Sacroiliac joint pain is believed to cause lower back and leg pain. The sacroiliac joint is located next to the bottom of the spine, under the lumbar and above the tailbone. This joint is reinforcement by surrounding ligaments and is very strong. The sacroiliac joint has minimal movement but acts as a shock-absorber.
What Causes Sacroiliac Joint Pain?
There are two main factors that can contribute to sacroiliac joint pain: Too much movement and too little movement. In the case of too much movement, or hypermobility or instability, pain can be felt in the lower back and radiate to the groin. In too little movement, or hypomobility or fixation, pain is felt on one side of the lower back or buttocks and can radiate down the leg. The pain associated with too little movement may be comparable to sciatica pain.
Other causes of sacroiliac joint pain include:
- Degenerative arthritis – osteoarthritis
- Anything that puts additional stress on the joints, for example, weight
- Any condition that disrupts normal walking patterns
- Rheumatoid arthritis
- Psoriatic arthritis
- Reactive arthritis
- Ankylosing spondylitis – a type of arthritis that affects all joints
Sacroiliac Joint Pain Not to Be Confused with Sciatica Pain
Although sacroiliac joint pain may feel like sciatica pain, it’s important not to confuse the two as they are quite different. Unlike sacroiliac joint pain, which is caused due to direct irritation of the sacroiliac joint, sciatica pain is the result of another spinal condition. Spinal conditions that cause sciatica pain include disc herniation, spinal stenosis and spinal fractures.
Treatment options, too, differ between the two conditions. Sciatica pain can be treated with cold/hot compresses, epidural injections, pain medication or surgery. Sacroiliac joint pain, however, is best treated with fusion surgery.
Alternative Treatment Options for Sacroiliac Joint Dysfunction
Alternative treatment options for sacroiliac joint dysfunction include:
- Cold/hot compresses and rest
- Medication – anti-inflammatory medication
- Chiropractic manipulations
- Supports and braces
- Physical therapy and exercise
- Sacroiliac joint injections
Physical Therapy and Exercises to Lower Back Pain in Sacroiliac Joint Dysfunction
In passive physical therapy the therapist does the majority of the work, for example, a passive treatment would be the therapist applying ice. In active physical therapy you do the work, including at-home exercises, provided by a registered physical therapist.
It may seem difficult to exercise when experiencing pain but it is recommended. However, it doesn’t have to be intense to achieve benefits.
Exercising can help stretch lower back muscles and make them more flexible. Exercises that should be included to help ease sacroiliac joint pain are aerobic, strength and flexibility. Below are some exercises you can try to ease pain.
Gluteal sets: Lay on your stomach with legs straight behind you. Squeeze your buttocks together and hold for 15 seconds then release. Repeat three sets.
Lower trunk rotation: Lay on your back with feet flat on the floor and bent knees. Tighten your abdomen as if you were going to get hit and push your lower back into the floor. Gently rotate knees from left to right.
Double knee to chest: Lay on your back with feet flat on the floor and bent knees. Tighten your abdomen as if you were going to get hit and push your lower back into the floor. Bring knees to chest and hold for five seconds, release for 10 seconds and repeat.
Tensor fascia lata stretch: This is the muscle which runs along the outside of your thighs and attaches to your pelvis. To stretch this muscle, stand with your legs crossed with your left foot in front of the right. Now lean to your right side to feel the stretch. Repeat this on the opposite side.
Cow face pose: Sit with your knees bent and the soles of your feet touching. Now, cross your right leg over your left knee until the knees are lined up above each other. With a straight back, raise your right arm and bend at the elbow to bring your hand behind your head. Bring your left hand behind your back and try to interlock your fingers. If you are unable to do this, use a yoga rope and hold on to each side to bring your hands as close together as possible. To deepen this stretch, slowly lean forward as far as you can go.
Piriformis stretch: Lay on your back with your legs extended. Bend your right knee and your arms to pull it towards your left shoulder. Stop when you can feel a stretch in your right buttocks.
Hip extension: Stand straight holding onto a chair, table, or wall. Squeeze your buttocks to pull your leg backward while your knee remains straight. Hold for a couple of seconds and bring your leg back down. Repeat a few times for both legs.
Squats: Position your feet shoulder-width apart. Begin to lower yourself down as if you were to sit down on a chair. Come as far down as you can without your knees coming past your toes, then rise back up.
Exercises to Avoid for Sacroiliac Joint Pain
If you suffer from sacroiliac joint pain, there are some exercises and activities that you should avoid. These include crunches or sit-ups, exercises that involve twisting or rotating, heavy weight-lifting, contact sports that can cause further injury to the sacroiliac joint like football or baseball, and excessive bike riding.