The sacroiliac joint is located in the lower part of the back and joins the tail bone (sacrum) to one of the pelvic bones (ilium). There are two sacroiliac joints – one on either side of the spine. The sacroiliac joints act to transfer weight from the spine to the pelvis and allow a small amount of movement to occur.
Sacroiliac joint dysfunction may occur from excessive forces being applied to the sacroiliac joint. This can be from bending, sitting, lifting, arching or twisting movements of the spine, or, from weight bearing forces associated with running or jumping. Injury to the sacroiliac joint may occur traumatically or due to repetitive or prolonged forces over time.
There are two main groups of sacroiliac dysfunction that cause SIJ pain:
- Hypermobility / Instability
- Hypomobility / Stiffness
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose sacroiliac joint dysfunction.
Treatment may comprise of:
- Soft tissue massage
- Electrotherapy (e.g. ultrasound)
- Use of a sacroiliac belt or lumbar brace
- Use of a lumbar roll for sitting
- Correction of any leg length discrepancy
- Dry needling
- Muscle energy techniques
- Activity modification advice
- Biomechanical correction
- Ergonomic advice
- Clinical Pilates
- Exercises to improve flexibility, strength, posture and core stability
- A gradual return to activity program
The recovery time for sacroiliac joint dysfunction may vary from patient to patient depending on compliance with physiotherapy. With ideal treatment, patients may be pain free in as little as several days, although typically this may take 2 – 3 weeks. It is important to note, however, that injured tissue takes approximately six weeks to restore the majority of its strength in ideal healing conditions. Care must therefore be taken when returning to activity during this period.