What is S-I Joint
Dysfunction?
By Dr. Robert V. Duvall, DPT, MPT, ATC,
MGFI
The S-I joint is
one of the most misunderstood areas of the human body. It has
been the source of much controversy in the medical community for many years.
Much of the debate relies on the fact that there are few reliable evaluation
methods for the S-I joint.
Contrary to disc
injuries, which can be evaluated using many types of diagnostic tools,
examining the S-I joints has proved to be quite unreliable. Clinicians need
to rely mostly on their experience rather than simple methods used to
examine the low back. Most medical professionals do not acknowledge it as a
source of pain and dysfunction. So patients leave a medical office with an
incomplete evaluation and often times, an inaccurate diagnosis.
The S-I
(Sacro-Iliac) joint is comprised of two bones; the sacrum and the ilium. You
have two S-I joints (left and right). They are located basically where the
spine meets the pelvis. Look for the two dimples in your low back. These two
joints allow for very little movement overall as compared to other more
prominent joints such as your hip or shoulder. The pelvic girdle is
generally described as the two S-I joints, the pubic symphysis (pubic bone
in front), the two hip joints, and the bottom two vertebrae (L4, L5).
What do you
feel?
Pain located at or
near the S-I joint on one side or both sides. Pain located in the low back,
buttock, and/or groin area. Another common symptom of a S-I joint
dysfunction is “sciatica”. Sciatica is best described as a sharp, often
shooting pain that begins in the buttocks and goes down the back of one leg.
S-I joint dysfunction may also cause nerve irritation of the nerves that
supply the groin or front of your thigh.
Other symptoms
include:
- Weakness in one
leg or both legs; difficulty standing on one leg and raising the other
leg (like marching)
- Numbness and
tingling in one leg (pins & needles)
- A burning pain
located near the “dimples”
- Difficulty
raising from a chair
- Muscle discomfort
in the buttock, hip, or low back (over 30 muscles attach to the pelvis;
from the hip, buttock, thigh, low back.
How does this
happen?
S-I joint
dysfunction is usually caused by an imbalance in the muscles of the hips and
glutes and it can also be caused by a fall or other traumatic event, such as
a car accident.
A condition known
as “hypermobility” may also predispose an individual to S-I joint
dysfunction. “Hypermobility” is best described as a condition in which the
joints have too much mobility. This condition generally affects women more
than men. Different hormone levels present in women, specifically “relaxin”,
can influence hypermobility. This hormone is released to prepare the body
for pregnancy, and its level in the blood changes throughout pregnancy
process. It basically causes the ligaments to “relax” and allow for more
movement to occur in the pelvic girdle region.
The best
treatment options
First of all, the
evaluation is critical to the success of treating a S-I joint dysfunction.
Most dysfunctions can be treated with manual techniques that generally
involve “mobilizations”, “manipulations”, or “muscle energy techniques”.
These techniques must be applied by a skilled medical professional, such as
a physical therapist. These techniques can prove to be quite helpful when
utilized appropriately following a thorough evaluation.
Once appropriate manual techniques have been administered, a comprehensive
exercise program must be implemented to address the following areas,
specifically muscle imbalances:
- Lumbar
stabilization program: strengthening abdominals and buttock muscles
- Improve
flexibility in lower extremity musculature
Some cases may only
need a detailed exercise program that addresses the muscle imbalances. You
can learn more about how to identify and address your muscle imbalances by
visiting
The Healthy
Back Institute for great back pain and sciatica relief exercises, back pain
information, support and expertise to help you get rid of the
back pain and sciatica.
Some S-I joint
dysfunctions may linger on for months and even years. Remember, if you are
engaged in a current treatment plan with little to no improvement, seek
other options. If you think you may have a S-I joint dysfunction, the first
step is to find a healthcare professional who is skilled and experienced in
addressing muscle imbalances.
For more
information on S-I Joint Dysfunction and how to treat it effectively,
learn more
about the lose the back pain system.
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Copyright January 2007
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