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
