That pain in your lower back or hip, especially when it travels down your leg, may not just be a simple muscle strain. The joint linking your spine and pelvis could be causing your pain. You might have a condition known as sacroiliac (SI) joint dysfunction. It is common for doctors to overlook or misdiagnose this issue.

The SI joint transfers load between the upper body and lower body (legs), ensures pelvic stability and assists in pelvic movement. When this joint becomes inflamed or unstable, you could feel a sharp pain in the lower back, hips, or buttocks. The pain becomes worse if you sit for long periods, suddenly stand up, or climb stairs.

Do not ignore these signs, especially if they persist or worsen. A proper diagnosis is required for effective treatment and long-term relief. At Suarez Physical Therapy, our Las Vegas physical therapists specialize in and use evidence-based techniques to identify and treat your SI joint dysfunction. Take the first step toward relief. Make an appointment with us to address your sacroiliac joint dysfunction.

Understanding Sacroiliac Joint Anatomy and Disorders

The SI joint connects the sacrum, the triangular bone at the bottom of the spine, to the pelvic iliac bones. You have two SI joints, one on each side of your lower spine. These joints are located just under your lower back (lumbar) region and above your tailbone. Tough ligaments stabilize these synovial joints that have limited but essential motion. Their interlocking surfaces help the structural integrity of the joint. They also help absorb shock, stabilize the pelvis, and transmit loads up and down your body.

When the SI joint loses its balance, dysfunction follows.

Hypermobility is when joints move too far. This can be due to loose ligaments, which destabilize the joint and cause strain. Joint movement and flexibility are greatly reduced in a hypermobile joint. When the sacroiliac joint becomes irritated, it becomes inflamed and is often linked with autoimmune disorders. When tissue gets disrupted, it irritates the nearby nerves and tissues, causing pain.

Common Causes of SI Joint Pain and Risk Factors

Common causes of SI joint pain include:

  1. Trauma and Injury

In many cases, SI joint pain originates from some form of trauma. This could be due to a fall, car accident, or similar accidents. Your joint might become misaligned, or the ligaments that stabilize it could be damaged, causing inflammation and pain. Even minor injuries, over time, could destabilize the area.

  1. Repetitive Stress and Overuse

Performing repetitive pelvic movements, including running, heavy lifting, or prolonged sitting, could cause pain in the sacroiliac joint. These activities slowly wear away at your joints. Repeating them repeatedly without rest or support irritates the joint and becomes painful.

  1. Pregnancy and Postural Changes

Hormonal changes cause the ligaments to become lax. Due to weight gain and postural changes, the SI joint comes under increased strain. You could also feel pain when standing, walking, or rolling in bed during or after pregnancy.

  1. Degenerative and Inflammatory Conditions

Osteoarthritis, a type of arthritis, wears away the cushioning cartilage in the joint. Conditions like rheumatoid arthritis, ankylosing spondylitis, and other chronic inflammatory arthritides could cause SI joint pain. Both factors can impair your SI joint's ability to work, typically causing chronic pain.

  1. Surgical History

After a lumbar fusion, your lower back could have less motion, increasing stress on your SI joint. Over time, this compensation will disrupt your spine and cause pain.

Risk Factors That Increase Susceptibility of Sacroiliac Joint Dysfunction

Certain risk factors heighten susceptibility, namely:

  • Aging and joint wear — As you age, the parts of your body wear and tear, and the same can be said for your joints. When there is wear on your joints, you can become prone to SI joint problems.
  • Jobs stress your joints— Heavy lifting jobs like construction work and prolonged sitting jobs like office jobs place continuous stress on the SI joint
  • Previous injuries to your body — An ankle injury or back pain can change how you move and walk and put extra strain on the SI joint.
  • Sports activity — Athletes, for example, runners and dancers, are also at risk of developing dysfunctions in the sacroiliac joint from repeated movements and stress on the joint.

When these risk factors interact with your body, they can lead to problems referred to as joint-related pain. Joint-related pain can be anything from a little annoying to really painful and can affect your life.

Common Symptoms of SI Joint Dysfunction

Patients sometimes acquire a stiff sacroiliac joint due to a lack of movement. Identifying particular symptoms can help to alert you to a problem. Common signs of SI joint dysfunction include:

  • Pain felt in the lower back or buttocks, usually only on one side
  • Dull, aching pain or occasional sharp, stabbing sensations
  • Pain that moves to the groin, upper thigh, or down the leg but infrequently below the knee
  • The discomfort felt at the bony area in the back of the pelvis
  • Long periods of sitting or standing can worsen the pain, which may worsen with movement
  • Discomfort while changing positions in bed or rising from a chair
  • Pain that worsens when walking unevenly or climbing stairs, especially deep in the buttock
  • No numbness or tingling, which helps rule out nerve problem
  • Symptoms that are localized and do not spread below the knee. Oftentimes, it will be mistaken for a lumbar strain, sciatica, or arthritis of the hip due to the pain pattern.

How is Sacroiliac Joint Dysfunction Diagnosed?

Diagnosing sacroiliac joint dysfunction accurately is necessary since it has symptoms similar to other spine and hip conditions. You should start compiling a complete medical history. Expect questions about when your pain started, where you feel pain, and what activities exacerbate the pain. Factors including trauma, pregnancy, arthritis, and lumbar fusion surgery may also influence the SI joint.

After taking your history, your doctor will examine the area directly. The physical test begins by checking for discomfort in the SI joint, exploring the degree of movement possible, and noticing how the body moves into a particular position. Special tests like the FABER (flexion, abduction, external rotation) test, thigh thrust, and Gaenslen’s test put stress on the SI joint. If these movements give you symptoms, it is a good sign of dysfunction.

Although X-rays, MRIs, or CT scans can rule out other causes, including fracture, tumor, or disc problem, they rarely confirm SIJD. A diagnostic injection remains the most trustworthy strategy. Your doctor injects a local anesthetic into the SI joint under image guidance. If your pain reduces within a few hours, it confirms that the joint is the source of your symptoms. This test helps to accurately diagnose SI joint dysfunction (SIJD) and help your doctor determine the best next step.

Treatment Options for Sacroiliac Joint Dysfunction

Managing sacroiliac joint dysfunction (SIJD) is a stepwise process that starts with conservative measures and ends with more aggressive therapies if needed. Initially, rest and activity modification are crucial. You must avoid sitting for an extended period, like at a desk, and decrease high-impact activities, including running. This will help minimize the strain. You could also use ice therapy since it helps reduce inflammation during the first 48 hours of a flare-up, while heat packs relieve stiffness in the chronic stage afterward. Furthermore, using non-steroidal anti-inflammatory drugs or NSAIDs, like ibuprofen or naproxen, can help with pain and inflammation. They work well if you take them regularly and as per the instructions.

If these recommendations are ineffective, a prescription could be warranted. Muscle relaxants like cyclobenzaprine can ease spasms. Further improvement with stronger anti-inflammatories will help address deeper inflammation. SI joint belts or braces could be encumbered to help compress the pelvis and reduce excess motion. They are invaluable for SI joint dysfunction associated with pregnancy or post-injury cases. They are light, so they can be worn during the day while doing activities.

If your sacroiliac joint (SIJ) pain is more severe or persistent, interventional treatments can target the SIJ to provide more extended periods of relief. Through extractive imaging techniques, therapeutic SI joint injections (usually of corticosteroids) help alleviate inflammation. These injections can help for weeks to months but could cause local soreness and sometimes cause blood sugar spikes. Regenerative medicine treatments like platelet-rich plasma (PRP) or stem cell injections may be considered. However, they lack sufficient evidence and should be used cautiously.

Another procedure your doctor could recommend is radiofrequency ablation (RFA). It is a minimally invasive procedure that uses heat to disrupt the nerves that transmit pain around the joint. RFA can help some people receive longer-term relief, from 6 to 12 months, and most people suffer only mild discomfort after the procedure.

If non-invasive methods do not work, you may have to consider SI joint fusion surgery. This process inserts screws or implants to tie the sacrum and ilium together through a small incision. Surgery provides lasting stability but can also cause infection, nerve injury, and hardware complications. It will take 6 to 12 months to recover, starting with weight-bearing and gradually returning to regular activity.

Physical Therapy to Address Sacroiliac Joint Dysfunction

Physical therapy is one of the treatment options for sacroiliac joint dysfunction (SIJD). Physical therapy is designed to address the dysfunction in the SI joint. Some of the physical therapy interventions could include:

  • Pelvic tilts, bridges, and stabilization exercises — These exercises help strengthen the tissues that support the SI joint, especially in the case of hypermobility. They help prevent further dysfunction by increasing stability and reducing strain on joints.
  • Mobilization techniques — When the joint is stiff (hypomobility), therapists prescribe minor hip rotations and leg swings to increase flexibility and movement.
  • Stretching exercises — Focusing on stretching the piriformis and hamstring muscles can help stretch out stiff tissues, reduce discomfort, and improve mobility.
  • Core-strengthening workouts — Exercises like planks and bird dogs help build core strength, creating more support around the pelvis and decreasing strain on the SI joint during daily activities.
  • Manual therapy techniques — A physical therapist will apply force to the sacroiliac joint in a controlled fashion to realign it and break up any adhesions. They could also massage the soft tissues around the joint, which helps to improve blood circulation and reduce stress on the joint.

Can Sacroiliac Joint Dysfunction Be Prevented?

Even though you cannot always prevent sacroiliac joint dysfunction (SIJD), you can take several actions to help reduce the likelihood of developing it, especially if you are prone to joint stress or have disabilities or conditions that make you more vulnerable to SIJD.

Strengthening your core and pelvic muscles is one of the most effective methods. Exercises like planks, bridges, and bird-dog pose to strengthen the joint's stability. The SI joint can more effectively absorb loads and maintain alignment during movement. To keep the tissue that connects to the joint flexible, you can also stretch specific muscles regularly to prevent tightness that can yank on the joint. It is especially important to stretch your hamstrings, hip flexors, and piriformis.

Regular key exercises and stretches can help improve stability and flexibility around the joint. Sitting with lumbar support like a rolled towel and standing with weight evenly placed on both legs helps prevent undue stress on the pelvis that could result in problems. When picking up something, bend your knees instead of your waist so a sudden force does not twist your SI joint. If you engage in repetitive activities like running, dancing, or manual labor, you can incorporate different routines like cross-training and wearing special shoes to minimize wear and tear. Just as beneficial is avoiding a prolonged position, for example, sitting without a break.

Pregnancy is a common trigger of SIJD, so specific prevention strategies are important. Health professionals recommend prenatal exercises incorporating pelvic stability to help offset the impact of hormones loosening ligaments. After giving birth, slowly returning to your regular activities helps maintain joint health. If you have arthritis or have injured yourself in the past, you will need to manage inflammation through your diet and regular checkups to reduce the risk of SIJD. Incorporating orthotics or heel lifts to address leg length discrepancy can help correct the slightly uneven gait that leads to joint stress.

Falling or being involved in accidents causes injury. Furthermore, being born with a condition that makes you loose-jointed, like hypermobility syndromes and degeneration due to age, can still cause SIJD. However, it is possible to lower the risk of developing this dysfunction. Doing low-impact exercises regularly, keeping weight down to avoid straining the joints, and seeking treatment for minor issues early on are great ways to delay or prevent the progression of SIJD.

Nutritional Considerations and SI Joint Health

Although physical therapy and specific exercises are important in treating sacroiliac joint dysfunction (SIJD), do not forget nutrition. The food you eat can contribute to the body’s inflammation levels and overall joint health. This could affect the discomfort from SI joint dysfunction (SIJD), especially with sacroiliitis, which is the inflammation of the SI joint.

You can complement the therapy with an anti-inflammatory diet to reduce the inflammatory aspect of SIJD. Some food is capable of decreasing inflammation in the body. Eating foods like salmon, mackerel, and tuna, which are rich in omega-3s found in fatty fish or plant sources like flaxseeds and walnuts, can help combat inflammation. Eating lots of colorful fruits and vegetables gives you antioxidants, which help fight inflammation and other health issues. These include berries, leafy greens, broccoli, and bell peppers, which are good to include regularly.

Another important nutritional consideration for SI joint health is maintaining a healthy weight. Excess weight causes stress and a load on the joints. Eating a healthy diet and exercising regularly can help people with SIJD achieve a weight that does not place additional mechanical stress on the two joints affected. Choosing good food for a healthy weight can indirectly help keep SI joints healthy.

Furthermore, drinking enough water is necessary for the health of all tissues, including the ligaments and cartilage surrounding the SI joints. Water keeps these tissues elastic and functioning. Low hydration levels can put the tissues under stress and cause injury. Drinking enough water daily is one easy way to promote healthy joints for overall health and wellness.

Dehydration can make tissues more prone to stress and injury. Ensuring sufficient daily water intake is a simple yet important means of protecting overall joint health.

Finding the Right Physical Therapist for Your Needs

When you need a physical therapist for a particular condition like sacroiliac joint dysfunction (SIJD), it helps to know the different focus areas. All licensed physical therapists understand physical therapy, but others advance their skills and practices in specific conditions and body parts.

When looking for a physical therapist for SIJD, you would hope to find one who specializes in orthopedic physical therapy or manual therapy. Some of the categories to look out for include the following:

  • Orthopedic physical therapists — Physical therapists who specialize in orthopedic physical therapy are trained in the musculoskeletal system (bones, muscles, ligaments, tendons, and joints). SI joint dysfunctions involve these tissues. They have been trained to evaluate and treat many orthopedic conditions, including spinal and pelvic pain.
  • Manual therapists — These specialists are trained to use hands-on techniques, including putting joints and tissues into a certain position to help relieve pain. These skills are often essential for addressing the biomechanical and pain issues associated with SIJD.

Although a general physical therapist can help, a therapist with a specialty or significant experience in orthopedic or manual therapy will probably know more about SI joint mechanics, common movement dysfunctions that occur with SIJD, and the best treatment approach. They will have the right tools to diagnose the problem by performing special tests and drawing up a treatment plan tailored to you.

Find a Physical Therapist Near Me

Having sacroiliac joint dysfunction is like having annoying pain all day long that makes it hard to do normal daily activities. However, if you understand the condition and the treatments available, it is a considerable step to regaining your comfort and mobility.

You do not want SI joint pain to limit your life. You can find significant relief and improved function by taking the right approach and concentrating on targeted exercises, changing your lifestyle, and manual therapy.

If you are looking for relief, specialized physical therapy can help manage SIJD. Explore your treatment options today. Do not let the pain hold you back any longer. Call Suarez Physical Therapy today at 702-368-6778 to seek treatment from a qualified Las Vegas physical therapist.