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Physical Therapy for SI Joint Pain, Part 1

        SI (sacroiliac) joints support the weight of the human body, distributing it across the pelvis. This acts as a shock absorber and reduces pressure on the spine.

This week, we delve into one of the most common lower back pain complaints – SI joint pain. There are many causes of this condition but fortunately, there are also solid treatment options.

        SI joints are located at the crux of the sacrum and ilium of the human body. The sacrum is located just above the coccyx, or tailbone. It is a triangle-shaped bone near the bottom of the spine. The ilium is one of the three bones that make up the hip bones. It is located at the uppermost point of the pelvis.

Causes

        SI joints are composed of bones with jagged edges. These jagged edges help them stay in alignment. Spaces between the bones of the SI joints are filled with fluid, which provides lubrication. These spaces are also filled with free nerve endings, which send pain signals to the brain. When the bones in the SI joint become out of alignment, it can be painful.

All of the bones in the SI joints are connected by muscles and extra-strong ligaments, which add stability and allow for limited movement. Though minimal, this movement is necessary for you to remain upright and for women to give birth.

Inflammation of one or both SI joints is called sacroiliac joint dysfunction, or sacroiliitis. This is a general term that encompasses a number of conditions, including the following:

  • Osteoarthritis - Years of stress on the SI joint can eventually wear down the cartilage and lead to osteoarthritis. Associated with aging, osteoarthritis can affect the SI joint, spine, and other joints throughout the body.
  • Ankylosing spondylitis - Ankylosing spondylitis (AS) is a type of inflammatory arthritis that affects the vertebrae and joints of the spine. In addition to causing pain, severe cases of AS can cause new bone growth that fuses the joints in the spine.

Although AS primarily affects SI joints, it can also cause inflammation in other joints and, more rarely, organs and eyes. AS is a chronic disease. It may cause intermittent episodes of mild pain, or more severe ongoing pain. This disease is diagnosed most frequently in young men.

  • Gout - Gout, or gouty arthritis, can occur if your body has high levels of uric acid. This disease is characterized by joint pain, which can be severe. Although gout almost always affects the large toe first, all joints can be affected, including the SI joint.
  • Injury - SI joints can be injured by trauma, such as injuries resulting from falls and car accidents.
  • Pregnancy - Relaxin, a hormone released during pregnancy, makes the SI joints more elastic. This enables the pelvis to widen to accommodate the birth of a baby. It also makes the joints less stable. Combined with weight gain and the weight of the baby, this often leads to SI joint pain. Women who experience this are more prone to getting arthritis in the SI joints, a risk that increases with each pregnancy.

Some women may walk abnormally while they’re pregnant. Once they give birth and resume walking normally, their SI joint pain may go away.

  • Walking patterns - Walking abnormally can cause SI joint dysfunction. You may walk abnormally because of issues like having one leg shorter than the other or favoring one leg because of pain. Correcting these problems may resolve your SI joint pain.

 

Next time, we will discuss the symptoms and methods of diagnosing SI joint pain. In the meantime, if you are experiencing pain in your lower back, buttocks, hips, or pelvis, don’t wait for the family physician. Visit Excel Rehabilitation Services on Burnside Ave. in Gonzales, Louisiana. You will receive one-on-one professional care from an experienced physical therapist!

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