Sacroiliac Joint Dysfunction: A common cause of low back pain?

Physical Therapy Question:

Recently I slipped and fell on ice, landing on my left side. Since then I have noticed left lower back pain that radiates into my left buttock and the back of my thigh. It is difficult for me to sit, walk and move due to the pain. I saw my family physician who ordered X-rays which where negative. He recommended naproxen and rest. This is not helping. Can physical therapy help me?


Physical Therapy Answer:

Approximately 40 percent of all low back pain is related to sacroiliac joint dysfunction. The sacroiliac joint (SI joint) is one of two joints in your pelvis that connect the tailbone (the sacrum) and the large pelvic bone (the ilium). The sacroiliac joints connect the spine to the pelvis there by forming the base by which spinal movements occur. Injury to the sacroiliac joint can occur from a direct fall on the buttocks, a motor vehicle accident, or even a lifting injury. In some cases it occurs through normal activities without a specific trauma. Regardless of the cause, the sacroiliac joints can become misaligned and the ligaments/muscles around the joint become strain/sprained causing inflammation, pain and difficulty with movement.

Sacroiliac joint dysfunction symptoms:Left or right side low back pain with stiffnessPain may radiate to the buttocks, back of thigh or groin.Pain is achy and becomes sharp with movementPain is often made worse with rolling in bed, putting on shoes/socks, getting up from a seated position.Tenderness to touch around the bony lumps on one side of your lower back.Sacroiliac joint dysfunction vs. SciaticaSacroiliac joint dysfunction can often be confused with Sciatica. The difference being that sciatia is caused by irritation of a nerve (low back nerve that makes up the sciatic nerve) in the low back. This is often associated with a herniated disc.

The most common symptoms of sciatica are; low back pain, pain/numbness/tingling radiating into the leg below the knee often into the foot. The pain is often hot/burning and lancinating with occasional weakness of the foot/ankle.Physical therapy treatment of sacroiliac joint dysfunctionPhysical therapy and chiropractic care is the treatment of choice for sacroiliac joint dysfunction. First of all, your physical therapist or chiropractor will take a complete history and perform an examination of the low back and pelvis to determine the structural cause of the pain.

The best treatment approach is to utilize a combination of hands-on soft tissue and sacroiliac joint techniques. There is an abundance of research demonstrating the efficacy of hands on techniques to decrease pain and improve function. Often soft tissue techniques (myofascial release, Graston technique, Active Release Technique) are used to help decrease muscle spasms, reduce inflammation, normalize healing tissue and desensitize painful nerve ending. This is followed by gentle joint techniques (mobilization, manipulation or muscle energy) to realign the sacroiliac joint. The patient is then given gentle stretches and exercises to promote healing and prevent recurrence. With treatment the patient most likely will notice a significant reduction in symptoms and a return to function.

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