Low back pain is a common complaint with people across all ages and stages of life. Because there are so many structures in the low back that can be causing your pain, it’s important to know from where the source of your pain is coming. One area that may be contributing to your back pain is your sacroiliac joint (SIJ). Your sacrum sits at the base of your spine and the two broad elephant ear shaped bones, called your ilium, connect to it on either side. This is what makes up your sacroiliac joint. In some people you can see little dimples right where this joint is located in their low back.
The sacroiliac joint is comprised of two very incongruent joint surfaces pressed together through a joint coupling that is held in place by broad ligaments and muscles. It’s when these incongruent surfaces get out of their normal position that pain can arise. Problems occur when either the ilium gets displaced, the sacrum, or both.
Through jarring motions such as stepping into a hole unexpectedly, jamming on the brakes in a car accident or falling onto your buttocks, the sacroiliac joint can get displaced. Also the repetitive jarring of running can sometime cause the ilium to get displaced upwards and cause pain.
The thing about this joint is that when the sacrum is not in it’s proper place there is no amount of stretching or exercise that you can do to get it back into place. An outside passive force is needed to help the sacrum find it’s happy home in the sacroiliac joint. On the other hand there are muscles, mainly the hamstrings and hip flexors, which influence the ilial bones that can be stretched and used to help the ilial bones find their way back into place. Usually it’s a combination of both that brings about the greatest relief of your pain.
So how do you know if your low back pain is coming from your sacroiliac joint?
Between 10-26% of all low back pain is attributed to the SIJ. In pregnancy, SIJ dysfunction is even more common. Up to 80% of all low back pain in pregnancy is SIJ related. (1)
SIJ dysfunction typically causes unilateral low back pain, just slightly off center. It can also radiate into the buttocks, groin or down the leg. The pain can be sharp and stabbing with motions or a dull achiness all the time.
There are certain motions that stress the SIJ, that when painful, implicate dysfunction in the joint. Painful motions such as standing putting your pants or socks on one leg/foot at a time or any weight bearing on one leg, is a very common sign of dysfunction in the SIJ. Usually it’s when the weight is being bared on the side in dysfunction that it is more painful, but not always the case. Also standing up from sitting, getting in and out of a car or climbing stairs can all strain the SIJ. If these motions are painful, then it’s most like that the SIJ is in dysfunction.
If you are experiencing any low back pain, seeking professional care, by seeing an orthopedic doctor, a physical therapist or a chiropractor, can help you determine the cause of your pain. Dysfunction in your SIJ can be helped through either physical therapy or chiropractic care. Learning how to keep your hamstrings and hip flexors flexible and your core strong can be beneficial.
To learn more about two other areas that may need to be addressed if you are not getting relief from traditional treatment, check out my other blog on the Sacroiliac joint.