Sacroiliac Joint Dysfunction and Your Ligaments

spinal stenosis

The sacroiliac (SI) joints in the lower back can suffer a condition known as SI joint dysfunction. While there are a few causes of this condition, they usually involve damage to the ligaments surrounding the joint.

SI joint dysfunction is characterized by hyper- or hypomobility of the joint. Hypermobility is more common. The SI joint is stabilized by an intricate network of strong ligaments and the deep muscles of the core group. The joints are located where the ilia, or large pelvic bones, meet the sacrum, the triangular bone at the base of the spine above the tailbone, on each side of the body. It is common for only one joint to be affected, and pelvic height discrepancy is usually involved.

The SI joint can become unstable when the ligaments that support it are either too stiff or too lax, with laxity being the most common. Ligaments can be torn or strained in a number of ways: falling, lifting improperly, prolonged poor posture, or a botched chiropractic session, since improper twisting can tear ligaments.

When a ligament that supports an SI joint is torn, it no longer holds the joint in its proper position. It is meant to move very little, between only 1 and 3 degrees. Any increase in movement creates pelvic and spinal instability, since the SI joint connects the spine to the lower body. If the joint is unable to transfer forces to the lower body and absorb shock from the upper body, the pain associated with SI joint dysfunction results.

SI joint pain is often centered on the injured joint itself in the lower back slightly off the mid-line. The pain can radiate throughout the buttock and into the thigh, and sometimes wraps around the hip and affects the groin.

While hypomobile SI joints benefit from mobilizing techniques like chiropractic manipulation, hypermobile joints need to be stabilized. The general treatment plan for a torn ligament is to refrain from straining it further by ceasing activities that stress it.

Resting the SI joint is extremely difficult; it is used in nearly every motion of the body, since it is connected to the spine and pelvis. The time it takes ligaments to heal - sometimes months - is also a concern, because bed rest that lasts beyond 2 days is detrimental to health. Muscles in the area need to be conditioned to help support the joint and inflammation must be reduced, all without aggravating the damaged ligament.

This is a difficult balance to strike, and the reason why SI joint dysfunction is notoriously difficult to treat. It is not impossible, however. During the beginning phase of treating a torn SI ligament, ice is recommended to decrease painful inflammation in the affected area. When a body part is injured, the brain responds by sending a cascade of fluids with materials to the site to both facilitate healing and prevent the perceived threat from spreading to the rest of the body. While the idea is to block off the unhealthy from the healthy, the inflammatory response is often counterproductive when it comes to injured body parts. The blockade formed prevents fresh blood and nutrients from getting to the area, creates painful swelling and can cause damage to surrounding tissues. Ice constricts blood vessels, limiting the amount of inflammatory materials that enter the area.

The second phase of treatment involves both limiting mobility by stabilizing ligaments and strengthening muscles that support its natural position. An SI joint belt, such as the one found at http://www.activeortho.com/si_belt_for_sacroiliac_pain.html, compresses the joint to limit mobility and provide support. This belt can greatly assist the first and second phases of treatment.

Once the ligament is healed, it is a good idea to condition the deep core muscles in the stomach, pelvis, lower back and buttocks to ensure that the joint continues to be properly supported. A physical therapist should be consulted to guide you through exercises that will not overstress your ligaments.

If these conservative treatments fail, it is possible that ligament-stiffening injections or fusion surgery will be recommended. These procedures are rare and best avoided, since the first is a temporary fix and the second may cause more harm than good.

For more information on SI joint dysfunction and a self-evaluation survey, see http://www.sidysfunction.com/generalinfo.php.