Do you get back pain when you lean forward to stand up, with prolonged sitting or climbing stairs? Does the pain start at your pelvis and radiate to your buttock? Then chances are the problem is your SI joint and not your Lumbar Spine.
What is the SI joint?
Your sacroiliac joint is where your pelvis joins your sacrum. There is one on either side of the sacrum. Their main job is to carry the weight of your upper body around and distribute the weight to the pelvis. They also act as a shock absorber for your spine as you move throughout your day.
The SI joint is a relatively flat joint with some ridges to help hold it in place, along with your ligament and muscle system. If you are hypermobile in your ligaments, then you are more likely to have issues with your SI joint.
The pain can mimic and be misdiagnosed as lumbar radicular pain or even just lower back pain. Common symptoms are:
- Pain is often localised over the buttock
- Pain can be sharp, stabbing, and/or shooting pain which extends down the posterior thigh usually not past the knee
- Difficulty sitting in one place for too long due to pain
- Local tenderness of the posterior aspect of the sacroiliac joint (near the posterior superior iliac spine)
- Pain occurs when the joint is mechanically stressed, e.g. forward bending, stair climbing
- For some, walking feels better, for others loading it is painful
The evidence suggests that up to 90% of people will present to a healthcare facility with some form of low back pain, around 10-25% of them are actually experiencing SI joint pain. The main causes of SI joint pain are:
- Approximately 20% of all SI pain cases are pregnancy related
- With 88% of cases involving microtrauma or an acute trauma, such as a fall or a car accident
If you have been treated for lumbar pain and feel like you’re not getting anywhere, or your pain appears to be lower, and around your buttocks or pelvis, then it is worth looking at your SI joint.
How do you treat the SI joint?
At Vitalis Physiotherapy we assess your whole body to find out why you are loading your pelvis so much. We will assess if your pelvis is correctly aligned, which muscles are tight and which are weak. We will then show you how to correct the imbalance and improve your pelvis stability to return to the things you love doing.
What can I do at home?
Pelvis love symmetry! Some simple things to do at home are:
- Sit on your sitting bones – do not cross your legs, or curl them to one side
- Stand with weight evenly on both legs – do not hand off your hip, like the super models do
- If sleeping on your side do place a pillow between your knees to help with alignment overnight
- An SIJ belt can help give your pelvis support while you get stronger
- Trigger ball your gluteal muscles – specifically piriformis