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Sacroiliac Dysfunction

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The sacroiliac joint is the large, boomerang shaped joint that is found in the pelvis between the ilium and the sacrum (see picture). The joint does not have any nerves passing through it, but does have nerves from 5 spinal levels (L4, L5, S1, S2, and S3) going to it. Sacroiliac problems usually result from poor lifting, prolonged activities that overstress the joint, or from injury due to falls. These conditions are extremely common and injury to the sacroiliac joint is the most common condition treated at Nasa Chiropractic.

Symptoms of sacroiliac (SI) joint injury or dysfunction:

ยท A patient with a sacroiliac joint injury may experience the following symptoms:

  • Pain in the low back to the right or left of center that may feel sharp and knifelike
  • Pain aggravated by changes of position from sitting to standing or from rolling over in bed
  • Pain that may be reduced with walking
  • Pain that may worsen with sitting

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A patient with a sacroiliac joint injury may also experience sciatic-like pain that radiates to the buttock, hip, posterior thigh, calf, or even the foot, mimicking a lumbar disc herniation. The pain results from overstressing of the ligaments of the joint or from a sprain of the ligaments (microtears of the actual fibers of the ligaments) that comprise the joint.

Exam Findings:

  • Limited and painful lumbar ranges of motion
  • Pain during orthopedic tests
  • Increased tenderness over the injured joint
  • Muscle spasms in the low back greater on the side of the injury
  • Painful gluteal muscles
  • Normal neurological exam findings (usually)
  • Unequal apparent leg length due to distortion of the pelvis secondary to injury

Treatment:

Sacroiliac joint injuries are treated through the use of spinal manipulation (spinal adjusting) to reposition the joint to its optimal biomechanical position in order to promote healing in proper spinal alignment. A typical course of treatment involves 8-10 visits over 3-4 weeks. Treatments in the first 1-2 weeks usually consist of spinal manipulation in conjunction with the use of therapy modalities in order to reduce inflammation and aid in pain recovery. Treatments may be changed after the first 1-2 weeks to incorporate stretching and strengthening of the muscles surrounding the joint in order to promote the best possible recovery.