Blog post produced and written by Sports Therapist Rui Costa.
What is Lower Back/SIJ Dysfunction?
Lower back pain is a prevalent musculoskeletal issue affecting individuals worldwide. A significant yet often overlooked cause of this discomfort is sacroiliac joint (SIJ) dysfunction. The SIJ connects the sacrum (the triangular bone at the base of the spine) to the iliac bones of the pelvis, playing a crucial role in load transfer between the upper body and legs. Dysfunction in this joint can lead to lower back pain, hip discomfort, and even radiating sensations down the legs.
SIJ dysfunction can result from various factors, including trauma, pregnancy, repetitive stress, leg length discrepancies, arthritis, or poor movement patterns. Symptoms often mimic sciatica, making accurate diagnosis challenging without a thorough assessment.
Why is SIJ Dysfunction Relevant?
Lower back pain is a leading cause of disability, affecting millions globally. SIJ dysfunction accounts for an estimated 15-30% of all lower back pain cases. Misdiagnosis can lead to ineffective treatments, prolonged discomfort, and unnecessary medical expenses.
A Patient’s Story: Recognising the Signs of SIJ Dysfunction
Recently, I treated a patient who had been experiencing chronic lower back pain for over a year. They had tried chiropractic care, massage therapy, and even a cortisone injection in their lumbar spine—but nothing provided lasting relief.
Upon assessment, I noticed their pain was aggravated by prolonged sitting, standing on one leg, and transitioning from sitting to standing. Specific tests, such as the FABER test and SIJ compression test, suggested sacroiliac joint involvement rather than a primary lumbar spine issue.
Treatment Approach: How We Addressed SIJ Dysfunction
Once we identified that the pain was due to SIJ dysfunction, we implemented a targeted rehabilitation plan, including:
- Leg strengthening exercises: Squats, lunges, and resistance band exercises to improve lower limb strength and support pelvic stability.
- Manual therapy: Mobilization techniques to enhance joint mobility and reduce discomfort.
- Mobility work: Exercises to reduce hip and lower back stiffness, promoting flexibility.
- Gait retraining and posture education: To promote proper movement patterns and prevent recurrence.
After four weeks, the patient reported a 50% reduction in pain. By eight weeks, they were pain-free and had regained full mobility, allowing them to return to their active lifestyle.
Research Behind SIJ Dysfunction and Treatment
Studies have shown that rehabilitation-based treatments can be effective for SIJ dysfunction. A systematic review and meta-analysis published in the Journal of Manual & Manipulative Therapy examined the efficacy of manual therapy for sacroiliac joint pain syndrome. The study found that manual therapy appears efficacious for improving disability in adults with SIJ pain syndrome, while its efficacy for pain reduction is uncertain.
Another study published in Pain Physician assessed the effects of manual therapy and home-based exercises on patients with SIJ dysfunction syndrome. The findings suggested that manual therapy, combined with specific sacroiliac joint exercises, provided significant pain relief and improved function.
Conclusion: Take the Right Approach to SIJ Dysfunction
Lower back pain can have multiple causes, and SIJ dysfunction is often overlooked. If you suffer from chronic lower back pain that hasn’t improved with traditional treatments, consider getting a professional assessment for SIJ involvement. Targeted rehabilitation and conservative management can provide lasting relief without the risks associated with injections or surgery.
If you’re struggling with persistent lower back pain, don’t wait—seek guidance from a qualified physiotherapist or musculoskeletal specialist to get the right diagnosis and treatment plan.
Note: This blog post is for informational purposes only and should not replace professional medical advice.
If you are ready to take the next step in your health journey, contact us today to schedule an appointment with one of our experienced physiotherapists. Let us help you achieve your health and wellness goals through personalised, evidence-based care.
