Sacroiliac Joint Pain (SIJ)

  • What is the sacroiliac joint?

  • The two sacroiliac joints are located at the bottom of the back, above the buttocks. 

  • The joint connects the spine to the pelvis.  

  • You can see the approximate location of the joints by looking for the “dimples” on your backside.

  • What is sacroiliac dysfunction?

    • Sacroiliac dysfunction means that one of both of the sacroiliac joints move improperly.  

    • They may be too stiff, allowing no movement, or too lax, allowing too much movement. 

      • Movements is only about 2 mm but can cause pain if the muscle pull between the two sides are imbalanced 

    • Improper mechanics leads to increased stress through the joints.  

  • What are the symptoms seen in SI joint dysfunction?

    • Patients often have pain in the low back (isolated to one side), which can radiate into the hip.

    • There may be increased pain with standing or walking or sitting.  

    • When SI Joint inflammation has been present for a long time, the piriformis muscle may become tight, and cause symptoms of sciatic nerve compression, or in other words, pain shooting down the back of the leg.

  • What causes sacroiliac joint pain?

    • Pain and inflammation can be a result of trauma, poor posture, decreased core strength/stability, arthritis, and repetitive movements.

  • How is sacroiliac joint dysfunction diagnosed?

    • The physician can diagnose this condition with the physical exam. 

    • The patient will have pain over the joint and ligaments are stretched.  

    • Leg length differences may also be apparent, but this is due to improper movement of the joint rather than a true difference in length.  

    • X-ray, CT, and MRI tests may not show any abnormality and therefore are not useful in making this diagnosis.

  • What is the treatment? 

    • Physical Therapy will show you stretching techniques to mobilize the joint and exercises to strengthen the muscles of the lower back, abdominal, hip, and thigh to stabilize the joint.