There are several factors that may contribute to the development of sacroiliac joint pain. These factors need to be assessed and corrected with direction from an Osteopath and may include:
- Biomechanical abnormalities
- Poor posture
- Lumbar spine stiffness
- A sedentary lifestyle
- Poor core stability
- Inappropriate lifting technique
- Being overweight
- Muscle imbalances, weakness or tightness
- Leg length differences
- A lifestyle involving large amounts of sitting, bending or lifting
- The pelvic girdle changes associated with pregnancy may also contribute to the development of sacroiliac joint pain.
Treatment depends on the cause of the pain and can include:
Osteopathy focuses on pain control in the acute phase. Modalities such as dry needling, superficial cold treatments, deep tissue massage, myofascial release, and muscle energy stretching techniques can help reduce pain.
Pelvic myofascial stretching in the neutral spine position can be used for immediate, short-term relief of discomfort. By identifying activities that aggravate the condition, the Osteopath can have the patient avoid these activities.
The recovery phase cannot proceed without an active, aggressive rehabilitation program. Often, SIJ injury leaves patients with significant deconditioning and muscle imbalances. These functional muscular deficits were sometimes present before the injury and may have predisposed the patient to injury. Some muscles are known to be functioning in a tight or shortened position, such as the hip flexors, hamstrings, tensor fascia lata, obturator internus, and rectus femoris. Other muscles may be weak or inhibited, such as the gluteal and abdominal muscles.
Treatment begins by correcting any mechanical or leg-length asymmetries (eg; orthotic/shoe lift), stretching overly tight lumbopelvic muscles, and strengthening weak and inhibited muscles.
Stabilisation exercises are performed with the patient in a more dynamic, functional position and often include balance and proprioceptive activities. Strengthening of the core muscles surrounding the spine is essential.
Finally, the patient will progress to sport or work specific training designed to return the patient to his or her previous level of functioning.
In patients who develop chronic injuries, an SIJ belt can provide compression and feedback to the gluteal muscles. Patients with ligamentous hypermobility can especially benefit from this apparatus because the belt can reduce SIJ rotation. Orthotics can decrease leg-length inequalities; these include custom-fitted orthotics, internal shoe lifts, and external shoe lifts.
Osteopaths are a key healthcare professional to treat Sacroiliac Joint Pain. If you see this condition with any of your patients, please think of referring to us so that we can assist you in getting the best results possible for your patients.