The Sacroiliac Joint Rarely Gets the Credit for the Back Pain It Causes

Back pain is one of the most common complaints of patient’s coming in for physical therapy. The sacroiliac joint (SIJ) can be a contributor to back pain. Interestingly enough, I was fairly oblivious of this sneaky cause of back pain until a senior clinician and women’s health practitioner opened my eyes and started my fascination with this joint.

The sacroiliac joint consists of 3 bones — the 2 ilium and the sacrum. The sacrum wedges snugly between the 2, serving as a keystone. Even though this is a “snug” joint, there is still a fair amount of movement that occurs here.

Common mechanisms of injury are:

• a sudden jar to the body
• falling on your buttocks
• a possible lift and twist maneuver

Common symptoms of SIJ pain are pain at the belt level and pain that radiates into the buttocks, hip, and/or thigh. Your physical therapist can diagnose SIJ dysfunction through observation, palpation, and special tests.

Treatment of SIJ dysfunction may entail:

• soft tissue mobilization of muscles, which may be in spasm or are short/tight
• muscle energy techniques to correct the malposition of the joint
• joint mobilization to decrease pain and/or improve the mobility of the joint
• strengthening of the muscles surrounding the joint, including the pelvic floor muscles
• stretching to decrease abnormal stress on the bones of the pelvis
• taping or the use of a brace to help stabilize the SIJ

The SIJ is a “snug” joint that experiences small amounts of movements, but has the ability to cause a large amount of back pain. If you suspect you are experiencing SIJ dysfunction, consult with your physician or physical therapist for a full evaluation.