Thursday 8 November 2012

Sacroiliac joint dysfunction




The sacroiliac joint is the joint between the sacrum and the ilium. The sacrum is the triangular shaped bone at the base of the spine and the ilium, the winged shaped bones of the waist. The joint is marked by the presence of dimples at the base of the spine, called the posterior superior iliac spines, or PSIS for short. The picture shows the sacroiliac joint circled in red.

The sacroiliac joint is a slightly movable joint and, unlike the elbow, is designed to slide. The sliding action helps to absorb the impacts of running and walking, and other less energetic movements like sitting, or bending forward.

The joint may not look like much, and may not move a lot, but it is an important joint in the body, and like many joint in the body, it can inflame too. Inflammation of the sacroiliac joint is called sacroiliitis. A typical symptom of sacroiliitis is pain around the dimples in the lower back, or the joint itself. However, the sacroiliac joint is closely associated with other muscles in the back including the gluteus maximus, piriformis, muscles in the lower back and muscles which flex the hip. These muscles will react by becoming tense, causing pain in the lower back and buttocks. Changes in the way you walk can cause the muscles of the leg to become tense too. If piriformis is affected, then you could experience piriformis syndrome, which was discussed in my previous article, resulting in sciatica. Nerves leaving the spine, at the L2 to S3 level, pass close to the sacroiliac joint. Inflammation at the joint can play on these nerves causing pain to be felt in the buttock, thigh and hip.

As you can see, symptoms can be complex and varied. I always get asked what happened first, did the sacroiliac dysfunction cause the other muscles to react, or did tension in the other muscles cause the sacroiliac joint to inflame in compensation. It is generally hard to say, but what is certain is that sacroiliac joint dysfunction usually exists alongside other problems. For this reason I will treat what I find.

During a consultation I will test the sacroiliac joint for dysfunction, the lower back and piriformis for tension.

Treatment will typically include soft tissue work to release tension in the lower back and piriformis. I use mobilisation techniques to release the muscles around the joint and help it to move again. When I mobilise, or move, the sacroiliac joint, you might hear a pop or click as the ilium and sacrum slide over one another, restoring movement to the joint.  

Jacque Cilliers Adv Dip. MT. (MSM)

For appointments: 0845 4585 376



1 comment:


  1. Sacroiliac Joint DysfunctionIt is the inflammation of Sacroiliac joint (SI JOINT),in which patient is having pain during walking and sitting

    ReplyDelete