Sacroiliac problems


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  What is sacroiliac joint dysfunction?

During normal movement of the spine and hips, stretching or compressive forces are put through the sacroiliac joints and surrounding ligaments. When these forces are sudden, repetitive or excessive, injury to the sacroiliac joint may result.

Sacroiliac joint dysfunction refers to pain in the sacroiliac joint caused by abnormal motion of the sacroiliac joint, either too much motion (hypermobility) or too little motion (hypomobility). This typically results in inflammation of the sacroiliac joint.

Causes of sacroiliac joint dysfunction

Common causes and contributory factors of SI joint dysfunction include:

  • Repetitive micro-trauma: low level trauma over a period of time can cause damage that can often build up without being noticed. Pain can then be triggered by fairly innocuous activities such as bending to pick something off the floor.
  • Muscular imbalances, weakness (poor core strength) or tightness around the lumbar spine and pelvis: This can develop from not only from sedentary activities, such as sitting in the office or at home watching the TV, but also from repetitive and excessive movements that are experienced during sport or even gardening develop over a long period of time giving little or no symptoms until it is too late.
  • Trauma such as a falls or road traffic accidents
  • Prolonged sitting, bending, twisting or lifting
  • Pregnancy: Hormones released during pregnancy, such as Relaxin, increases the laxity of the pelvic ligaments can make them more vulnerable to injury.
  • After birth problems when the pelvis has not gone back to its previous position
  • Problems with the lower limb: biomechanical abnormalities, such as flat feet or leg length differences, can increase pressure on the SI joint, which can cause repetitive strain to the SI ligaments.
  • Poor posture
  • Obesity
  • Excessive or repetitive forces associated with impact sports: examples include running, rugby and golf.

Signs and symptoms of sacroiliac joint dysfunction:

  • Pain and tenderness is usually felt on one side of the low back over top of the buttock. Rarely is it felt on both sides.
  • Pain can sometimes refer into the buttock back of the leg, front of the thigh and groin.
  • Pain can come on suddenly or develop gradually over a period of time.
  • Pain is worsened by sitting, bending (e.g. putting on shoes and socks), lifting or twisting.
  • Increased weight bearing such as standing on one leg can increase the pain e.g. with walking up and down stairs
  • Lying down usually eases the pain.

Diagnosis of sacroiliac joint dysfunction

SI joint dysfunction is a major source of low back pain. Pain from the SI joint is often under-diagnosed, under-appreciated, and misunderstood. The clinical presentation together with a thorough examination by an Osteopath is usually sufficient to diagnose sacroiliac joint dysfunction. Very occasionally you may need to be referred for further investigations such as an X-ray, MRI, bone scan or CT scan so aid in the diagnosis.

Osteopathy Treatment for sacroiliac joint dysfunction

Osteopathic treatment aims to assist in the bodies natural healing process, speeding up the recovery, and reducing the likelihood of future recurrence.

In the acute phase (when the injury has just happened), Osteopaths will aim to reduce the pain and inflammation. They will also aim to improve the function of other parts of the musculo-skeletal system to reduce the stress on the injured area. Ice-packs can also help within the first 48-72 hours.

After the acute phase, treatment is focused on improving the stability of the area by introducing rehabilitation exercises and lifestyle modifications.

Treatment methods used may include:

  • soft tissue massage & stretching
  • joint mobilisation & manipulation
  • dry needling
  • taping
  • the use of a sacroiliac or lumbar support belts
  • correction of any leg length discrepancy
  • activity modification advice
  • ergonomics advice (your working environment)
  • exercises to improve flexibility, strength, posture and core stability

Prognosis of sacroiliac joint dysfunction

Patients can get dramatic pain relief from Osteopathic manipulation, but typically this relief may take 3-6 weeks. The recovery time will vary depending on individual and compliance with advice and exercises.

Shiatsu

  • Similar to acupuncture, Shiatsu works to regulate the flow of energy or ‘qi’ thus maintaining health in all ages. Qi is the vital energy in the body that underlies all functions.
  • Qi flows in specific pathways known as meridians
  • Shiatsu practitioners can detect which meridians are too energised and those which are lacking in energy. Either imbalance can lead to blocks to healing and also to what we call dis-ease or indeed, chronic pain.
  • Specific points relative to the presenting pain are pressed on the major meridians of the body to cause energy to flow more easily. This combined with acupressure, trigger points and Thai style stretching makes this a is very effective treatment.
  • This explains why so many are delighted with the improvement in other areas e.g. constipation, painful arthritic joints, headaches, overwhelm, anxiety, obsessing about work, memory problems, period pain, nausea, asthma and so on. 
  • BCC Clients are finding shiatsu a great help in managing their chronic pain as specific points are pressed related to that particular pain.

Reflexology

  • encourages relaxation - so important for the body to heal itself
  • aids flexibility - by working on the muscles and joints of the body through  the feet, movement becomes easier and less painful
  • increases the circulation of blood with its oxygen, nutrients and healing  hormones
  • assists the removal of waste products from your exertions - this is done by affecting the circulation of venous blood and lymph through the body
  • decreases tension and those ‘uptight’ and anxious feelings
  • speeds up recovery time after surgery or injury
  • improves the repair mechanisms of the body and reduces inflammation

More and more people are working with talking and energy therapies for chronic pain. Here at BCC we have Emotional Freedom Technique (EFT) and Matrix Reimprinting to help.

Touch is essential for life so there is a direct link to that 'feel better response' to massage. Relaxation effects are so important for everyone but especially for anyone with depression.

SWEDISH MASSAGE AND REMEDIAL AND SPORTS MASSAGE: BENEFITS OF MANAGING SACROILIAC PAIN

  • Health relies on a state of balance and can be described as the ability to adapt and cope with whatever occurs, combined with feelings of comfort, safety and enthusiasm
  • Touch in the form of massage can make a huge difference. There are many explanations for this:
    • improved circulation – more oxygenated blood plus removal of toxins
    • reduction in pain – massage stimulates the brain to release natural painkillers e.g. serotonin
    • anxiety reduction – it has been shown that relaxation and anxiety cannot co-exist. This helps the person realise that they can cope.
    • helps with sleeping problems and increases deep sleep
    • relaxation effects – as the body lets go of accumulated tension it is able to work better as there are fewer demands being placed on it
    • healing – touch is healing and certainly the improved circulation already described improves healing time and is why sports people seek massage therapy
    • energy – we tend to have more energy after a massage. Tension tends to ‘trap’ energy; massage tends to encourage energy to flow.   The Massage Therapist will hopefully create all these effects which are made even more special by the caring and love given, as well as his / her intent
    • increases range of motion
    • helps to restore or maintain a healthy structure - essential to avoid  chronic conditions developing
    • improves body awareness - helping posture.

  • People who are starved of touch can feel very isolated and anxious which then affects their total well-being, after all, solitary confinement must be the worst punishment. Appropriate touch is soothing and relaxing and also helps that ‘feel good feeling’.

 

THERAPY OPTIONS AVAILABLE FOR THIS CONDITION AT BROOKS-CARTER CLINIC