“Sacroiliac joint syndrome is a significant source of pain in 15% to 30% of people with mechanical low back pain.”
— Physiopedia
Pain in the sacroiliac (SI) joint can be quite uncomfortable, and can affect your ability to perform daily activities. The SI joint is the connection between the spine and the pelvis, specifically connecting the hip bones to the sacrum. It is essential for load transfer between the spine and lower extremity (shock absorber and torque converter). Due to the wear and tear this joint goes through, dysfunction can lead to a number of symptoms.
SI joint pain can be difficult to distinguish from low back pain, so it is important to be assessed by a physiotherapist to determine where your pain is coming from. Approximately 90% of the population will at some experience or present to the clinic with some form of low back pain/pathology. About 10% to 25% of these patients are thought to be experiencing pain from the SI joint (Physiopedia).
The SI joint is a stable joint and supported by large ligaments and some of the strongest muscles in the body. One of the most common causes of SI issues is trauma, causing strain to ligaments around the joint. Pain can also arise due to abnormality of the sacrum bone, degenerative changes, osteoarthritis or increased laxity of the ligaments due to pregnancy.
When SI joint issues arise, you will typically notice it in daily activity such as sitting, laying, climbing stairs, etc. Symptoms of SI joint dysfunction include:
Low back pain
Pain directly along SI joint
Thigh pain
Difficulty sitting
Pain with bending
Pain along buttocks
Radiating pain into lower extremity
Physiotherapy always involves a detailed patient history, which is a major part in making the correct diagnosis. Injuries to the SI joint can mimic low back pain, so an assessment is important in determining the cause of the pain. Physiotherapists use a variety of provocation tests to determine if pain is caused by certain movements.
If an SI joint dysfunction is determined, warmup, mobility and strengthening exercises are all important parts of rehabilitation. Some exercises include:
Warm/up/mobility:
Knees side to side - 3 x 10 second hold each side
Child’s pose - 3 x 30 second hold
Rolling gluteals - 30 seconds each side
Stability exercises:
Bird dog - 3 x 5 per side
Dead bug - 3 x 5 per side
Strength:
Glute bridge - 3 x 7 reps
Single leg dips w/ abduction - 3 x 7
If you notice pain in your low back or SI joint, be sure to contact a physiotherapist to assess your pain. With a detailed assessment, we can determine the cause of your pain. Got questions? We are always here to help! Email or book in with one of our physiotherapists.
