SI joint pain or Sacroiliac pain
How can I help my sacroiliac joint pain?
There are many ways that the sacroiliac joint becomes distressed and painful.
Sacroiliac pain and pregnancy
A common cause of SI joint dysfunction and pain is the stress applied to the low back and pelvis during pregnancy. The hormones relaxin and oxytocin are released all throughout the pregnancy into the woman’s body to allow for widening of the pelvis to give more room to the growing baby and prepare for ligament relaxation that occurs during childbirth. Relaxation of the many ligaments around the SI joints can result in excessive motion in the SI joints, allowing for abnormal pelvic mechanics, increased SI joint stress, abnormal wear and pain. The changes in the SI joint ligaments are the reason for the altered waddle gait so common in pregnancy.
Sacroiliac joint arthritis
Just like any other weight-bearing joints of the body, the SI joints have a layer of cartilage that covers the bone surface of the joint. This cartilage serves to provide improved movement and a shock absorber between bones of the joint . If this joint cartilage becomes damaged or is worn down by excessive use, the bones begin to rub against each other, allowing degenerative arthritis (osteoarthritis) to develop. Arthritis of the SI joint is said to be the most common reason for pain and joint dysfunction.
Symptoms and signs of SI joint dysfunction
Common signs and symptoms/signs of an SI joint problem:
- Deep dull pain lower back pain on one side, occasionally on both sides.
- Pain is often a mild to moderate ache around the dimple near the sacrum.
- Pain aggravated while doing those activities that stress the SI joints (getting up from a chair, bending the knees while climbing stairs).
- When SI joint dysfunction is severe it can cause referred or reflex pain into the hip, groin or lower leg on the same side as the involved SI joint. Even when severe the pain rarely radiate below the knee.
- SI joint pain often increases with prolonged sitting or prolonged walking.
Treatments for sacroiliac joint dysfunction (SI joint pain) are usually effective and consist of conservative in nature, designed to ultimately restore normal motion in the joint.
Typical treatments for sacroiliac joint pain:
- Ice and rest – with heat only later in the recovery cycle
Initially use ice or cold packs, applied in 20 minute intervals to reduce inflammation in the SI area, along with rest to reduce irritation. The need for ice and rest is based on the presence of intense and sharp pain that is aggravated by prolonged sitting or standing. This can continue for several days to several weeks, depending on ability to reduce pain and increase activity. After the pain subsides, meaning the inflammation is reduced, the use of moist heat to the same area can begin to assist the healing process. At this time it is advised that a slow and gradual return to normal activities that do not provoke a return of pain.
- SI brace or support
When the SI joint movement is excessive (“hypermobile” or too loose), an orthopedic support can be used to snugly hold the SI joints together. The SI brace looks like a rather wide 3-4” belt that is worn below the hips and waist, to stabilize the area and allow rest for the excessively mobile SI joints. Pain reduction and comfort are often immediate when the SI brace is worn. As the symptoms improve the belt is worn less often and more loosely than during the acute stage, perhaps only during extreme or prolonged activity.
A small amount of pain medication (acetaminophen), or anti-inflammatory medication (ibuprofen) to reduce the swelling that is contributing to the pain can be used. Once acute pain is reduced this probably should be discontinued to allow the individual to know exactly how much inflammation is present and what types of actions and postures are aggravating the SI joint problem. Too much medication allows the individual to often aggravate the condition because of the absent pain warning signal.
- Chiropractic manipulation
Manual manipulation provided by a chiropractor or osteopath is indicated to restore normal SI joint movement when the joint is fixated or “stuck” outside its normal position.
Controlled, gradual stretching and exercise of muscles is often indicated to tone the ligaments and muscles around the affected sacroiliac joint, as well as to increase range of motion. This activity will increase the flow of blood into the area, and increase the flow of lymphatic fluid out of the area, both promoting a healing response.