Treating Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction describes the pain and discomfort that occurs from improper (too frequent or not frequent enough) use of the sacroiliac joint. The sacroiliac joint is attached to both sides of the spinal column and is located in the lower back. Its primary function is to assist the body in weight redistribution from the upper body to the legs upon standing. When the joint is over or underused, it can become inflamed, causing individuals to experience a sharp pain in the lower back. Pain can also migrate from the back to the thighs, upper back, and buttocks. Fortunately, there are several options for treatment.

Supports And Braces

Overuse of the sacroiliac joint can cause it to become too loose, leading to slipping and irritation of the tissue surrounding the joint. A loose sacroiliac joint is considered hypermobile. Individuals with a hypermobile sacroiliac joint may find relief from a variety of supports and braces, designed to keep the loose joint in place, leading to decreased irritation, inflammation, and pain. A pelvic brace is a commonly used stabilizer for the sacroiliac joint. Pelvic braces, which are made of breathable, stretchy material, are typically four to eight inches in size and are worn tightly around the waist to limit pelvic mobility. When worn properly, a pelvic brace can help realign the pelvis and promote healing and reduce stress on the sacroiliac joint.

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Pain Medication

Individuals experiencing mild to moderate pain may find relief in over the counter medications. Anti-inflammatories, such as ibuprofen, and pain relievers, such as acetaminophen, can be used to reduce pain-inducing inflammation. Individuals with more severe symptoms may need to speak with a doctor for stronger medications to combat symptoms. These may include narcotic pain medication and muscle relaxers. Narcotics reduce pain by attaching to opioid receptors in the brain to block signals of pain to the brain, while muscle relaxers interact with the brain to reduce muscle stiffness. Although muscle relaxers and narcotics can quickly and efficiently reduce pain caused by sacroiliac joint dysfunction, they are not recommended as the first course of treatment nor should they be used for long periods, as the potential for addiction is high.

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Cold Or Hot Compresses

One of the primary causes of pain in sacroiliac joint dysfunction is due to the inflammation and swelling of joint tissue. Cold compresses or hot compresses can be beneficial in not only providing pain relief but can also aid in joint tissue recovery and the reduction of muscle spasms and tension. An ice pack placed on the lower back and in the pelvic region can reduce swelling and provide temporary pain relief to the region affected. A moist or dry hot compress can loosen stiff muscles and increase the range of motion. It is often recommended that hot and cold therapy be used in tandem, with twenty minutes of hot therapy used to reduce muscle tension and allow light rotation and stretching of the joint and surrounding muscles, followed by twenty minutes of cold therapy to reduce any swelling that may have occurred with light exercise and promote healing.

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Rest Period

Since sacroiliac joint dysfunction is often caused by overuse of the sacroiliac joint, a brief rest period of one or two days can be beneficial. Rest allows this joint to recover and heal without further damage. Doctors may suggest patients with sacroiliac joint dysfunction refrain from all physical activity during this time or may encourage them to only engage in light activity and to avoid weight-bearing exercises that may cause further damage. During the period of rest, patients may utilize other treatment methods to aid in their recovery, including the use of medications and hot compresses or cold compresses. It is important to note the period of rest should not extend beyond two days as extended periods of non-use can actually increase stiffness and joint immobility.

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Manual Manipulation

Patients who find little to no relief with common methods of treatment for sacroiliac joint dysfunction and experience pain from under usage of the joint can include manual manipulation to their treatment regimen. This method of treatment has been found to be highly effective and is performed under the care of an osteopathic physician or chiropractor. Manual manipulation involves adjusting the hips and lower back region by applying pressure and light rotation to the sacroiliac joint, hips, pelvis, and muscles surrounding the lower spine. This treatment decreases joint immobility and muscle stiffness and pain while increasing range of motion and flexibility.

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Physical Therapy

A physical therapist or another qualified health professional can perform what is referred to as manual manipulation, which is proven to be effective in treating sacroiliac joint pain. Physical therapy is known to be useful for individuals affected by sacroiliac joint dysfunction who are in pain due to too little motion. The physical therapist or other medical professional applies physical adjustments to a patient's sacroiliac hips joint and lower back. The goal of these physical adjustments is to decrease tension in the muscles, reduce joint fixation, and restore an adequate range of motion. When an individual with sacroiliac joint dysfunction experiences pain and disability due to their sacroiliac joint being too lose, the use of medical braces or supports can be effective. A physical therapist can help patients learn how to perform daily tasks and adapt to the presence of a brace or supports.

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Certain Injections

Certain injections may need to be used to help alleviate symptoms caused by sacroiliac joint dysfunction. The injections used to treat pain from sacroiliac joint dysfunction are comprised of an anesthetic substance like lidocaine and a steroid such as cortisone. This mixture is injected directly into a patient's sacroiliac joint in the lower back and hip. These injections can work for a minimum of one day up to a maximum of a few years. These injections may be administered once a month until the patient has met the threshold of three injections within one year. The numbing medication in the injections can alleviate an individual's pain for up to between twenty-four and forty-eight hours following its administration. After the numbing medication wears off, the steroid part of the injection can help provide relief from symptoms associated with inflammation around the joint for a longer duration.

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Chiropractic Adjustment

The goal of chiropractic treatment for sacroiliac joint dysfunction is to find a method that yields the best outcome but is also well tolerated. There are two main chiropractic adjustment techniques used to treat sacroiliac joint dysfunction. Low velocity, low amplitude thrust spinal mobilization is a gentle technique. High velocity, low-amplitude thrust or spinal manipulation is a more traditional approach, and though it is not as gentle as the spinal mobilization method, it can be more effective. The traditional chiropractic maneuver or adjustment makes the cracking sound similar to what is heard when cracking the knuckles. The actual sensation of this maneuver is usually relieving even when the sounds give an impression of something uncomfortable. Some patients cannot tolerate the sound effects of this traditional approach and choose do undergo spinal mobilization instead.

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Joint Fusion Surgery

An individual with sacroiliac joint dysfunction that has not been responsive to the use of other treatment methods may be advised to undergo a procedure referred to as joint fusion surgery. During a joint fusion surgery, the cartilaginous tissue that covers and protects the surfaces of the sacroiliac joints is excised. Special plates and screws are used to hold the patient's sacroiliac joint bones in place against each other until the bones fuse or grow together over time. A surgeon may use a bone graft across the affected joint in some patients. This type of procedure stops all forms of motion at the affected joint, which alleviates pain. This type of procedure is only recommended when other nonsurgical treatment methods have been used for between eight and twelve weeks and have not been effective. While joint fusion surgery has shown to be relatively successful at alleviating the pain associated with sacroiliac joint dysfunction, it does not work for everyone.

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Yoga

Certain yoga poses are more beneficial for individuals affected by sacroiliac joint dysfunction than others. Asymmetrical forward bends and twists can assist with decrease the torque through the sacroiliac joint. Standing poses and simple backbends can help with building, strengthening, and maintaining the muscles associated with the sacroiliac joint. Maintaining the strength of these muscles can help prevent further pain due to sacroiliac joint dysfunction and displacement of the joint. While yoga exercises have shown to help many patients affected by sacroiliac joint dysfunction, incorrectly performing these poses can cause the joint to become stressed further and cause injury.