A pain in your lower back suddenly happens, maybe after an injury. The first diagnosis maybe pain related to the sciatic nerve, but there is a chance it could be sacroiliac joint pain.
The Sacroiliac (SI) Joint is the junction between the bottom portion (sacrum) of the spine and part of the pelvis (iliac crest).
“The sacroiliac joint, also known as the SI joint, is an interesting joint that serves to connect the pelvis to the lumbar spine,” says Jude Miller DC, MS, CCSP, ICSC, CME
, an Advanced Practice Clinician & Faculty at Logan University and Chiropractic Team Physician at University of Memphis. “ The SI joints functions include helping to transfer the weight of the upper body and lumbar spine into the lower extremity and helps to absorb forces from the low extremity. It helps to transmit rotational forces from the lower extremity to the lumbar spine."
The SI joint and surrounding tissues contain nerves that help with the body's postural awareness. The SI joints are also involved in how we walk, and can be involved in the process of giving birth.
SI Joint pain can be the source of low back pain in one or both sides. Pain usually occurs in the lower back, buttocks, groin and lower extremities. The pain in the buttocks, even shooting down the back of the leg, can mimic sciatic pain. Sitting and standing for a long time can increase pain.
Physicians may call SI joint pain by other terms such as sacroiliitis, SI joint degeneration, SI joint inflammation, SI joint syndrome, SI joint disruption and SI joint strain.
“Pain originating from the SI joints and surrounding structures is typically felt over the gluteal area and low back, although in some cases pain can be felt in the [back and side of the] leg all the way to the foot at times. Other referral patterns can involve the groin and lower abdomen. The pain can vary in quality from dull to severe. It is typically [one side], but can present [on both sides],” says Miller.
SI Joint Pain Causes
According to Dr. Miller, other risk factors related to SI joint pain are activities that causes repetitive stress on the joint such as frequent heavy lifting, sports, labor intensive jobs, and abnormal gait, a history of prior lumbar surgery, pregnancy or having recently given birth can also cause aggravate the SI joint.
According to Dr. Miller, a lot of SI joint pain is the result of both repetitive minor injuries and larger individual injuries. Dr. Miller notes that most dysfunction of the SI joint can be broken down into two main categories: “hypermobility/instability” (too much motion) and “hypomobility/fixation” (too little motion).
How Long Does SI Joint Pain Last?
According to the Mayfield Clinic in Cincinnati, SI joint pain can range from mild to severe, depending on the injury’s extent and cause. Acute SI joint pain usually happens all of a sudden, healing after several days or a few weeks. People with chronic SI Joint pain can have it for over three months. The pain can be consistent or happen with certain movements.
“Most cases of SI joint pain are managed conservatively and resolve in a relatively short period of time ranging from a few days to weeks. Cases of SI pain caused by systemic rheumatological problems, long-standing altered biomechanics, or severe trauma can be more chronic in nature lasting months to years, with periods of exacerbation and relief,” says Miller.
Diagnosis and Treatment
According to Open Access Musculoskeletal Medicine Journal, the SI joint is estimated to cause pain for 15 percent to 30 percent of back pain suffers, making it difficult to diagnose. “Young to middle age women experience SI joint pain due to dysfunction more than other demographics,'” adds Miller. Therefore, it is important to be examined by a spine specialist to determine if your SI joint is causing your pain.
Lab tests may be helpul, says Miller. Also, conservative care is also an option for patients with SI joint pain. The treatment plan varies depending on the underlying cause of the SI joint pain.
Dr. Miller recommends reducing stress on the joint as one key part in treating SI joint pain. This can be through rest or modifying activities which cause pain. Ice and heat can help as well. Manipulation and exercises which help improve strength and motion can also be part of a complete treatment plan.
Miller recommends chiropractic care and physical therapy for the management of SI joint related pain and says if those don’t resolve pain in three months, a medical referral may be necessary.
“SI joint pain recovery varies from person to person,” Dr. Miller notes. He advises that an appropriate trial of Chiropractic care for SI joint pain is two to three visits a week for up to four to six weeks. Dr. Miller also adds, “If you are not feeling at least 50% better at the end of a trial of care additional diagnostic testing or other interventions may be indicated. For some patients with other complicating factors a longer trial may be indicated.”
It’s important to know the cause of your SI joint pain prior to receiving a detailed treatment plan. Miller advises that if you have low back or buttocks pain associated with swelling, fever, change in sensation, change in bowel or bladder function, instability, or severe pain consult with your medical provider as this could be a sign of a more serious condition.
SI joint pain should resolve itself with in a couple of weeks of self-care. If your SI pain is recurring, it should be evaluated by a health care provider. Miller adds, “If you have a personal or family history of rheumatological diseases such as rheumatoid arthritis, ankylosing spondylitis or other inflammatory arthritis or cancer, early evaluation by a health care provider is recommended.”
Updated: June 5, 2021