechanics when lifting or bending, engaging in regular exercise to strengthen the core and pelvic muscles, and avoiding activities that exacerbate symptoms.
What are the treatment options for Sacroiliac Pain?
Treatment for sacroiliac pian may include rest, activity modification, chiropractic, physical therapy, myofascial release, Shockwave Therapy, SI joint injections (using corticosteroids or local anesthetics), anti-inflammatory medications, muscle relaxants, or in severe cases, surgical interventions such as SI joint fusion.
How long does Sacroiliac Pain last?
The duration of sacroiliac pain can vary greatly depending upon the underlying cause, severity of symptoms, receiving the proper treatments, and the individual’s response to treatment. In some cases, symptoms may resolve with conservative measures within a few weeks, while others may require ongoing management or interventions for long-term relief.
Can Sacroiliac Pain lead to other complications?
While sacroiliac pain itself is not typically associated with serious complications, persistent or untreated symptoms may lead to functional limitations, decreased quality of life, and secondary issues such as muscle weakness, stiffness, compensatory movement patterns, and lumbar disc herniations.
When should I see a doctor for Sacroiliac Pain?
You should seek medical attention for sacroiliac pain if you experience severe or persistent symptoms that interfere with daily activities, if pain is accompanied by other concerning symptoms such as fever, numbness, or weakness in the legs, or if symptoms worsen despite self-care measures. A healthcare provider can evaluate your symptoms, provide an accurate diagnosis, and recommend appropriate treatment options for sacroiliac pain.
