Understanding Sacroiliac Joint (SIJ) Pain: Insights from a Chiropractor

As a chiropractor, I encounter a multitude of musculoskeletal issues in my practice, and one of the most common yet often misunderstood conditions is Sacroiliac Joint (SIJ) pain. The SIJ, located at the base of the spine, plays a crucial role in connecting the pelvis to the lower spine. When this joint becomes painful or dysfunctional, it can lead to significant discomfort and mobility issues. In this post, we’ll delve into the details of SIJ pain, its causes, symptoms, and how chiropractic care can offer relief.

What is the Sacroiliac Joint?

The sacroiliac joint is where the sacrum, the triangular bone at the base of the spine, connects to the ilium, or the “wings” of the pelvis. This joint is supported by strong ligaments, and its primary role is to provide stability and support for the upper body, particularly during activities like walking, lifting, and standing.

Here is an image of the SIJ using X-rays and demonstrates what it is we are looking at when assessing these joints through imaging:

Causes of SIJ Pain

SIJ pain can arise from various factors, often related to:

1. Trauma or Injury:

• A fall, car accident, or sports injury can strain the SIJ, leading to inflammation and pain.

2. Pregnancy:

• The hormonal changes during pregnancy can loosen the ligaments around the SIJ, causing instability and pain as well as a change the biomechanics of the spine and pelvis due to weight gain around the stomach (naturally)

3. Arthritis:

• Conditions like osteoarthritis or ankylosing spondylitis can affect the SIJ, leading to pain and stiffness.

4. Degeneration:

• Wear and tear over time can cause degeneration of the SIJ, resulting in pain, especially in older individuals.

5. Biomechanical Issues:

• Poor prolonged positioning, significant uneven leg length, or gait abnormalities can stress the SIJ, causing pain over time.

Symptoms of SIJ Pain

Identifying SIJ pain can be tricky because its symptoms often mimic other conditions like sciatica or lumbar spine issues. Common symptoms include:

• Pain: Typically felt on one side of the lower back or buttocks. The pain might also radiate down to the thigh or groin.
• Stiffness: Difficulty in moving the affected side, especially after prolonged sitting or standing. < getting in and out of a car seat can also be a big issue for patients experiencing SIJ pain.
• Instability: Feeling like the pelvis is giving way or “unlocking” during movement.
• Numbness or tingling: Sometimes felt in the leg, resembling sciatic nerve pain.

Chiropractic Care for SIJ Pain

Chiropractic care offers a conservative, non-invasive approach to managing SIJ pain. Here’s how chiropractors approach treatment:

1. Chiropractic Adjustments:

• Manipulation/mobilisation/chiropractic adjustments aim to stretch and mve the SIJ and improve its mobility. This can reduce pain and restore function.

2. Soft Tissue Therapy:

• Techniques like massage or myofascial release can help relax tight muscles and tight/sore/inflamed ligaments around the SIJ, many of which reduce tension and pain.

3. Exercise Prescription:

• Tailored exercises can strengthen the muscles and ligaments supporting the SIJ, improving stability and preventing future episodes of pain.

4. Posture Correction:

• Education on proper posture and ergonomics is crucial to prevent recurring SIJ issues.

5. Supports:

In some cases where SIJ pain fails to respond to chiropractic exclusively, sometimes we will recommend the use of an SIJ belt which acts as a tight tourniquet across the lower abdomen and pelvis to relieve pressure off the SIJ’s. We typically recommend the use of Mediflex supports Sacroiliac Belt which can be found here https://mediflexsupports.com.au/ , we also stock these belts in the clinic and can fit them upon request.

Conclusion

Sacroiliac Joint pain can be challenging, but it is manageable with the right approach. As a chiropractor, I’ve seen countless patients find relief and improved function through chiropractic care. If you’re experiencing lower back or pelvic pain, especially with the described symptoms, consider consulting with a chiropractor for a thorough evaluation and personalized treatment plan. Remember, addressing SIJ pain early can prevent it from becoming a chronic issue, allowing you to move with greater comfort and flexibility in your daily life.

Yours in health

Dr Matthew Gooch (Chiropractor)