Sacroiliac Joint Dysfunction

The sacrum is a triangular bone that whose northern border is the bottom of the lumbar spine, is bordered laterally by the walls of the pelvis, and whose southern border is the coccyx. The sacrum is a triangular bone that are separate individual vertebrae when we are born, and become fused by the time we become adults. The sacrum is attached to the bottom of the spine by the last L5-S1 lumbar disc. The bottom of the sacrum is connected to the coccyx, also known as the tailbone. The two sides of the sacrum are attached to the ilium of the pelvis by a group of ligaments that collectively make up a structure known as the sacroiliac joint.

The question of how often sacroiliac joint dysfunction occurs, and in what percentages of cases sacroiliac joint dysfunction causes back pain is a matter of debate. Unlike other supportive structures of the spine, such as the discs and facet joints, there is little physical or documented evidence that the ligaments of the sacroiliac joint wear out to cause instability of the spine. The ligaments of the sacroiliac joint are very strong, and do not become torn or strained to the point of becoming sagging unless subjected to the most violent conditions, like a car accident. On the other hand, all of the ligaments of the body lose some of their flexibility with age, and they may become loosened if subjected to excessive pressures over a period of months or years. Some doctors and chiropractors believe that the SI joint does move and that strains of these joints are a significant cause of low back pain. Chiropractors believe that falls, bad posture, and other factors can move the SI joint on one side of the body out of alignment, and that chiropractic adjustments can be performed to put the sacrum back into proper alignment. Orthopedic surgeons, who believe that sacroiliac joint dysfunction is caused by a chronic loosening of the ligaments may perform sclerosing injections to tighten up lax ligaments of the SI joints.

Sacroiliac joint dysfunction is also known as SI Joint Pain. The belief is that when one of both sides of this joint loses mobility or becomes loose due to accident, trauma, or chronically back postural habits (slouching, lack of exercise) that the result may be lower back pain or radiating leg pain. Many of the common symptoms of SI joint pain are similar to other low back pain symptoms caused by arthritic changes to the facet joint or discs, including:
  • Radiating pain traveling down the leg in addition to lower back pain.
  • Occasional bilateral pain, but more often, unilateral pain in one buttock that radiates down the leg.
Some differences between sacroiliac joint dysfunction and other degenerative causes of low back pain include:
  • SI joint dysfunction rarely travels as far as the foot.
  • Men are unlikely to experience low back pain symptoms as a result of sacroiliac joint dysfunction.
  • Sacroiliac joint dysfunction is usually treated non-surgically, because it rarely involves tearing of the ligaments.
Sacroiliac joint dysfunction is usually treated non-surgically, since the pathology to the joint rarely involves tearing of the ligaments. Treatment options may include medications to treat the pain, physical therapy and exercise, support braces, or sacroiliac joint injections.