Sacroiliac Joint Dysfunction: Overview, Causes, and Chiropractic Care

Sacroiliac joint dysfunction (SIJD) refers to pain and improper functioning in one or both sacroiliac joints, located where the sacrum connects to the ilium of the pelvis. These joints play a key role in transmitting weight from the upper body to the legs and absorbing shock during movement. Dysfunction can arise when these joints become either too mobile (hypermobile) or too restricted (hypomobile), leading to discomfort and impaired movement.

Mechanisms and Causes of Sacroiliac Joint Dysfunction

Joint Instability(Hypermobility)

SIJ moves too much that causes the surrounding muscles and ligaments need to work harder to keep the joint stable.

Causes of hypermobility:

• Trauma: Direct injuries or falls can misalign or damage the joint.
• Pregnancy: Hormonal changes during pregnancy cause ligamentous laxity, increasing the risk of SIJD as the pelvis shifts.
• Connective tissue disorders: Conditions like Ehlers-Danlos syndrome can lead to overly flexible joints, including the SI joint.

Joint Stiffness(Hypomoility)

In contrast, SI joint moves too little or becomes fixation that leads to compensatory movement patterns and pain.

Causes of hypomobility:

• Arthritis: Inflammatory conditions such as osteoarthritis or ankylosing spondylitis may affect the sacroiliac joint, leading to dysfunction.
• Postural imbalances: Poor posture, particularly in the lower back and pelvis, may lead to chronic stress on the SI joints.
• Chronic inflammation: Repetitive stress or inflammation can cause fibrosis in the ligaments, reducing joint movement.
• Prolonged immobility: Sedentary lifestyles or prolonged sitting can lead to stiffening of the joint.

Leg length discrepancies

A difference in leg length can place uneven stress on the SI joints, contributing to dysfunction. The joint on the shorter leg side may become hypermobile as it compensates, while the joint on the longer leg side may become hypomobile.

Muscle Imbalances

Muscles surrounding the pelvis, like the gluteal muscles and the hip flexors, play a significant role in stabilizing the SI joint. When the weakness and tightness occurring in these muscles, misalignment and uneven forces distribution in the SI joint can lead to dysfunction. Core weakness can put excessive strain on the SI joint, which fails to provide proper stabilization for the pelvis and lower back.

Repetitive Stress

Activities involving repetitive motions, like running, heavy lifting, or twisting, can cause wear and tear on the sacroiliac joint. Over time, this can lead to inflammation, joint degeneration, and dysfunction. Occupations that require heavy physical labor or athletes are at a higher risk for SIJD due to repetitive stress.

Inflammatory Component

The latest research has shown the inflammatory processes to play a role that develop chronic SIJD rather than pure mechanical causes. This emerging new concept suggests that individuals with autoimmune conditions such as ankylosing spondylitis (AS) or psoriatic arthritis (PS) may prone to SIJ inflammation.

Neurological Factors

A recent study found SIJ pain suffers often exhibit decreased proprioception in the pelvic region. It contributes to compensatory movement patterns and a higher risk of injury to lumbar spine and hip joints. Compared to the traditional strength and mobility exercises for SIJ, this focuses on and integrate proprioceptive training into rehabilitation programs.

Symptoms

The most common symptom of SIJD is pain, often described as sharp or aching, in the lower back or buttocks. This pain may radiate to the thighs or groin, and it often worsens with standing, sitting for prolonged periods, or climbing stairs. In some cases, individuals experience stiffness or reduced mobility in the lower back and pelvis.

Chiropractic Management of SIJD

Chiropractic care offers a non-invasive and effective approach to managing sacroiliac joint dysfunction. Chiropractors assess the alignment and mobility of the pelvis and spine to address the root cause of dysfunction. Several techniques may be employed:

• Chiropractic Adjustments: Specific spinal manipulations are used to restore proper alignment and mobility to the SI joint. This can help alleviate pain and improve function by addressing joint restrictions or misalignments.
• Soft Tissue Therapy: Chiropractic care may include soft tissue techniques such as massage or myofascial release to reduce muscle tension and inflammation around the SI joint.
• Postural Correction and Exercises: Chiropractors often recommend corrective exercises to improve posture and strengthen the muscles supporting the pelvis, reducing the risk of future dysfunction.
• Pelvic Blocking Techniques: Some chiropractors use specially designed blocks to adjust the pelvis and restore balance in the sacroiliac joints without the need for forceful manipulation.

Other Treatment Options:

Physical Therapy, Acupuncture, Anti-inflammatory drugs, Sacroiliac joint injections,Prolotherapy and platelet-rich plasma (PRP) therapy, Radiofrequency ablation(RFA), Bracing or SI belts and Surgery.

Precautions and Long-term Care

To prevent recurrences, individuals with SIJD should focus on improving core strength, flexibility, and posture. Chiropractors may recommend lifestyle adjustments, such as avoiding prolonged sitting or standing, using proper lifting techniques, and addressing any contributing factors like leg length discrepancies or poor footwear.

Conclusion

Sacroiliac joint dysfunction is a common condition that can significantly impact daily activities. Chiropractic care offers a holistic and patient-centered approach to managing SIJD, with a focus on restoring alignment, improving function, and preventing recurrence. Early intervention can lead to better outcomes and help patients regain their quality of life.

For those experiencing chronic lower back or pelvic pain, a comprehensive assessment by a chiropractor can determine whether sacroiliac joint dysfunction is the underlying cause and help develop a tailored treatment plan.