Sacroiliac Joint Dysfunction
What is sacroiliac joint dysfunction?
The sacroiliac joints (SIJ) are located in our lower back. We have two of these joints, which essentially join each of our hips to our lower spine. The sacrum is a flat triangular bone which connects our two hip bones, via a part of the hip bone called the ilium. The sacroiliac joint is the name for this connection.
There is not much motion at this joint, it is instead required to be strong and stable as it transfers force from our upper to our lower body. SIJ dysfunction is the term given to pain and irritation at this joint causing lower back pain.
Typically pain begins in the lower back or the buttock. The pain may also radiate to the lower hip or the groin. SIJ dysfunction can affect one or both sides.
How does Sacroiliac joint dysfunction occur?
The sacroiliac joint can become painful and problematic if the joint is not properly stabilised. This can occur from either too much or too little movement at the joint, usually because the supporting ligaments are either too tight or too loose. Changes in the ligaments can happen after an injury, overuse, poor posture, pregnancy and childbirth or after back or hip surgery.
Asymmetrical movement between the two SIJs can also lead to SIJ pain. This can occur as a result of a leg length difference or unilateral muscle weakness at the hips or gluteal muscles.
What is the treatment for Sacroiliac Joint Dysfunction?
Treatment by a physiotherapist or a chiropractor will usually involve a combination of hands on manual therapies in order to help to improve the range and quality of motion at this SIJ. Strengthening exercises should also be prescribed to stabilise the back joint.
Can a podiatrist help with lower back pain?
If your biomechanics are contributing to your SIJ pain then a podiatrist certainly can help. Your foot posture and function may have an effect higher up your body up the kinetic chain. For example, if your foot pronates or ‘rolls inwards’ this causes changes in the foot, knee and leg. A pronated foot tends to be associated with internal rotation tibia (shinbone), inwards collapse of the knee and a internal twist of the femur (thighbone). This can put the alignment of the lower back under increased strain.
A study by Cho and Yoon in 2015 looked at the relationship between foot mechanics and poor pelvic alignment. The focused particularly on patients with lower back pain. They found a significant decrease in SIJ pain after shoe inserts were worn. They believe this is because the inserts reduce the mechanical stress on the SIJ by stabilising the pelvis.
A podiatrist can examine your stance, gait and biomechanics to help determine if you may benefit from a pair of foot orthotics.
References
Cho, B. Y., & Yoon, J. G. (2015). The effect of gait training with shoe inserts on the improvement of pain and gait in sacroiliac joint patients. Journal of physical therapy science, 27(8), 2469–2471. https://doi.org/10.1589/jpts.27.2469
