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.