In my last two blog posts, I’ve covered the 2 most common causes of back pain and sciatica: 1) HERNIATED DISC; and 2) ARTHRITIS, DISC DEGENERATION, AND STENOSIS. Now let’s move on to the 3rd most common cause, which can be a really tricky one.
3) SI JOINT/PELVIS
The Sacroiliac Joint, or SI Joint for short, is the joint between the sacrum (the base of your spine, where your tailbone is) and the pelvis. Your sacrum is the base, or foundation, of your spine. When looking at the pelvis, approximately 70% of the time the right half of the pelvis will rotate forward, and that can create problems all the way up the back. It generally affects 10% to 25% of individuals who complain of low back pain, and can occur in anybody–all age ranges–which can affect us throughout our entire life. Symptoms can occur due to trauma, such as a fall, where one lands on one side of the body; due to muscle imbalances; due to certain types of arthritis; or very commonly during childbirth.
WHAT ARE THE KEY INDICATORS OF SI JOINT/PELVIS DISCOMFORT?
Individuals who complain of SI Joint/Pelvis discomfort may experience:
- Pain or discomfort with sitting or driving
- pain rolling over in bed (changing positions)–and it’s all throughout the night
- pain getting into/out of a car
- pain with standing on 1 leg to get dressed, or perhaps to shave a leg
WHAT MAKES THIS SO TRICKY?
What makes this really tricky is that an individual who has been experiencing SI Joint/Pelvis discomfort for a long time will frequently have DISC symptoms up above (whether it is a herniated disc or degenerative disc disease). So, they may have pain with standing and walking from arthritis or disc degeneration up above, but now they also have pain with sitting as well. In order to attempt to relieve symptoms, the individual will typically shift their weight to the opposite side.Another issue with SI Joint/Pelvis symptoms is that, in addition to often being missed on a MRI, when an individual experiences symptoms down the leg from underlying SI or Pelvic issues, it tends to be very, very broad–so they’ll complain about pain on the outside of their leg, or wrapping around into the groin, or even into the front of the leg, but it’s broad (unlike someone with a herniated disc who could take their finger and draw a line down the back of their leg).
In addition, sciatic symptoms from a SI Joint or Pelvis problem almost always have weakness. Also, one of the more serious issues that we see happens with alarming frequency, where the individual will experience leakage (loss of bowel or bladder control–more frequently bladder). But many times, even though it can be very embarrassing, when we re-align the pelvis that underlying leakage is resolved, because when the pelvis is where it is supposed to be, the muscles within the pelvis can fire the way that they are supposed to, which now allows the individual to control bladder flow.
HOW CAN PHYSICAL THERAPY HELP WITH RELIEVING LOW BACK PAIN FROM SI/PELVIS ISSUES?
Successful treatment is focused on allowing you to return and actively participate in your everyday daily activities. Treatment is based upon both the outcome of findings from your thorough Physical Therapy evaluation coupled with your personal goals. Your program will most likely include:
- Manual Therapy, which may include soft tissue massage for sore or tight muscle groups; muscle energy techniques to help re-align the position of the pelvis; and joint mobilization to improve mobility of the spine, pelvis, and hip.
- Flexibility and Stretching exercises to improve mobility of the spine and lower extremities, which can help to diminish stress at the SI Joint during normal daily activities.
- Strengthening exercises to improve stability of the SI and spinal joints, which helps to decrease stress on the ligaments. Weak muscle groups that are targeted are often the lower abdominals, pelvic floor, and buttocks.
- Postural Awareness and Body Mechanics to make recommendations to improve how you sit, stand, bend, lift, carry, and also sleep.
If you or a loved one is experiencing any of the symptoms commonly associated with SI Joint/Pelvis issues, don’t wait to take action. Call my office at once at (302)691-9055, or visit my website at www.wildermanpt.com to schedule your FREE, 30-minute consultation to see how Physical Therapy can help you. Don’t delay–if you need some more help with back pain please call my clinic at (302)691-9055, or request my free information report which shows the 14 ways to ease back pain by clicking on the report.