Sacroiliac SI Joint: Dysfunction, Pain, Treatment, and Therapy

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Definition

Sacroiliac SI joint dysfunction, also known as sacroiliac syndrome, sacroiliac dysfunction, sacroiliac joint syndrome, sacroiliac joint disease, SI joint pain, or sacroiliac dysfunction and instability commonly refers to sacroiliac joint pain due to abnormal excess of motion or lack thereof in the joint area which typically results in inflammation, pain, reduced mobility, neurological disorders, and other potentially debilitating problems.

sacroiliac-joint-dysfunction sacroiliac-joint-pain

The sacroiliac joint connects the pelvis (iliac crest) with the sacrum (the triangular bone at the bottom of the spine). The joint has the role of stabilizing, transferring, and absorbing the impact forces, protecting the spine. A network of ligaments and muscles keeps is all together and allows a normal motion of the sacroiliac joint of around 2-4 mm in any direction. Such ligaments are more flexible in women because of birth necessity, thus women are at a higher risk of developing sacroiliac joint dysfunction.

If the joint itself, the surrounding ligaments, and/or if other proximal soft tissues become inflamed or damaged, then sacroiliac joint dysfunction occurs, reducing mobility and causing pain.

The ligaments of the sacroiliac joint include:
a. Anterior sacroiliac ligament
b. Interosseous sacroiliac ligament
c. Posterior sacroiliac ligament
d. Sacrotuberous ligament
e. Sacrospinous ligament

Symptoms

First Aid

In the case of a sacroiliac joint dysfunction crisis, the P.R.I.C.E. method is suitable for immediate pain relief.

Protection means refraining from strenuous physical activities and protecting the affected region from additional trauma. Always keep this principle in mind when setting your behavioral guided program. Pay attention to the way you sleep, walk, drive etc.

Rest means exactly that, getting 7-8 hours of sleep every day and doing everything you can to allow your body to focus and heal the affected area. It’s a general principle in which the patient seeks to better his lifestyle towards a more efficient recuperation.

Ice is very useful and fast method of relieving pain, lack of mobility, and general discomfort by both reducing inflammation and numbing the pain nerves. Just wrap a dozen of ice cubes in a towel and apply directly.

ice-SI-dysfunction

Compression can be very helpful in stabilizing the hip area, keeping inflammation down, and relieving pressure stress. Search for supports, braces, belts and other types of orthopedic devices that could benefit you greatly.

Elevation refers to the fact that symptoms may be reduced whenever the patient sits or lays in convenient positions. Speak to a doctor or chiropractor about your specific condition and try out different positions until you find a couple of comfortable ones that will allow you to continue your day-to-day life.

jack-knife-sacroiliac-joint-pain prone-position-SI-dysfunction fowler-position-sacroiliac-joint-pain correct-body-posture-SI-dysfunction

Causes

Fifty-eight percent of sacroiliac joint dysfunction cases resulted from a forceful torsion or high impacts incidents such as a car crash or hard fall.

In more severe cases, the overly stretched ligaments will often result in an incongruent or asymmetrical locking/catching of the hip bones, one tilted anteriorly while the other’s tilted posteriorly which causes debilitating pain.

Hormone imbalances of any kind can cause ligamentous laxity which can result in sacroiliac joint dysfunction by weakening the sacroiliac structure. Pregnancy, menopause, hormone replacement therapy, steroid cycles, and so on can cause hormone imbalances.

Pregnancy is an especially important period as it affects the levels of the protein hormone relaxin which allows the female pelvis to distend the birthing canal. Sometimes, after giving birth to a large baby or after extended labors, the stretched ligaments may not return completely to their initial tautness and can cause chronic sacroiliac joint pain, instability, and sacroiliac joint dysfunction.

Biomechanical incongruencies such as bone or muscle length irregularities can favor the development of sacroiliac joint dysfunction because of an altered gait pattern and increased force stress on the SI joint and other associated structures. So, leg or arm length inequality relating the bone or muscle can seriously favor the development of the sacroiliac syndrome.

 

A history of bone-related diseases such as scoliosis, osteoarthritis, polio, and so on can also trigger sacroiliac dysfunction.

Improper footwear can cause an array of health problems, including sacroiliac joint disease. Consider experimenting with low heel-to-drop or minimalistic/barefoot shoes. Give your feet some time to adapt before participating in sports activity in such shoes as the foot will have to absorb a larger amount of shock which will prove beneficial in the long run. Contrary to popular belief, more cushioning is not the best option for feet and general health.

Past surgeries or other invasive procedures regarding the spine such as spinal fusions can contribute to the formation of sacroiliac joint dysfunction. As a matter of fact, 75% of post-lumbar fusion patients exhibit SI joint degeneration within 5 years of surgery.

Prevention

Avoid competitive sports, especially contact sports, weightlifting, high-impact cardio such as running, basketball, volleyball, and generally hard twisting movements of the torso, as these can certainly aggravate the sacroiliac joints and ligaments. Try to find low-impact alternatives such as swimming, static elliptical, static bike, isolating machines, treadmills etc.

Sacroiliac joint dysfunction cases

Hypermobility (excess joint movement)

Sacroiliac joint dysfunction, instability or insufficiency refers to the fact that the lax ligaments are unable to support and sustain the joint due to weakness, injury, tear or sprained ligament tissue, resulting in joint hypermobility. So, this condition is categorized as an extra-articular dysfunction because the problem does not derive from the joint itself but from the surrounding ligaments. Rarely does the joint indicate degenerative changes such as arthritis. In most cases, the sacroiliac joint appears to be healthy and normal until a considerable period of time has passed with the condition left untreated.

Hypomobility (insufficient joint mobility)

Hypomobility is closely related to hypermobility and often times both conditions interact. Meaning that the joint may exhibit excessive mobility in some directions while incapable of moving in other directions.

Dr. Jerry Hesch developed in 2015 a treatment method and made the separation between treatable and non-treatable hypomobility.

1. Non-treatable hypermobile joint (ankylosed)
The motion limitation is non-mutable despite rehabilitation program. Etiology indicates aging, disease, past trauma with intra-articular bleeding and recalcitrant scar tissue formation etc.

2. Treatable hypomobile joint
Such rigid hypomobility cases are somewhat clinically underappreciated but typically responds well to brief intervention and usually involves both a positional and a reflex muscular interplay.

Pathological Hypomobility is a specific term of the disease referring to an intra-articular disorder which can appear due to age, degenerative joint disease, ankylosing spondylitis, rheumatoid arthritis, or an infection.

Diagnosis

Sacroiliac joint dysfunction can be difficult to correctly diagnose because the symptoms mimic other common bone conditions. Usually, the tests include studying the patient’s medical history, a physical examination, and sacroiliac joint injection before further examination.

 

Imaging

  • X-rays: It’s an electromagnetic high energy wave and very short wavelength which passes through different tissues and forms a photographic or digital image of the insides, describing the internal composition of the respective body part.
  • CT scan: A Computed Tomography or Computer Assisted Tomography is a cross-sectional or tomographic image from different angles using multiple X-rays. It allows a better image to be shown of the scanned body part.
  • Magnetic resonance imaging (MRI): It’s a complex imaging technique in which radio waves, field gradients, and strong magnetic fields combine to create a detailed anatomic photo of the examined body part.

Complex imaging

  • SPECT (Single-photon emission computed tomography)

If the aforementioned imaging tests do not reveal sufficient information, then a more complex nuclear-based imaging technique will be deployed. SPECT is a nuclear tomographic imaging method which uses gamma rays. A solution of gamma-emitting radioisotope (a radionuclide) is delivered intravenously which binds to specific tissues and delivers true 3D cross-sectional images.

Epidural Injection Procedure

A highly skilled physician will inject a lidocaine numbing solution into the joint (epidural space) by using fluoroscopic guidance (live X-ray). Sometimes, a dye substance is injected so that the joint is better visualized by increasing color contrast which is called an arthrogram. Furthermore, a steroid compound is also injected at the same time to decrease inflammation.

If the pain disappears upon subsequent testing, then it’s safe to conclude that the joint itself was the cause of pain and discomfort.

Physical examination

Upon assessing the patient through palpation, a series of provocative test are needed for further confirmation. As a rule of thumb, at least 3 out of 5 tests should result positive for confirmation.

1. Distraction: tensile force is being applied to the anterior aspect of the sacroiliac joint.

The patient lies supine with their forearm under their lower back to maintain lordosis. A pillow is put under the patient’s knees. Then, the examiner places his hands on the anterior and medial parts of both the patient’s left and right anterior superior iliac spine and pushes downwards. The examiner may cross his hands for a better downward push.

2. Thigh Thrust: anteroposterior stress is applied to the SI joint.

The patient lies supine with the flexed leg of the affected hip side planted on the mat while forming a 90-degree angle between his torso and tight. The examiner stabilizes the pelvis at the opposite anterior superior iliac spine with his hand. Then, the examiner generates increasing force through the axis of the femur.

3. FABER (Flexion, ABduction, External Rotation): tensile force is applied to the anterior part of the SI joint.

The patient lies supine with the affected side leg crossed over the opposite tight. The examiner stabilizes the pelvis at the opposite anterior superior iliac spine with his hand. Then, the examiner applies gentle downward force on the knee of the crossed leg while amplifying the flexion, abduction, and external rotation of the hip.

4. Compression: compression force is applied to the SI joints.

The patient lays sideways on the affected side. A pillow is placed between the knees while facing away from the examiner. The doctor then applies a gradual downward force on the anterior aspect of the lateral ilium, just between the iliac crest and greater trochanter.

5. Gaenslen’s: torsional force is applied to the SI joints.

The patient lies supine close to the edge of the table while letting his non-affected leg hangs off the table from the knee. The other leg is flexed with the foot planted on the table. The examiner stabilizes the leg by placing a hand on the flexed knee, thus keeps the ilium in a slightly posterior position throughout the maneuver.

6. Fortin finger test: the patient indicates twice the pain region.

The test can be performed both while sitting or standing. The patient will use its finger to localize the exact location of the pain. If the patient identifies twice the pain region within 1 cm (0.4 in.) of the inferomedial posterior superior iliac spine, then the test results positive for sacroiliac joint dysfunction.

 

Treatment

Generally, the treatment stretches and exercises consist of increasing motion in the hypomobile direction while reducing the motion in the hypermobile direction. In short terms, a compensatory strengthening program of the joint and ligaments for improving stability.

Chiropractic treatment. Adjustments by a chiropractor can help relieve pain. He’ll use techniques that move your muscles and joints.

Radiofrequency neurotomy or radiofrequency ablation (RFA) uses medium frequency alternating current between 350 kHz and 500 kHz to scar and destroy the nerve endings that transmit pain to the brain. A lateral branch neurotomy (ablation) provokes small heat lessons on the nerve endings and is usually paired with local anesthetics or conscious sedation anesthesia. Both the medial and lateral nerve branches pose little risk towards such invasive interventions as they’re not that important. The loss of these nerves has been proven to be safe. The success rate for pain relief is somewhere between 30% and 50% of all patients undergoing such treatment for at least 2 years, after this period the nerve endings regenerate.

Prolotherapy or regenerative injection therapy is an alternative medicine treatment that seeks to relieve pain and ligament laxity by injecting an irritant solution intraarticularly. The compounds used are usually natural such as saline, sugar or polyol substances and/or artificial numbing solutions. Side-effects are rare and include the potential for lightheadedness, allergic reactions, bruising, infection, nerve damage, back and neck pain, and disc injury.

Nerve treatment involves permanently damaging the nerve endings that sends pain signals to the brain. This method is rarely deployed due to the fact that it may cause unwanted numbness and other neurological dysfunctions.

Water therapy may provide immediate symptom relief due to the buoyancy effect of the water, relieving joint and ligament pressure.

Supports, braces, belts and other non-invasive orthopedic devices may prove extremely beneficiary, especially custom-made orthopedics. Most commonly, a wide belt called a sacroiliac belt which wraps around the hips, in order to tightly support the sacroiliac joint together may prove effective in most cases.

Surgery (Sacroiliac Joint Fusion)

Particular severe cases of the injury may require invasive procedures such as a sacroiliac joint fusion which seeks to restore the joint and ligaments to their normal function. The operation consists in removing the articular cartilage from both sides of the joint forming bones. Then, the two bones are screwed together with plates and screws until the two bones fuse together. This stops the abnormal motion and eliminates pain.

Complications of the sacroiliac joint fusion

With all major invasive surgical procedures, some complications may occur such as problems with anesthesia, thrombophlebitis, infection, nerve damage, implant or hardware problems, nonunion, ongoing pain etc.

  • Anesthesia problems such as allergic reactions or impaired lung function may occur in certain patients. Discuss your medical history with your anesthesiologist.
  • Thrombophlebitis, deep venous thrombosis (DVT) or more commonly known as blood clots can occur after any invasive operation due to the blood-thickening drugs and patient’s immobility. Symptoms include swelling, warmness, bruising, discoloration, and engorged superficial veins. This condition, if left untreated, can lead to a life-threatening disease called pulmonary embolism (PE) in which the deep vein blood-cloth dislodges and travels to the lung, putting the patient’s life at risk. Make sure to request blood-thinning drugs post-surgery. Infections are rare but can definitely occur. Deep infections can travel to the bones and bloodstream which can be life threatening.
  • Nerve damage post-surgery is also a rare complication and occurs whenever invasive procedures are done to the spinal cord or spinal nerves. Such complications occur because of a human error or because if unexpected tissue inflammation or scarring. Any surgery that is done near the spinal canal can potentially cause injury to the spinal cord or spinal nerves. Injury can occur from bumping or cutting the nerve tissue with a surgical instrument, from swelling around the nerve, or from the formation of scar tissue.
  • Implant or hardware problems are rare and usually occur in countries where the medical system is weak and/or corrupt. Also, human bone grafts can present various problematics if done incorrectly. Such procedures must be periodically inspected. Sometimes, additional hardware must be inserted subsequently after the initial surgery.
  • Nonunion or pseudarthrosis (false joint) can occur if the targeted tissues fail to unionize. In such cases, a second operation is needed to correct the nonunion by placing additional hardware and instrumentation.
  • Ongoing pain may occur in cases of complex surgeries such as a sacroiliac joint fusion. Immediate pain and discomfort after the surgery are normal, but in some cases, pain may continue long after the surgery which may require further invasive or noninvasive treatment.

Diet and lifestyle

Diet and lifestyle are very important to your general health and rehabilitation. A plant-based diet or, better yet, a strict vegan diet will benefit you greatly, keeping inflammation to an absolute minimum and giving your body the best nutrients out there. With a plant-based diet, you’ll reduce all-cause mortality and you’ll feel better all-around with tangible improvements. Furthermore, on top of your plant-based or vegan diet, you’ll also need a proper sleep pattern and adequate hydration alongside a drastic reduction of harmful vices such as smoking, drinking, coffee etc. It’s advised you monitor your micro and macro nutrient ratio, especially when transitioning to veganism. Make sure you’re meeting your needs in terms of Calcium, B12, Vitamin D etc.

Carbohydrates:

  • Fruits
  • Whole grains such as rice, buckwheat, barley, bread, whole wheat pasta etc.
  • Vegetables such as sweet potatoes, winter squash, whole corn etc.

Proteins:

  • Veggies
  • Non-Dairy Milk such as almond, soy milk, rice etc.
  • Hemp seeds
  • Lentils
  • Nut Butter
  • Quinoa
  • Hemp seeds
  • Tofu
  • Tempeh
  • Beans
  • Sprouted-grain bread

Fats:

  • Nuts and seeds
  • Avocado
  • Vegetable oils
  • Peanut, almond, and cashew butter
  • Fake meats
  • Coconut oil

Calcium
Men and premenopausal women should consume at least 1000 mg of calcium. Postmenopausal women should consume 1200 mg of calcium. Don’t take more than 2000mg of calcium a day, in total.

Vitamin D
Men and women should consume between 600 and 800 international units (IU) of vitamin D per day. Don’t take more than 800 IU of vitamin D a day as high doses can be toxic, especially after proceed periods of time.

B12 is especially important on both a vegan and non-vegan diet because it’s produced by certain bacteria and might lack in our modern foods. So monitor your intake and eat B12-fortified foods.

B12 in micrograms (μg)
Age RDA                                (μg)
0-6 months…………………..0.4
7-12 months…………………0.5
1-3 years………………………0.9
4-8 years………………………1.2
9-13 years…………………….1.8
14+ years……………………..2.4
pregnant women………….2.6
lactating women………….2.8

Sleep is also very important for your body to heal, so aim for 7-9 hours of sleep each day.
Adequate hydration is also very important because the majority of the body’s processes need water. For proper hydration, remember the 8×8 rule: drink 8 servings of 8 ounces of water a day (a total of 2L of water a day).
Sunlight
Get at least 1 hour of sunlight, every day. Continue maintaining a physically active lifestyle to encourage calcium synthesis in the body.

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) are over-the-counter nonsteroidal anti-inflammatory drugs which seem to be the best choice for symptom relief such as:

  • Ibuprofen: These drugs should be taken after a fiber-rich meal as to avoid fairly rare side-effects such as gastrointestinal bleeding. Furthermore, carefully read the package insert. Refrain if you’re suffering from asthma, heart conditions, kidney, or liver. It’s also sold under the brand names of Nurofen, Advil, Brufen, Motrin etc.
  • Naproxen: These drugs should also be administered after a fiber-rich meal as to reduce the fairly rare side-effects of stomach ulcers. Usually, a proton-pump inhibitor auxiliary drug is prescribed alongside Naproxen for patients with past health conditions that could put them at risk. Carefully inspect the package insert and avoid administration if you had duodenal ulcer, gastric ulcer or similar conditions. It is also sold under the brand names of Naprelan, Aleve, Naprosyn, Anaprox etc.
  • Methyl salicylate-based analgesic heat rub gels are also known as wintergreen or wintergreen oil which is an organic ester, naturally produced by many plants, particularly wintergreens. The gel is synthetically produced and it’s intended for topic use. Don’t ingest and apply a moderate quantity! Other names of the substance include Betula oil, salicylic acid methyl ester or methyl 2-hydroxybenzoate.
  • Selective COX-2 inhibitors are another type of nonsteroidal anti-inflammatory drug (NSAID) that directly targets cyclooxygenase-2 enzyme accountable for inflammation and pain which also reduces the risk of peptic ulceration. The drug is also sold under the generic name of Celecoxib. Thoughtfully read the package insert as these chemicals increase complications in patients with heart problems or under treatment for cancer!

Steroid-based medication

  • Cortisone is a steroid hormone (corticosteroid) produced by the adrenal gland in response to stress. It can be administered via multiple routes of administrations: IV intravenously, orally, intraarticularly, and transcutaneously. Cortisone suppresses the immune system, reducing inflammation and pain. Long-term use, especially when taken orally can trigger the following side-effects: diabetes, mellitus, hyperglycemia, changes in insulin, osteoporosis, changes in moods,amenorrhoea, cataracts, Cushing’s syndrome, glaucoma, and other. Speak to your doctor to see if you’re fit for a Cortisone treatment.
  • Growth Hormone (GH) is also known as somatotropin or human growth hormone which is a peptide hormone that stimulates cell reproduction, regeneration and tissue growth in humans and other animals. Studies have shown that GH can aid significantly in the reconstruction and tensile strengthening of bones. Ask your doctor if you’re fit for a short GH cycle.
  • Selective androgen receptor modulators (SARMs) or partial androgens are a novel class of androgen receptor ligands which simulate the effects of androgenic substances such as anabolic steroids but with reduced side-effects such as virilization, heightened cholesterol levels, damage to the testes, prostate, liver etc. Ask your doctor to see if these new-gen drugs may benefit you.
  • TB-500 is another new-gen peptide drug which regulates the cell-building protein called Actin with strong anti-inflammatory proprieties. The drug contains a fraction of the human protein called thymosin beta-4 of 43 amino acids encoded by the TMSB4X gene. It’s has been proven to aid in tissue regeneration of muscles, heart, skin, cornea, while also drastically lowering inflammation. The TB-500 molecule has a very low molecular weight, allowing it to be injected anywhere, subcutaneously, intramuscularly, and intravenously because it travels fast and doesn’t bind to the extracellular matrix.

Narcotic painkillers (can cause severe addiction!)

Opiates and opioids, commonly morphine and heroin, as well as derivatives can provide instant pain relief but can also cause severe addiction, so only administer when in debilitating pain. Talk to your doctor before taking such powerful drugs and be careful to not overdose or prolong the recommended administration period!

Physical therapy

This scale applies to both typical movements such as flexion/extension, rotation, etc. It also applies to passive accessory motions such as superior, inferior, medial and lateral glide etc.

Lumbopelvic Stabilization Training (stretches, poses, and exercises)

1. Knee-to-chest stretch

knee-to-chest-SI-dysfunction-stretch

The knee-to-chest stretch is one of the safest exercises for rehabilitating sacroiliac joint dysfunction. It stretches the back, hips, glutes, and tight.

Lie supine on a soft mat and proceed to grab a knee to your chest and gently pull it until you feel your muscles stretch. Hold for about 10 seconds and push your leg horizontally to its initial position. The negative part of the exercise will slightly work the abdominals and tight muscles. Alternate legs and repeat for a couple of sets a day.

Alternatively, you can do the same stretch with both legs. Avoid pain and only do the negative repetitions (returning to initial position) if there’s no pain on the way back

2. Piriformis stretch

piriformis-stretch-SI-pain

Lie supine on a soft mat and cross your legs with the leg of the affected side on top and form a triangle, resting the lateral malleolus on the opposite tight, just above the knee. Then, grab the bottom leg and pull towards your chest until you feel a stretch in the buttock and hip area, hold the stretch for half a minuted and alternate. Do a couple of holds for each leg.

3. Knee swipes/hip twists

Lie supine on a soft mat with your knees flexed and feet firmly planted on the mat. While keeping your knees together proceed to swipe left and right. You’ll be describing an arch with your knees. Hold for a few seconds on each side to stretch the glutes, tight, and back. Contract your abdominals to switch sides and hold the final twisted position for another couple of seconds. Do dozens of repetitions a set and complete a few sets a day.

4. Pelvic tilt

pelvic-tilt-sacroiliac-joint-pain-dysfunction

Lie supine on the mat with your legs flexed and your feet planted on the floor. Proceed to slowly raise one leg at the time for about 6 inches (15 cm) off the floor toward the ceiling and hold at the top for 5 seconds, then switch legs. Do a dozen of total reps a day.

5. Bridges/hip thrusts

hip-thrusts-sacroiliac-joint-pain-dysfunction

While lying face-up with your feet planted on the ground and your knees flexed. Proceed to thrust your hips towards the ceiling while supporting your weight with your arms. Hold the top position for a couple of seconds and slowly lower yourself down. Do a couple of dozen of repetitions each day.

At the top, concentrate on squeezing the glutes, hamstrings, and back muscles while stretching your lower abdominals.

6. Cobra/bhujangasana pose

cobra-Bhujangasana-Yoga-pose-sacroiliac-joint-injury

Lie prone on a soft mat. Plant your hands just beneath your shoulders as you would with a push-up. Proceed to push your upper body weight with your arms while looking towards the ceiling. Strengthen your arms fully, extend your back, try to pull your shoulders away from your ears, and focus on the stretch and muscular contraction of the back and glutes. Hold the top position for half a minute and lower yourself back flat on your stomach. Do a couple of reps a day.

7. Triangle/trikonasana pose

triangle-Trikonasana-Yoga-SI-joint-injury

The next yoga-inspired pose is to be done while standing up and will greatly stretch the outer tight, lower lateral abdominals, back, and glutes, so let pain be your guide and stop if discomfort turns into pain.

Assume a wide stance, slightly wider than shoulder width, extend your arms laterally to form a “T” and then proceed to touch each foot with your hands while maintaining your arms stretched out parallel to the ground. Also, point your feet in the same direction as your arms, to the outside and hold the final position for a couple of seconds. While holding the final position, make sure to turn your head towards the free which will point to the ceiling.

8. Child’s pose/proskynesis stretch

child-pose-sacroiliac-joint-pain

Bow your body with your arms extended in front of you, on the ground while sitting on your knees. Tighten your lower body and stretch the arms in front of you. Maintain the position for a minute or so and try to stretch the back, glutes, and upper body. Assume this position a couple of times a day.

9. Bird Dog

Get on all fours and proceeded to lift a leg up parallel to the ground and then lift the opposite arm in the same fashion. Don’t arch your back, keep it parallel to the ground. Hold both your arm and opposite leg up for a couple of seconds, slowly lower them down, and then alternate. Do a couple of dozen repetitions each day and focus on the squeeze at the top in your delts, glutes, hamstrings,
and lower back.

Prognosis

After a non-invasive treatment for sacroiliac joint dysfunction, you’ll have to refrain from strenuous physical activity for a couple of weeks, then, you can proceed towards a comprehensive rehabilitation program.

After a sacroiliac joint dysfunction surgery, you’ll have to wait around six weeks before attempting a rehabilitation program which will last for about 6 to 8 weeks. Expect full recovery after 6 months. The patient also has to design a guided behavioral program as to avoid interfering with the rehabilitation progress, this means controlling day-to-day activities such as walking, going to the bathroom, working etc.

 

Related diseases

Sacroiliitis refers to the inflammation of the sacroiliac joint itself which may or not be a consequence of sacroiliac joint dysfunction. In theory, this often false-positive disease is less severe than sacroiliac joint dysfunction and may be easier to treat. Symptoms of Sacroiliitis include pain in the upper leg and lower back, buttock and hip pain, fever, swelling, stiffness.

Pelvic floor dysfunction occurs whenever there’s an impairment to the sacroiliac joint, hip joints, lower back or coccyx and whenever the pelvic floor descends under the pubococcygeal line. The injury affects up to 50% of women. Obesity, menopause, pregnancy and childbirth are all risk factors. Symptoms include pelvic pain, stiffness, dyspareunia, bladder/bowel incontinence, and gross organ protrusion.

Pelvic floor muscle disorder is a disease in which the pelvic floor muscles remain contracted, tenses, clenched involuntarily. The specific biological pathways are rather unknown but it’s commonly accepted that it’s a result of a natural inclination, learned behavior to stress, pain, trauma, or any combination of these.

Psoriatic arthritis is a chronic inflammatory condition which afflicts people with psoriasis, an autoimmune disease. Genetic predisposition plays a huge factor alongside obesity, lifestyle, and other factors. The disease occurs in 30% of people with psoriasis. HLA-B27 genotype is found in 40-50% of individuals with psoriatic arthritis. Symptoms include the extreme swelling of extremities, nails changing shape and/or falling, color changes to the skin as well as its texture (e.g. red itchy scaly plaques).

There are five main types of psoriatic arthritis:p

  1. Oligoarticular: “Oligo” means “few”, “little” and comes from Greek. So, it’s the milder form affecting up to 3 joints.
  2. Polyarticular: “Poly” means “many” or “much” and also comes from Greek. It’s a more severe form where multiple joints are being affected.
  3. Arthritis mutilans: “Mutilans” comes from Latin and means mutilating. The disease is also called chronic absorptive arthritis and it’s a very severe, deforming form of arthritis.
  4. Spondyloarthritis: this type affects the spine or the sacroiliac joint of the spine, causing stiffness and pain.
  5. Distal interphalangeal predominant: this type affects the furthermost parts of the extremities, meaning fingers, toes, and nails.

Many other spine-related diseases such as disc herniations or spondylitis can manifest similar symptoms to the sacroiliac joint dysfunction.

Conclusion

Sacroiliac joint dysfunction is a relatively common condition that affects between 15% and 38% of the general population, with women being 3 to 4 times more likely to be affected than men. It’s a cause of pain, discomfort, and impaired mobility that can be treated with both invasive and non-invasive treatments. P.R.I.C.E. first aid method is recommended whenever symptoms are first discovered or whenever a crisis ensues. A comprehensive rehabilitation program is needed afterward consisting of training the glutes, back muscles, abdominals, quadriceps, and hamstrings.

Constant medical supervision is paramount as complications can be life-threatening. Information contained in this article is from credible, references sources. Please consult a healthcare provider for further information.

Sources

  1. Unknown, Comprehensive Diagnostic Approach for the Sacroiliac (SI) Joint, Spine Health, May 05, 2017
  2. Jerry Hesch, MHS, P.T. , THE HESCH METHOD OF TREATING SACROILIAC JOINT DYSFUNCTION: INTEGRATING THE SI, SYMPHYSIS PUBIS, PELVIS, HIP AND LUMBAR SPINE , Hesch Institute, May 25, 2017
  3. Web MD Staff, Is Your SI Joint Giving You Back Pain?, Web MD, May 05, 2017
  4. Spine Health Staff, Sacroiliac Joint Dysfunction Health Center, Spine Health, May 05, 2017
  5. Ray M. Baker, MD , Radiofrequency Neurotomy for Facet and Sacroiliac Joint Pain, Spine Health, May 25, 2017
  6. Fortin JD1, Falco FJ., The Fortin finger test: an indicator of sacroiliac pain., US National Library of Medicine National Institutes of Health , May 25, 1997
  7. Staff Writer, Sacroiliac Joint Dysfunction , Ortho Gate, May 25, 2017
  8. SIJ Pain Staff Writer, Sacroiliac Joint Dysfunction, SIJ Pain, May 05, 2017
  9. Staff Writer, Fortin's Sign, The Student Physical Therapist, May 05, 2017
  10. Staff Writer, SI Joint Dysfunction, SI Bone, May 05, 2017
  11. Staff Writer, 7 Best Sacroiliac Joint Pain Exercises, and 5 to Avoid , Braceability, May 05, 2017