The SI joint (sacroiliac joint) is present on each side of the spine connecting the sacrum (triangular bone at the bottom of the spine) to the Ilium (the bone which is part of the hip joint). It transmits all the forces of the upper body to the pelvis and legs.
Inflammation of one or both sacroiliac joints is sacroilitis. This inflammation can cause pain at the lower back area (buttocks) and can even extend to one or both lower limbs. Sacroiliitis can be difficult to diagnose, because it can be mistaken for other causes of low back pain, herniated/bulging disc.
Factors causing pain and discomfort:
The pain associated with this condition mostly occurs in the buttocks region and the lower back. It can also affect the legs, groin and feet. The pain may be dull and achy or sharp and stabby. This pain can be aggravated by:
- Standing for longer periods of time.
- Weight bearing on a single leg or on one leg more than the other.
- Climbing a stair case
- During Running.
- Taking longer strides while
It may be caused due to:
- Any injury or trauma.
- Infection to the joint or around the joint
- Arthritis: sacroilitis can be caused by a few types of arthritis which are mentioned below.
Osteoarthritis: this occurs due to degeneration of the cartilage which protects the bony ends. Obesity, aging and other factors can affect the SI joint cartilage which can further lead to sacroilitis.
Ankylosing spondylitis (AS): this disease affects the joints of the vertebrae or the spine causing more pain and stiffness in the joints affected. Inflammation of the SI joint is an early symptom of ankylosing spondylitis.
Psoriatic arthritis: This type of arthritis can occur with psoriasis- a condition in which white and scaly red patches appear on the skin.
Physio Therapeutic approach:
- Management of pain can be done by pain relieving modalities like IFT (interferential therapy) and also by moist heat pack.
- SI joint manipulation can be done.
- Joint stabilization can be done by using pelvic belt.
- Lumbar stabilization can be done by training the patient with heavy-load functional dynamic tasks like encouraging quadripud position and single leg extensions in that position, alternate arm or leg extensions in the same position.
- It can be managed by stretching’s and core strengthening exercises like tummy tuck in’s, single knee to chest ex’s, knees to chest ex’s, pelvic bridging’s, trunk rotations, etc.
- Practice of good postural adaptations while sitting or standing position.
- Change in your sleeping position if needed. If you notice that lying down in a certain way is making your symptoms get even worse than before, try a different position until you find one that is comfortable for you. One can also try sleeping with a pillow placed between the knees (this will help to maintain proper alignment of the hips).
- Rest when you need to, but do not overdo it.