Over the last few years, I have treated various individuals (male and female, young and old), for a condition that is often under and/or misdiagnosed. Patients usually come to my office as a last resort – after trying various treatments that have not provided them with any longer term success. These patients usually complain of locking or discomfort in their hip joint and point to an area above their buttock. Sometimes, they complain of lower back pain or thigh pain. After a history and physical examination, I notice that it is neither the hip or back that is the source of pain/discomfort. In other words, the pain/discomfort/locking maybe a consequence of a bad back or hip, but not the source of the pain. The type of condition that I diagnose is known as Sacroiliac Joint Dysfunction (SI Joint Dysfunction). Try saying that name five times fast.
What is the Sacroiliac Joint?
The sacrum is the triangular bone located at the bottom of the spinal column. Above the sacrum, you find articulation with the last lumbar vertebrae (L5) and below is the joint made with the coccyx (tailbone). At either sides of the sacrum you have two ilium or ala. The sacroiliac joint is the joint that is formed between the sacrum and ala. The ilium is the bone that also forms part of the area of the hip joint (where the thigh bone, known as the femur, articulates with the ala). The hip joint is the joint that allows us to move our thighs freely in many directions – upwards, outwards and backwards.
What is the function of the Sacroiliac Joint?
The function of the SI joints is to allow torsional or twisting movements as well as to provide shock absorption from the forces coming above and/or below the joint. Our thighs and legs act like long levers and without the sacroiliac joints and other joints within the area, the pelvis would be at greater risk of fracture or injury.
What is Sacroiliac Joint Dysfunction? What does dysfunction mean?
Sacroiliac Joint Dysfunction refers to the SI joint not working properly. Sometimes the joint can be either too tight (hypomobile) or too loose (hypermobile). Said another way, the joints can either be locked/restricted (hypo) or loose/abnormally moveable (hypermobile). When you have a hypo or hyper SI joint, you influence the ligaments, muscles and other surrounding soft tissues in the area (gluteal muscles, piriformis muscles, etc). As a result of the dysfunction, you change the biomechanics of the joints above and below the area – the back and the hip joints. The question is – Is it an injury or dysfunction to the back or hips that causes the SI joint dysfunction OR is it the SI Joint dysfunction that causes the hip and/or back pain? This is the chicken and egg scenario that we commonly get faced with as health practitioners. I think it can go either way.
What Conservative Treatments are available for SI Joint Dysfunction?
Chiropractic adjustments work very well for SI Joint Dysfunction. Furthermore, I find that electrotherapy, soft tissue therapy, laser therapy and taping techniques, in combination, also help. Of course, it is important to address the other joints in the region to ensure that they are functioning properly. Strengthening exercises are also prescribed for the lower back, core, gluts and legs.
What is a Chiropractic Adjustment?
An adjustment is a highly skilled and precise movement usually applied by hand to a joint of the body. Adjustment loosens the joint to restore proper movement and optimize function.
When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about.
Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor. Your chiropractor is well-trained to determine if your problem will respond to chiropractic care or if you require referral to another health care provider.
-Ontario Chiropractic Association
I hope you have enjoyed this blog post. Please feel free to write any comments or to contact me if you have any questions.
Dr. Luciano Di Loreto
Chiropractor & Acupuncture Provider