What To Do About Sacroiliac Joint Issues


The sacroiliac, or SI, joint connects the sacrum at the base of the spine to the pelvis. You have one joint on either side of the sacrum. The joint is responsible for the following:

  • Transferring energy and load between your upper and lower body
  • Absorbing shock as you walk so that vibration does not affect the spine

If the joint is dysfunctional, it can be extremely stiff or abnormally mobile. This can cause pain on one side of the lower back. SI problems cause up to 25 percent of lower back pain. This joint becomes looser in pregnant women. Women who are expecting or who have recently given birth are more likely to experience SI joint issues.

Symptoms of Sacroiliac Joint Dysfunction

People can experience SI joint problems due to muscle stiffness, muscle imbalances, hip problems, some kinds of arthritis, injury or hormonal changes. Whether the dysfunction is caused by stiffness or excess mobility in the joint, symptoms include the following:

  • Asymmetrical pain in one side of the lower back, tailbone or groin
  • Pain that extends down the thigh
  • Soreness, aching or stabbing feelings when stooping over, moving from sitting to sitting or turning the upper body
  • Tight or tender muscles in the hips and buttocks
  • Pain that gets worse with movement or sustained sitting

Diagnosing Sacroiliac Joint Dysfunction

Seeing a physical therapist can help you determine if your SI joint is the cause of your symptoms. You’ll be asked several questions about your experience. Be ready to indicate exactly where you feel the pain and if certain physical movements make it better or worse.

The medical professional will examine your spine, hip, pelvis and legs. This will help the professional evaluate your agility and flexibility. The strength of the muscles in your lower body will also be assessed. Specific tests may be conducted to ensure that you don’t have a different medical problem.

Can Physical Therapy Aid In Sacroiliac Joint Dysfunction

A physical therapist with experience treating this condition can help reestablish function in the SI joint. Physical therapy often includes the following:
Manual rehabilitation – This involves massage or releasing points in the soft tissue to help reduce tightness and realign the pelvis. Your therapist may also gently manipulate the joint to help it move more efficiently.

Stretching – Increasing the suppleness of the muscles around the joint can help the spine and pelvis work together better and decrease strain at the SI joint.

Strengthening – Building up the muscles around the spine and pelvis can ease pain and pressure placed on the ligaments. It can also help balance weak muscles.

Posture – You can learn how to move your body more efficiently during your daily routines to improve the condition.

Modalities – This involves using thermal, electrical or mechanical energy to relieve pain. It can entail using ice packs, heating pads or electrical stimulation.

Stabilizers – A specialized belt that supports the joints in the pelvis may be worn to make the pelvis more stable as you go about your day. Pregnant women especially may benefit from using an SI belt.

SI joint dysfunction can be preventable at times. Avoiding falls and maintaining proper alignment can help the joint work properly. Keeping your muscles balanced and dexterous can also prevent this condition. If you have experienced an SI joint problem, keeping up with exercises recommended by a medical professional can help prevent you from experiencing the problem again.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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