The Sacroliliac (SI) joint is meant to provide optimal stability for the pelvis while also providing an essential amount of motion. SI joint pain can be very severe and easily confused with lumbar disc pain based on the typical referral pattern of pain. It is often to experience pain down the posterior thigh. It is also the most common culprit in low back pain in pregnancy. Pain is often worse with a sit to stand motion, walking, and/or stairs. Often patients with SI joint dysfunction remark that pain is worse with the sit to stand motion. The pain is generally better with rest.
SI joint pain can be caused by a variety of muscle imbalances in the lower back and hip region. It is also possible to experience pain caused by muscle imbalances in the lower extremities. For example, in many patients, the larger gluteal muscles provide an insufficient amount of stability for the joint. In this case, the smaller hip external rotator muscles (which cross the joint line, below the SI) are over active. This can cause compression on the lower SI preventing optimal movement. Other patients, often runners, could have insufficient movement in the foot and ankle. Therefore, causes the force to move up the leg resulting in compression at the SI joint, restricting its movement.
Sacroiliac joint dysfunction requires a multifaceted treatment approach and starts with an accurate diagnosis. Such an approach includes the appropriate diagnostic imaging with a goal of not just figuring out the what but also the why. The reason for this is because this condition is often missed by most medical providers. Once there is an appropriate diagnosis, the treatment would typically include multiple techniques for recovery. For example, treatments like functional rehabilitation program, Instrument Assisted Soft Tissue Manipulation (IASTM) or other forms of myofascial release, joint manipulation or mobilization.