The sacroiliac joint connects the sacrum to your pelvis and has very limited range of motion. It is a very stable joint that helps you maintain your posture and body alignment and to prevent low back pain and hip pain. Sacroiliac joint pain is common among those who sit often, which can also lead to sciatica, or the irritation of the sciatic nerve that runs from your lower back through both sides of your buttocks and into both legs.
Role of Physical Therapy
Physical therapy helps you restore the sacroiliac joint's mobility, which can be limited if the joint is inflamed, by perform passive range of motion exercises and corrective exercises. Passive range of motion exercises involves the physical therapist moving your hip and leg joints without you doing any work. Once some mobility is established, corrective exercise training requires you to move and stretch the hip joints to teach you how to move properly. This involves range of motion exercises that flex, extend and rotate the hip joints in coordination with your lower back and legs.
Causes and Symptoms
Sacroiliac joint pain can be caused by a traumatic injury, such as a vehicle accident or a fall, pregnancy or arthritis. This can lead to inflammation of the sciatic nerve which causes sciatic. The pain usually occurs on one side of hip rather than both sides. The compressive or sharp pain in the hip inhibits are ability to walk, stand, roll or even sit.
Diagnosis
The physical therapist first conducts a health history to determine if you have a history of back pain, poor ergonomics and other health issues that may contribute to sacroiliac joint pain. Several tests are performed on you to find the source of pain, such as the compression test, where both sides of the joint are forced together, or bringing the knees to your chest and are compressed. Depending on the severity of pain and the initial tests, the physical therapist may require you to get an X-ray or a CAT scan to determine if there are any broken bones or joint abnormalities. For people with less severe symptoms, the therapist may perform a movement test, such as a squat test and gait test, to see how well the whole body moves.
Treatment
Many physical therapists use corrective exercise as a way to treat sacroiliac joint pain once the source of pain is found. Corrective exercise training addresses joint and movement dysfunction in your entire body, not just at the painful site. It also prevents secondary joint and muscle pain from sacroiliac joint pain.
For example, if your pelvis is tilted to your left and causes the right side of your pelvis to be higher than the other side, it can compress the sciatic in the sacroiliac joint. This posture also places more pressure upon the left hip and knee joint which can cause hip and knee pain. Correct exercise can either help you attain a normal pelvic alignment or prevent the conditions from worsening.
References
- Spine-Health.com; Exercise for Sciatic Pain from Sacroiliac Joint Dysfunction; Ron Miller
- Mayo Clinic; Sacroiliitis; July 15, 2010
- ABC Physical Therapy
- Pain-Free Program; Anthony Carey; 2005
