Sacroiliac Joint (Sij)


The Sacroiliac Joint (Sij)

The Sacroiliac Joint (SIJ), located at the base of the spine and connecting the spine to the hips, is vital in supporting the body’s weight and movement. Despite its importance, it remains a relatively less understood part of our anatomy. Often, pain experienced in the lower back or hips can be attributed to issues within the SIJ. However, diagnosing and treating SIJ problems can be challenging due to the complexity of the joint and its proximity to other structures that can cause similar symptoms.

Structure and Anatomy of the Sacroiliac Joint

You need to understand the anatomy, structure and position of the sacroiliac joint in order to properly evaluate and diagnose any pain or dysfunction related to it.

This joint is a bony articulation between the sacrum and ilium bones of the pelvis. It is supported by strong ligaments, including two large ligaments – the anterior and posterior sacroiliac ligaments – that attach from one side of the joint to the other.

The SIJ has a small surface area with an articular capsule surrounding it for stability. This allows for minimal mobility at this joint, which helps protect it from injury during normal activities like walking, running, or lifting heavy objects.

Pain is typically caused by strain in this area, on these supporting structures, or irritation of the joint surface itself. Understanding how this joint functions will help medical professionals more accurately diagnose any issues with it.

Functions of the SIJ

The main purpose of your SIJ is to provide stability and absorb shock. This joint plays a vital role in the body as it helps transfer forces between the upper and lower body, such as when walking or running.

It also aids in the movement of the hips, pelvis, and lumbar spine. The following are some other functions of the SIJ:

  • Long dorsal sacroiliac ligament: This ligament helps stabilize the SI joint by connecting it to other bones in the pelvic joint region.
  • Posture maintenance: The SI joint helps maintain posture by providing support during standing or sitting postures.

Common Symptoms and Causes of Sacroiliac Joint Pain – Sacroiliitis, Spondylolisthesis and Others

Pain in the lower back can often be attributed to  SIJ. This joint connects your lower spine to your pelvis and transfers pain along your upper body and legs. Sometimes the discomfort is a simple axial low back pain as well. Si joint Dysfunction can cause pain that may radiate into the buttocks, thighs, and feet.

Sacroilic join shown in the human skeleton
Photo Credit: rawpixel, Freepik

Common causes of pain in the SIJ include sacroiliitis, which is a form of arthritis that affects the joint; spondylolisthesis, which is when one vertebra slips forward over another; and hypermobility in the joint caused by lax ligaments. In addition, injury or trauma to the area may cause inflammation or swelling, which raises suspicion of sacroiliac joint dysfunction emanating within the joint.

It’s important to identify any underlying causes of pain in the SIJ to treat it effectively.

Diagnosing Sources of Sacroiliac Joint Dysfunction

To identify the source of your lower back discomfort, it’s important to diagnose any possible SIJ issues.

Diagnosing an SIJ problem can involve:

  • Examining pain patterns and joint mobility: Your doctor may check for tenderness or pain along the typical areas when touched. They will also assess your joint mobility by having you move in certain ways.
  • Conducting diagnostic tests: Imaging tests such as an X-ray, ultrasound, or MRI may be done to look at the structure of the SIJ. Other specialized tests may include nerve studies, lab work, and fluid analysis from around the joint.

By accurately diagnosing your pain in the SIJ, you can better understand its cause and develop an effective treatment plan. Left untreated it can lead to pain across the joint

Treatments for SIJ Pain

Finding relief from lower back pain can be complex, but a variety of treatments can help manage SIJ discomfort. The sacroiliac joint (SIJ) is located between the sacrum and the ilium in the pelvis. When this joint becomes inflamed or injured, it can cause significant pain.

injection can help alleviate back pain
Photo Credit: fxquadro, Freepik

Options of Treatment for pain in the SIJ depend on its severity and underlying cause. Generally, nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce inflammation and relieve pain; physical therapy exercises are also commonly used to strengthen and stabilize the area. In more severe cases, corticosteroid injections or surgery may be necessary to alleviate pain.

For some injections into the sacroiliac joint to alleviate stress to the SI joint is the best course of action. So, it’s important to consult a doctor if persistent SI joint pain persists, so they can help you determine the most effective treatment option for pain relief depending on your situation.

Prevention of SIJ Pain

You can take steps to prevent SIJ discomfort and promote joint health. To begin, it’s important to understand the anatomy of the sacroiliac joint (SIJ). The long dorsal sacroiliac ligament provides stability between the spine and pelvis and helps control movement in this area.

Practising good posture can help reduce strain on the SIJ and associated pelvic pain. Additionally, regular exercise that strengthens core muscles is beneficial for the overall support of the SIJ.

Finally, avoiding activities that stress the lower back, such as running or lifting heavy objects, can help prevent pain in the SIJ. By following these tips, you can ensure the healthy functioning of your sacroiliac joint and avoid any potential issues.

Exercises for Pain in the SIJ

Some exercises that can help with Sacroiliac Joint (SIJ) pain:

  • Pelvic Tilts: Pelvic tilts strengthen the lower abdominal muscles, which can help stabilize the SIJ. Lie on your back, bend your knees, and gently rock your pelvis upwards, flattening your back against the floor. Hold for a few seconds, then return to the starting position.
  • Knee to Chest Stretch: This stretch can help relieve SIJ and lower back pain. Lie on your back, bend your knees, and bring one knee towards your chest. Hold for a few seconds, then switch sides.
  • Bird Dog Exercise: This exercise strengthens the core and improves balance, which can support the SIJ. Start on your hands and knees, extend one arm and the opposite leg at the same time, hold for a few seconds, and then switch sides.
  • Bridge Exercise: The bridge exercise strengthens the glutes and lower back muscles, which can provide better support for the SIJ. Lie on your back, bend your knees, and lift your hips off the floor while keeping your shoulders down.
  • Water Aerobics or Swimming: These exercises provide a low-impact way to strengthen your muscles and improve flexibility without putting too much strain on the joints.

As with any exercise regimen, it’s crucial to consult with a healthcare professional or physical therapist before starting these exercises to ensure they are appropriate for your specific situation. Always perform exercises in a controlled manner, focusing on proper form to avoid injury.

Alternative Therapies for Pain in the SIJ

Alternative therapies can offer much-needed relief and improved mobility for those suffering from pain in the sacroiliac joint. From yoga to chiropractic care, various treatments are available to target the source of pain.

therapy can help with sacroiliac joint paint SIJ
Photo Credit: Freepik

Here are three alternative therapies for sacroiliac joint dysfunction:

  1. Yoga: Yoga is an excellent way to strengthen the muscles around the sacroiliac joint and improve flexibility, reducing lower back pain and stiffness.
  2. Acupuncture: Acupuncture can help reduce referred pain by targeting specific points on the body that may be associated with SIJ dysfunction.
  3. Chiropractic Care: Chiropractors use various techniques such as spinal manipulation and massage to treat sacroiliac joint dysfunction and bring back motion in the joint.

These are just some of the many alternative treatments that relieve SIJ-related discomfort and improve your overall quality of life.

Frequently Asked Questions (FAQs) About Sacroiliac Joint Pain

What is sacroiliac joint pain like?

Pain in the Sacroiliac joint can manifest as a sharp, stabbing, or dull ache in the lower back, region near the hip joint or pain in the buttocks area. The pain can sometimes radiate down the legs, mimicking sciatica.

What triggers pain in the sacroiliac joint?

Pain in the Sacroiliac joint can be triggered by various factors, including prolonged sitting or standing, bending, lifting, running, or climbing stairs. Certain conditions like pregnancy, gait issues, arthritis, or injury can also lead to SI joint pain.

What are the 5 tests for sacroiliac pain?

The five common tests for diagnosing sacroiliac joint dysfunction are:

  1. Distraction test
  2. Thigh thrust test
  3. Compression test
  4. Gaenslen’s test
  5. Patrick’s (FABER) test.

Each test involves different positions or movements to provoke SI joint pain and assess its source.

What is sacroiliac joint pain (SIJ)?

Pain in the Sacroiliac joint refers to pain that originates from the sacroiliac joint, which is the joint connecting the sacrum (lower part of the spine) to the pelvis. This type of pain is also known as sacroiliac joint dysfunction or sacroiliitis.

What are the symptoms and causes of sacroiliac joint pain?

The symptoms of pain in the Sacroiliac joint may include pain in the low back, pain in the hips or buttocks, leg pain, and pain that may radiate down to the thighs. Common causes of pain in the sacroiliac joint include trauma or injury, pregnancy, degenerative joint disease, and joint inflammation.

How is the sacroiliac joint structured?

The sacroiliac joint is a synovial joint, which means it has a joint capsule that surrounds and protects it. Several ligaments, including the interosseous sacroiliac ligament support the joint. The movements of the sacroiliac joints are minimal but allow for slight rotation and tilting of the pelvis.

How is sacroiliac joint pain diagnosed?

Diagnosis of sacroiliac joint dysfunction can be challenging because the symptoms overlap with other conditions. However, a thorough physical examination, medical history review, and imaging tests such as X-rays, MRI, or CT scans can help diagnose accurately.

What are common sources of sacroiliac joint pain?

Pain in the Sacroiliac joint can originate from various sources, including the ligaments of the sacroiliac joint, inflammation of the joint, degenerative changes in the joint, and dysfunction in the sacroiliac joint due to various factors such as trauma, pregnancy, or repetitive stress on the joint.

What are the treatment options for sacroiliac joint dysfunction?

Treatment for sacroiliac joint dysfunction may include non-surgical options such as physical therapy, pain medications, sacroiliac joint injections, or wearing a sacroiliac joint belt for added support. Surgery may sometimes be recommended to stabilize the joint or address any underlying conditions causing the pain.

Is sacroiliac joint pain typically associated with low back pain?

Yes, patients with low back pain often show signs of pain in the sacroiliac joint. The pain may radiate from the lower back to the buttocks, hips, and thighs. However, it’s important to note that not all low back pain is caused by sacroiliac joint dysfunction, and a healthcare professional should make a proper diagnosis.