Sign in

What is Sacroiliac Joint Pain?

Hey everybody, this is Mike Uhrlaub with another episode of Power Your Life. I want to talk to you about “What is Sacroiliac (SI) Joint Pain”, also commonly called “RSI Joint Dysfunction” or “SSI Joint Pain”.

It’s an extremely common back condition, but before I get into that, I want to talk about a client of mine I had a while back, Sue.

Sue came to me with intense lower back pain. She had slipped on her wood deck right after it rained and tweaked her back. Now, she couldn’t sleep or put her socks and shoes on. There was this really intense, low back pain and no one could seem to figure out what was going on. After going to a couple of doctors she eventually found her way to a neurosurgeon who did an MRI.

Image for post
Image for post

They told her she had a herniated or a bulged disc and that she needed surgery. She came to me before getting the surgery and I identified a sacroiliac or SI joint problem. However, her pain continued to get so intense she opted get the surgery. About three or four months after her surgery the pain was still the same. She returned to me frustrated her situation hadn’t changed. After assessing I found there was still a sacroiliac joint problem.

We had to be very careful because we had to make sure that our fusion was completely stable and taken care of. But as we worked on getting her sacroiliac joint taken care of, her symptoms and pain started to get better. Working with getter her SI joint aligned we progressed to keeping it stable and her pain went away. She was finally able to return to work, put on her socks, shoes, and life for her got much better.

She was really angry for a while because she was told it was one thing and the surgery didn’t fix it. Then she’s coming in and being treated for something else which fixes her problem. She asked me “why did I have surgery in the first place?” That was a valid question for her to have. Had surgery fixed the problem, her pain should have been taken care of.

Where is the SI Joint?

[caption id=”attachment_7245" align=”alignright” width=”300"]

Image for post
Image for post

Pelvis with descriptions of areas.[/caption]

You have what is called an ilium on each side. In between here, you have your sacrum and tailbone. When we say SI joint, we mean the sacroiliac joint. You have two of them: a right and a left. The joint between the ilium and tailbone is sacrum. When you bend forward and backward, they rotate back and forth on each other. There are a lot of thick ligaments that hold everything together. There’s a ton of muscle around this area to stabilize and hold it in place.

What can happen, is the pelvis, known as the allium, can rotate and get stuck. Whether it be forward, backward, twisted, or jammed up. We call those “sacral torsions”. All of those things will pull and torque on that joint setting off inflammation and making it extremely irritated and very sore. A lot of pain in that area can mimic other back problems. That’s why it’s very important to go to somebody who knows what they’re looking at. Just because you do an MRI of the spine and see bulges of the discs, doesn’t mean that’s what the issue is.

Ranging from hip pain, sciatica issues, muscle tightening around the area pinching off a nerve, to phantom disc pain. This makes it confusing and hard to pinpoint SI joint pain. Another issue is x-ray’s and MRI’s don’t show direct turning of the SI joint or it getting stuck. If your doctor is not aware of the SI joint problems or not versed, he can misdiagnose it for a disc related problem. That’s why it’s really dangerous to only treat according to what the x-ray or MRI shows. You have to treat somebody based on their symptoms. I’m very passionate about that because things can be missed if you’re not looking really closely. There’s special testing and things we do that can differentiate between them.

We use techniques that utilize the natural contractions of the muscles, hip, and spine to actually realign and pull back into place. But the key to fixing these problems are fixing the imbalances.

The Gluteus Medius, Gluteus Maximus (butt muscles), hip tightness, hamstrings, and lower abdominals can all affect your SSI joint. Weakness in these can cause a loss of mobility and issues in your nervous system. You need these in order to bend over, touch your toes, tie your shoes, or lift things. If your hips don’t allow for that movement, a lot of stress goes right to that SSI joint. It can start to inflame the joint and cause it to lock up.

Image for post
Image for post

If you don’t have that balance, you can’t fix that problem. The SSI joint problem is often misdiagnosed because when you go to get taken care of, they don’t always consider all of the sources. They take an x-ray or send you for an MRI and everything else isn’t looked at. They’re not looking at what’s going on with your gluteal muscles, hip joint, or hip flexors. If you go in, then they just look straight at your back and they’re not looking everywhere for a potential issue then what you get is a prescription for pills, injections, or like Sue, can end up with surgery.

Just like Sue, this may not fix your problem, just prolong the issue. If you’re not addressing imbalances, not looking at the areas above and below the spine or that area in question, you’re going to miss something.

This is the take home message I wanted you to have about this talk today. You can go to this SSI joint and inject or realign it, but if you don’t fix the things pulling it out of place, guess what’s going to happen? It’s going to get pulled back out again. Three or four months later you’re going to be dealing with the same issue. Fixing those imbalances is the key.

If you would like to find out what the five best kept secrets are for fast back pain relief. I have this new eBook put together and it gives you just that. All you have to do is email me at Mike@flex-pt.com or message us through Facebook messenger. Just say, “Hey, I want the new back pain eBook” and we’ll get that sent out to you right away.

I’d like to leave you with this thought-provoking quote from Joyce Meyers.

Image for post
Image for post

I ran across this quote earlier and I think it really fits us today. The struggles we go through are real, but there is hope. There is a reason we go through these struggles; it develops our strength and stamina we will need down the road. I’ll let you guys think on that one for a while. Until next time, Power Your Life and keep moving forward.

I am a Physical Therapist and CEO/Owner of Flex Physical Therapy.

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store