Sacroiliac Joint Dysfunction
The sacroiliac joint lies near to bottom of the spine – below the lumbar spine and above the tailbone (coccyx). It connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis.
[Figure 1]
Figure 1:
CHARACTERISTICS:
- A series of ridges and valleys that fit together like a lock and key.
- Strong ligaments that surround it and help to provide support (Figure 2].
- A small amount of motion that allows for a walking gait pattern in normal human locomotion.
- Transmits all the forces of the upper body to the pelvis (hips) and legs.
Figure 2:
While it is not clear how the pain is caused, in most cases it is thought that an alteration in the normal joint motion may be the culprit that causes sacroiliac pain. Less commonly, an inflammatory process affecting the SI joints may be the cause.
Pain from sacroiliac joint dysfunction can present in different ways. Most commonly pain will be felt in the low back and buttocks just to the left or right of midline near where the joint is located. However, it is very common for patients to experience pain that refers into the hips, groin, back of the thigh and leg. This can make diagnosing sacroiliac-related pain very challenging for clinicians, and there is no single diagnostic test that is superior in making the diagnosis.
Most patients with sacroiliac joint dysfunction and pain respond favorably to a well designed course of physical therapy and/or chiropractic mobilization/manipulation. Occasionally anti-inflammatories and even a therapeutic injection of local anesthetic and steroid are needed to relieve pain and promote progression with therapy.
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