Sacroiliac Joint Dysfunction (SIJD)
Clinical Symptoms of Sacroiliac Joint Dysfunction
1. Lumbosacral pain
2. Buttock Pain
3. Pain radiating to the leg
4. Hip pain
5. Groin pain
6. Urinary frequency
7. Iliac crest pain
8. Transient numbness, prickling or tingling
9. Increased pain with menstruation
10. Increased pain with sexual intercourse
11. Increased pain with stair climbing
12. Increased pain with sustained positions (i.e., sitting, walking, lying)
Only about 15% of SI patients need surgical intervention. Many can actually benefit from CORRECT/ACCURATE SI Therapy (can be hard to find!). It may sound like everyone with SIJD needs surgery but in reality it’s mostly those of us who’ve already had chronic SIJD instability, long term. Because we sustained too much dam…age BEFORE we’ve actually found effective SI therapy protocols! Severe SIJD patients can be less likely to stabilize from therapy alone because sometimes the joints and soft tissues have already suffered too much structural and soft tissue damage. Yet, as you know, there is no rule book that can predict how SIJD effects each person! Some SI patients stabilize surprisingly well even after suffering for years once they locate an effective PT!
SACROILIAC JOINTS :
The sacrum is the lower portion of the spine where several vertebrae are fused together. The sacrum has a joint on either side with the ilium, the back part of the pelvis. The pubic rami, the front part of the pelvis, fit together in the front forming the pubic symphysis. The sacroiliac joints are L shaped in contour with a shorter upper and longer lower arm. Normally the sacroiliac joint is configured in such a way that the bones have an interlocking structure, which assists in keeping them properly aligned. In some cases the opposing joint surfaces are quite flat. This type of joint is much less stable and can lead to a shearing or sliding misalignment. Some sacroiliac joints reverse the normal concave-convex ‘locking’ relationship, which can lead to rotational misalignment. The variation in joint configuration results in a corresponding variation in integrity. This means that some sacroiliac joints are inherently weaker or more prone to misalignment.
A clear understanding of the difference in the signs and symptoms of sacroiliac joint dysfunction and other pathologies is key in making the proper diagnosis. Because the diagnosis of SI joint dysfunction is made primarily from the patient’s subjective complaints and the physical evaluation, it’s diagnosis is somewhat problematic for the clinician.
The most common manifestation of sacroiliac joint dysfunction is acute pain in the low back, in the area of the Posterior Superior Iliac Spine (PSIS) positioned approximately 2 inches from the midline and very deep-seated. Usually, tenderness is found near the lumbo-sacral promontory and in the PSIS area, one more pronounced than the other. Radiating pain into the buttock, hip, groin and thigh is often experienced. The pain is frequently increased by prolonged sitting, standing, walking or lying. The patient reports that frequent position changes are needed to maintain any degree of comfort.
QUESTION: Is there more than ONE kind of Sacroiliac Joint Dysfunction?
ANSWER: YES! There are 5 types of Dysfunctions which affect the Pelvic Girdle and can cause symptoms of pain to be experianced in the low back region.
CLINICAL EXERPT written by Dr.Alan Lippitt, MD:
5 types of Dysfunctions:
1. ILIAL UPSLIP OR SHEAR WITH ILIAL ROTATION
2. ILIAL DOWNSLIP
3. ILIAL ROTATION AND/OR FLARE
4. SACRAL DYSFUNCTION
5. PUBIC LESION