Pain in the lower back is very common in part due to the large number of things that cause it. In addition to lumbar disc degeneration, facet joint inflammation, and muscle tightness, one of the potential causes of a patient’s pain is dysfunction in the sacroiliac joints. These are the joints that connect the sacrum, a structure at the base of the spine, to the pelvis. Although pain from sacroiliac joint dysfunction can be a major problem, it is often responsive to the non-invasive, non-addictive treatments provided in a chiropractic office.
How Sacroiliac Dysfunction Occurs
The sacrum is made up of several vertebrae that are fused together without any discs between them. Some of the roots of the sciatic nerves emerge from the sacrum, and the coccyx, or tailbone, hangs beneath it. The top portions of the pelvis are the iliac crests, and the places on either side of the sacrum where it connects to the pelvis are normally among the body’s more stable joints. The deep connective soft tissues of the pelvic region keep the sacroiliac joints in place and provide them with cushioning.
When the sacroiliac joint is inflamed, we call that “sacroiliitis.” However, inflammation is not always necessary for the joint to be unstable or too stiff. Sacroiliac joint dysfunction does not always have a clear cause, but it can sometimes be traced back to traumatic injuries, different kinds of arthritis, or the weakening of joints and connective tissues caused by hormones released during pregnancy. People are also at risk of developing it if one of their legs is longer than the other.
Symptoms and Identification
Pain from sacroiliac joint dysfunction may radiate to the lower back, the buttocks, the groin, or the thigh, but is usually only felt on one side. It may be described as dull or sharp and sometimes mimics symptoms of sciatica. The pain is often worse when a person walks up stairs or has to stand for a long time.
Several tests are used to diagnose sacroiliac joint dysfunction. Many of them involve a doctor pressing against the sacroiliac joint and other structures to see what elicits a response, and some require a patient to demonstrate their range of motion. A doctor may also try numbing the joint to determine whether that alleviates the pain. Imaging tests may be commissioned to rule out other potential causes.
Chiropractic and Other Common Treatments
Adjustments by hand or instrument are one of the most popular and effective ways of relieving sacroiliac pain. In addition to adjusting the joint itself, a chiropractor may work its surrounding soft tissues if they have tightened. Rest can be helpful for joint pain immediately after an injury, but allowing soft tissues to go unused for too long will cause them to tighten, so it is a good idea to get professional advice about which movements are safe. Some chiropractic offices provide hard and soft tissue mobilization while a patient lies on a specialized table with movable panels that will help them to stretch.
Other treatments that may be offered complementary to chiropractic adjustments include heat therapy, ultrasound, and therapeutic massage. Preventing sacroiliac pain from returning may require a person to engage in physical therapy and to perform exercises to improve their hip strength and flexibility from then on. When the sacroiliac joint is too loose, a patient might also be given a pelvic brace to wear when they’re not performing strength-training exercises. Each case of sacroiliac pain is different and may require some trial-and-error to treat, by conservative treatments are often all that are necessary.