SI Joint Dysfunction

SI Joint Dysfunction

Also called: Sacroiliac Joint Dysfunction or Sacroilitis

The sacroiliac joint forms part of the spine and the pelvis. Where the spine and the pelvis joins, an extra joint is found - called the sacroiliac joint, or SI joint, for short. 

In normal, healthy people, when they bend down to pick up a pen or tie their shoes, most of the movement should occur by the healthy spine and healthy adjacent, large hip joints. When any injury, disease or surgery affects the hip joints and/or the lower spine, movement is often lost in these regions. To help us compensate and keep putting socks on, picking up toys in the kids rooms, etc., the SI joint often "takes up the slack." The interesting thing is that this joint has many strong ligaments and big muscles to protect it, and does not have a lot of movement and does not like this extra movement. When the SI joint picks up more of the slack, it often irritates the joint. The big sciatic nerve runs very close to the joint, which makes this joint quiet sensitive- another way of saying it can become painful in the area and even refer some pain to adjacent areas. Sacroiltis often refers to the process whereby the SI joint become irritated and inflamed. 

Treatment of SI Joint dysfunction:

There are many treatment strategies for SI joint dysfunction:

  • Treatment may focus on regaining movement from the larger adjacent (spinal and hip) joints through hands-on treatment and/or exercises. By increasing movement to these joints, the SI joint often will revert back to it's minimal movement, easing the irritation.
  • Spinal stabilization exercises. Therapists may design an exercise program aimed at tightening up the muscles around the SI joint, thus alleviating the unwanted stress to the joint, easing pain and restore normal movement. 
  • Modalities. Therapists may decide to use some modalities to help ease spasm, pain and inflammation of the SI joint.
  • Injections. Some physicians may believe that an injection of steroid in the joint may ease the pain, spasm and inflammation. This is often done when a lot of pain is present and to help therapy regain movement and get muscles to work better in the area.
  • Nerve ablation therapy. In very small percentages of patients with chronic pain in the SI joint who are unable to respond to any physical therapy, doctors may decide to burn the little nerve that makes you "feel the pain" from the SI joint. This may alleviate the pain and allow you to exercise better and strengthen the muscles and allow the ligaments to tighten.

Last thought:

The pain from SI joints often "come and go". Patients have good and bad days. Don't let this worry you= it's normal these joints and we expect it. It all depends on the type of movements you do/ have done.

 

*For more information- ask your physical therapist. This is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional. 

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