Sacroiliac Joint pain
SI joint pain
A common presentation during and after pregnancy
SI joint pain (or Sacro-Iliac Joint pain) affects predominantly women during and after pregnancy. It can also affect men. The SI Joints sit where the sacrum (the very end of your spine) meets the pelvis (more specifically, the right and left ilium). It can be one, or both joints to be painful.
The quality of pain can be sharp or dull, often without radiation (the pain remains local). Usually it is worse during the morning and it eases with movement.
Anatomy of the SI Joint:
The sacroiliac joint is located at the junction of the sacrum and the ilium on both sides of the lower back. It is a synovial joint with limited movement, as it is primarily designed to support the weight of the upper body and transfer it to the pelvis and lower limbs. The stability of the SI joint is maintained by strong ligaments and muscles surrounding it.
Symptoms of Sacroiliac Joint Pain:
SI joint pain is often characterized by a deep, dull ache in the lower back and buttocks. The pain may radiate down the back of the thigh and may be more prominent on one side. Other common symptoms include:
Pain with Movement: Activities that involve bending, twisting, or prolonged sitting/standing can trigger or worsen SI joint pain.
Pain While Climbing Stairs: The act of climbing stairs may exacerbate SI joint pain due to increased stress on the joint.
Pain when Changing Positions: Transitioning from sitting to standing or vice versa can be painful for individuals with SI joint issues.
Instability: Some people may experience a feeling of instability in the lower back or a sense that the pelvis is "out of alignment."
Causes of Sacroiliac Joint Pain:
Several factors can contribute to SI joint pain:
Trauma or Injury: A fall, accident, or direct impact to the lower back can cause SI joint dysfunction and pain.
Arthritis: Inflammatory arthritis conditions, such as ankylosing spondylitis, can affect the SI joint and lead to pain and stiffness.
Pregnancy: During pregnancy, hormonal changes and the release of relaxin hormone can lead to increased joint laxity, potentially causing SI joint pain.
Degenerative Changes: As people age, wear and tear on the SI joint may lead to osteoarthritis and subsequent pain.
Leg Length Discrepancy: A significant difference in leg lengths can affect the alignment of the pelvis and SI joint, leading to pain.
SI Joint Pain during Pregnancy:
During pregnancy, the body releases the hormone relaxin to prepare the pelvis for childbirth. Relaxin increases the ligamentous laxity around the SI joint and other pelvic structures, which can lead to SI joint pain and instability. Additionally, the growing uterus and the shifting of the body's center of gravity during pregnancy can put additional strain on the SI joint, exacerbating pain and discomfort.
NHS and NICE Guidelines for Managing SI Joint Pain:
The UK's National Health Service (NHS) and the National Institute for Health and Care Excellence (NICE) have developed guidelines for managing SI joint pain. Treatment options may include:
Pain Relief: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be recommended to manage mild to moderate SI joint pain.
Mobilisation: Chiropractic, Osteopathy or Physiotherapy, as prescribed by NICE guidelines, can include exercises to strengthen the muscles supporting the SI joint, improve flexibility, and enhance joint stability.
Injections: For severe SI joint pain, corticosteroid injections may be administered directly into the joint to reduce inflammation and alleviate pain.
Role of Chiropractic and Manual Therapy:
Chiropractors and manual therapists can play a significant role in managing SI joint pain. They employ various techniques to restore proper alignment, mobility, and function to the SI joint and surrounding structures. Treatment may involve:
Chiropractic Adjustments: Specific adjustments to the SI joint can help realign the joint, reduce inflammation, and alleviate pain.
Soft Tissue Therapy: Manual techniques, such as massage and myofascial release, can target tight muscles and soft tissues around the SI joint, promoting relaxation and reducing tension.
Exercise Prescription: Chiropractors may design tailored exercise programs to strengthen the core and pelvic muscles, which can improve the stability of the SI joint.
Advice on Posture and Movement: Education on proper posture and body mechanics can help individuals avoid movements that exacerbate SI joint pain and improve overall biomechanics.
Sacroiliac joint pain can cause significant discomfort in the lower back and pelvis, impacting daily activities and quality of life. Understanding the anatomy of the SI joint, recognizing the symptoms, and identifying the causes are essential steps in managing this condition effectively. NHS and NICE guidelines offer evidence-based approaches to address SI joint pain, including pain relief, physical therapy, and supportive devices. Additionally, chiropractic and manual therapy can play a valuable role in managing SI joint pain by providing specific adjustments, soft tissue therapy, exercise prescription, and expert advice on posture and movement. If you experience persistent or severe SI joint pain, it is crucial to seek professional evaluation and guidance to determine the most appropriate treatment plan for your individual needs. It is always worth to investigate lower back pain causes, especially if severe lower back pain.
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