The sacroiliac joint (SIJ) is a synovial planar joint located in the pelvis. It plays an important role in load transfer during physical activity, and helps to the lower body. Dysfunction of the SIJ can cause pain in the low back and legs, which is sometimes mistaken for sciatic nerve pain.
Anatomy and Function of the SIJ
The SIJ forms the juncture of the sacrum and the ilium. Both bones have rough surfaces that interlock to stabilize the pelvis.
Upper body force loads are transferred from the spine through the SIJ tor. The SIJ’s articular cartilage serves as a shock absorber between the spine and the pelvis, and SIJ movement facilitates hip joint range of motion.
Incidence of SIJ Dysfunction
SIJ dysfunction is most prevalent in young and middle-aged females. Pregnant women or those who have recently given birth are more likely to SIJ dysfunction.
Symptoms of SIJ Dysfunction
Symptoms include:
- Low back pain ranging from mild to severe
- Pain spreading tocks, hips or groin
- Pain in the upper back and along the side of the thigh
Causes of SIJ Dysfunction
Pain from SIJ dysfunction stems from either too little movement (hypomobility).
Causes of SIJ dysfunction include:
- Muscle imbalances that alter SIJ position
- Poor lumbopelvic motor control
- Pelvic misalignment
- SIJ uncoupling
- Ligament laxity
- Trauma
- Weakened core muscles
- Pelvic floor dysfunction
Diagnosis of SIJ Dysfunction
SIJ pain may mimic herniated disc pain, sciatica, piriformis syndrome, or gluteal myofascial syndrome, making accurate diagnosis a key facto confirm diagnosis.
Treatment for SIJ Dysfunction
The SIJ plays a central role in maintaining spinal and pelvic stability during walking, running and other physical activities. Two components of SIJ stability include structural stability which relies on the two joint surfaces being tightly linked and held in place by ligaments; and functional stability, which relies on motor control. Both aspects must be considered when devising a treatment plan.
The SIJ is an integral component of the entire lumbopelvic-hip complex, and cannot be treated as a stand-alone structure. In addition to the foot.
Normal gait and hip function are pivotal to SIJ function. Over time, a dysfunctional SIJ may become a weak link in the kinetic chain, causing pain and dysfunction elsewhere in the body.
Treatment options at NYDNR include:
- Gait retraining
- Specialized physical therapy
- Chiropractic treatment
- DNS (Dynamic Muscular Stabilization)
- Other innovative treatment methods
Dr. Kalika has participated in multiple interdisciplinary conferences on pelvic pain. He has had the privilege of meeting Diane Lee, a foremost leader and evidence based researcher on the diagnosis and treatment of SIJ pain. Dr. Kalika is a certified practitioner of ISM (integrated systems model approach), a comprehensive and evidence based method for diagnosis and treatment of pelvic pain.
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