Sacra-ila-what? This joint, once thought to be immobile, is a key player in low back pain and sciatica-like symptoms. Sacroiliac joint dysfunction is a condition that, in many, can go undiagnosed. If missed, this condition can lead to improper management and unnecessary medical costs, or even unnecessary low back surgery.
The sacroiliac joint (SI joint) is the joint that is made where the pelvis and the sacrum meet. This joint is crucial for walking as it has to shear back and forth. If the SI joint becomes fixated the muscles of the back and glutes will be overloaded with the task of extending the low back and trail leg as you walk. Further, due to most of our jobs as Americans requiring prolonged sitting, glute muscle deterioration is very common. As a result of SI dysfunction and lack of glute strength, the muscles of the low back have to work much harder and become fatigued leading to chronic low back tightness and increased risk of injury.
Symptoms of sacroiliac joint dysfunction can include low back pain, glute pain, groin pain, thigh pain, and pain on the outside of the leg. These symptoms are either a result of improper SI joint mobility itself or secondary symptoms due to improper function. Further, the piriformis muscle may become tight leading to sciatica-like symptoms. This muscle runs right next to the sciatic nerve. If it becomes tight it can irritate the nerve leading to pain, numbness, tingling, and/or weakness of the lower extremity.
So what should you do if you think you might be suffering from this condition? As a chiropractor, I believe in exhausting conservative treatment options before considering injections or surgery. In most cases manipulation, passive modalities, and exercise can significantly decrease the symptoms associated with sacroiliac joint dysfunction. Your chiropractor can assess the joint’s integrity and provide treatments that improve its mobility. SI joint steroid injections are very common and can provide some benefit to the patient. However, these do not address the root cause of the pain or why the patient started experiencing the pain in the first place.
The best course of action is to first attempt treatment with a chiropractor to see if your specific condition can be managed conservatively before opting for any irreversible treatments.