The sacroiliac joints, of which there are two in the lower back (above your buttocks, with one on each side), are essential pelvic structures that connect the sacrum, a triangular bone at the spine’s base, to the ilium, the upper pelvis.

The sacroiliac (SI) joints consist of a synovial joint at the front and a fibrous joint at the back that transfer upper body weight to the pelvis and legs, absorbing and dissipating forces created by physical motion. While SI joints have limited movement, they provide flexibility and functional motion.

The Symptoms of SI Joint Issues

Sacroiliac (SI) joint pain often mimics lower back or hip pain, ranging from mild to unbearable discomfort. Symptoms when the SI joints become inflamed or irritated include -

• Lower back, buttocks, and hip pain.
• Difficulty when sitting or standing for a long time.
• Pain exacerbated by specific activities (e.g., climbing stairs or running).
• Radiating leg pain which is often mistaken for sciatica.

Common Causes of SI Joint Pain

These include -

• Traumatic Injuries can be caused by a sudden impact, such as a fall, car accident, or sports injury, and may misalign and inflame these joints.
• Repetitive Stress involves repetitive motions or uneven weight distribution that overburdens these joints.
• Standing or Sitting in one position for extended periods is enough to put pressure on the SI joints, especially if one’s posture is poor.
• Arthritis

• Osteoarthritis, which can cause stiffness and pain, especially in older adults, refers to cartilage worn away after breaking down for years.
• Ankylosing spondylitis, which causes chronic pain, stiffness, and eventual joint fusion, is an inflammatory condition that impacts SI joints and the spine.

• Degenerative Disc Disease refers to spinal disc degeneration that can cause a change in how one walks, causing excessive SI joint pressure.
• Pregnancy and Childbirth – ligaments become looser from hormonal changes experienced during pregnancy, which makes these joints prone to misalignment. Weight gain also stresses these joints.
• Leg Length Discrepancy – uneven legs create an uneven distribution of weight that stresses SI joints.
• Hypermobile Joints refer to excessive SI joint motion, which causes painful symptoms. Conversely, hypomobile refers to SI joints with limited movement, which may develop due to arthritis.
• Pelvic and Spinal Misalignment – poor posture, a misaligned pelvis or spine, or previous injuries can cause imbalanced SI joint stress.
• Sacroiliitis is when the SI joints become inflamed, inhibiting mobility.
• Post-Surgical Changes can shift weight across SI joints.

Treatment Options

Treating SI (sacroiliac) joint pain involves managing the underlying cause, stabilizing the joint, reducing inflammation, and restoring mobility. Treatment plans are tailored to the individual, ranging from conservative approaches to surgical options when circumstances dictate. However, even when surgery is necessary, chiropractic often plays a vital role in recovery.

Manual Therapies

Hands-on techniques like chiropractic adjustments can help alleviate pain and restore function. Complementary therapies (such as massage, yoga, mindfulness, and acupuncture) can reduce tension and improve flexibility.

Physiotherapy

• Stretch tight muscles to relieve SI joint pressure.
• Strengthen core, glutes, and pelvic muscles to support the joint.
• Work to improve the hip and lumbar spine’s range of motion to reduce joint stress.

Lifestyle Modifications

Avoid movements aggravating the condition (e.g., extended sitting and heavy lifting). Use supportive seating and ensure proper posture when working or participating in leisure activities.

Heat and Cold Therapy

• Ice therapy numbs pain while reducing inflammation.
• Heat therapy promotes circulation while reducing muscle tension.

Prevention Tips

Maintaining a healthy weight, staying active to strengthen muscles, and avoiding sitting or standing with poor posture can reduce SI joint stress.

If you suspect SI joint issues, consult a chiropractor for more information.