Sacro-Iliac Joint (SIJ) Pain - Fact Sheet
What is Sacro-Iliac Joint (SIJ) Pain ?
What is the Sacro-iliac joint (SIJ) ?
The Sacro-iliac joint (SIJ) involves the bones of the pelvis and sacrum, and the associated ligaments and muscles of the pelvic region. The SIJ provides a stable base for the spine and hips to move from and is generally an inherently stable joint.
What is the Sacro-iliac joint (SIJ) Pain ?
Sacro-iliac joint pain generally occurs due to irritation of the long-dorsal Sacro-iliac ligament, which is a highly innervated and sensitive structure. This ligament can be stretched and irritated over time due to SIJ dysfunction (also known as SIJ instability), or as a result of an acute SIJ sprain. In both cases, the treatment remains similar.
Signs and symptoms of SIJ Pain ?
• Low back pain, generally beginning at the base of the pelvis, which can refer into the buttocks (gluteals), the lateral thigh, or even down to the ankle.
• Pelvic pain, located more closely to the pubic bones or pubic symphysis.
• Pain with OR following activities such as lifting, walking, and running. Pain is generally ok at rest.
• Pain or difficulty standing on one leg.
• Local tenderness over the long-dorsal ligament of the SIJ
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Treatment of SIJ Pain ?
Avoid misdiagnosis: The lumbar spine and hips can also cause localised back pain; therefore an examiner should always look to rule out issues arising from these areas before making a diagnosis of SIJ pain.
Hands-on treatment: muscle bracing (particularly in the gluteals) is common in SIJ pain. Reducing this bracing can help better activate the muscles that stabilise the SIJ. This should not be solely relied upon to reduce pain, as evidence suggests this works mainly in the short term, giving 2-3days relief.
Strengthening Exercises: the absolute KEY to treatment of SIJ issues. Exercises targeting large co-contractions of the gluteals (buttocks), deep abdominal muscles and low back muscles create forces across the SIJ resulting in a stabilising effect. This helps take the strain off the long dorsal ligament and reduce pain.
