The SIJ or sacroiliac joint is commonly believed to cause many individuals pain but is it really the source? This is the first question I ask myself when any individual says this or points to this region as painful.
To better understand where the pain is coming from, we must first understand basic anatomy and pain referral patterns. That, plus the most common reasons for SIJ region pain.
To begin with, the SIJ is an extremely stable joint that is part of completing the pelvic ring and is the bottom point of the spine. By the time a person is fully mature skeletally, this joint does not move except in a few instances. Next, scientists mapped out areas that pain refers to and basically every segment of the lower back including the muscles and ligaments can refer pain into the SI region. So location alone does not answer the question of where the pain is coming from.
Groups of people who have been found to have a higher likelihood of TRUE SIJ issues include: women who are pregnant or recently pregnant, individuals with lax ligaments, and trauma to the lower body or spine. Outside of these groups, TRUE SIJ issues are much less common. But that doesn’t mean someone doesn’t have pain in this region.
How then does one determine if the SIJ is the source of pain? This is determined by getting a good history from the individual and then performing an evidence based examination. There is specific testing noted to be related to TRUE SIJ pain. If a person is positive on those tests, then the SIJ is more likely the source of the pain. However, if the tests are negative then something else is causing the referred pain.
If an SIJ problem is discovered, can it be treated? Absolutely. There are any number treatment strategies to ease the pain. Often some form of active treatment is necessary. In more extreme cases some supports can be used, especially if pregnant or recently so.
A common belief is manual manipulation can “put” an SIJ back into place. Well, researchers looked at that and proved this concept false (see HERE). Except in rare instances, an SIJ is not “out of place.” But, this does not mean manual manipulation may not be helpful, only that the rationale for treatment should be stated differently.
What to do if you have pain in the SIJ region? Don’t wait weeks or months to seek treatment. The fastest way back to feeling better is fast treatment. Next, find a provider who will work 1-on-1 (for real) with you, not someone juggling 2-4 other patients at the same time as you. 1-on-1 care shown to be more effective and efficient helping people in pain. Finally, get your questions answered by an expert in treating SIJ pain by filling out this quick FORM to learn more.