The sacroiliac joints connect the base of the spine to the pelvis , supporting and stabilizing the spine as you walk, climb stairs, bend over, and lift heavy objects. An injury or trauma to the sacroiliac joint can cause instability in the legs and is a common cause of back pain .
There are several treatment options for iliac joint pain, from physical therapy to surgery . Many people also find relief, temporary or permanent, not too technical, through gentle and targeted body movements.
This article looks at the causes and symptoms of sacroiliac joint pain and various ways to treat it. It also includes a list of exercises and stretches that you can try at home to strengthen and stabilize your SI joints and relieve pain .
What is sacroiliac joint instability?
Injury to one or both SI joints can compromise their stabilization, resulting in either too much joint movement (hypermobility) or too little movement (hypomobility). This is known as sacroiliac joint instability or sacroiliac joint dysfunction.
The SI joints act as shock absorbers, distributing force through the pelvis and lower body to protect and stabilize the spine. In doing so, your SI joints play a crucial role in maintaining an upright position when walking or running.
But when injured, your SI joint becomes inflamed and you lose the ability to evenly distribute load across your pelvis. In turn, this stress is unevenly distributed to the pelvic joints and surrounding tissues, causing pain and other symptoms .
People with injuries to the lumbar joint often experience instability in the legs, which can bend or buckle, especially when the person leans forward, turns, climbs stairs or uphill, or stands up from a seated position.
SI joint instability is estimated to be the cause of low back pain in 10-25% of people.
The pain is usually concentrated in the lower back, groin , thighs , or tailbone . While some people experience a dull, aching ache, others experience a sharp throbbing pain that radiates to their lower extremities, especially the thigh , knee , or foot .
Other possible symptoms of SI joint instability include:
You can injure or damage the sacroiliac joints suddenly due to an accident or sudden injury, or they can become damaged over time due to aging, chronic disease, or overuse .
In particular, the following groups of people are at increased risk for SI joint injury:
Sacroiliac joint instability can affect women more than men. Of 84 people who received treatment for low back pain, 69% of those diagnosed with iliac instability were women, according to a small study from 2021. Additionally, 49% were between 45 and 64 years old.
Sacroiliac joint instability causes pain and weakness in the lower back, hips, and legs. This is a common cause of back pain, but you may be at higher risk if you are an athlete, pregnant, or have a chronic bone or joint disease such as scoliosis or arthritis.
Many people with sacroiliac joint instability report that it is painful and debilitating on a daily basis. Because of how common sacroiliac joint injury is, numerous treatment options are available, from physical therapy to fusion surgery.
Treatment focuses on reducing inflammation, restoring mobility , and stabilizing the SI joint. While surgery is generally not the first option your doctor will consider, he may end up suggesting it if all other treatment options are unsuccessful.
Possible treatment options include:
- Hot and cold compresses : Alternate between a warm compress and a cold compress to relieve inflammation and pain, being careful never to apply heat or ice directly to the skin.
- Over-the- Counter (OTC) Medications: When needed, take an over-the-counter pain reliever that reduces swelling, such as ibuprofen (Advil) or naproxen (Aleve).
- Manual manipulation – See a chiropractor who can adjust your SI joint to relieve your pain and restore joint stability.
- Physical Therapy : For chronic iliac joint pain, gradual physical therapy can help strengthen the muscles around the joint, restore stability, and speed healing.
- Water Therapy : Doing physical therapy exercises in the water is an easy way to strengthen and stabilize the SI joint.
- Back Braces – If your lumbar joint pain is due to hypermobility, your physical therapist or chiropractor may recommend a back brace or support to stabilize your lumbar joint so it can heal.
- Sacroiliac Joint Injections: Your doctor may also recommend sacroiliac injections, which consist of steroids and a local anesthetic and are injected into and around the sacroiliac joint to relieve pain.
- Radiofrequency ablation : For this minimally invasive procedure, the surgeon will use radio waves to heat and disconnect certain nerves that transmit pain signals from the lower back to the brain.
- Fusion Surgery – Another minimally invasive procedure in which the surgeon fuses one or both sacroiliac joints to restore stability.
With your doctor's approval, you can also try numerous stretching and home exercises to reduce SI joint pain and instability.
Exercises to help relieve pain.
A consistent program of stretching and exercise can help strengthen, stabilize, and repair a damaged SI joint. The program should include the following:
- Stretching: to improve mobility by relaxing tight muscles in the back, hips, or buttocks that can put additional pressure on the SI joint.
- Strength Development – To stabilize the iliac joint by strengthening supporting muscles, including the core, glutes, and thighs.
- Specific mild aerobics: to accelerate the healing process by improving blood flow so that oxygen and nutrients can rebuild the soft tissues of the iliac joint.
Exercise therapy designed to treat iliac pain is not designed to put too much pressure on you, and you should avoid anything that causes or aggravates your pain.
If at any time you feel your pain getting worse or your SI joint weak, stop what you're doing, rest, and eliminate painful exercise from your routine.
Depending on your symptoms and the type of injury, your doctor may recommend that you try some exercises and avoid others. Improper exercise can make your pain worse or cause further injury, so it's important to consult your doctor before starting work.
When to call your doctor
Within three weeks of full and consistent physical therapy, you should begin to notice some improvement in SI pain and joint instability. If you don't, tell your doctor so he can reevaluate your symptoms and consider other treatment options.
Sacroiliac joint instability is a common source of low back pain, which can begin gradually or suddenly due to injury. Fortunately, your doctor or physical therapist can treat pain in a variety of ways, from back braces and physical therapy to surgery.
You can also reduce SI joint pain and instability from the comfort of your home with stretching and exercise. Talk to your doctor before starting an exercise program to make sure it's right for you and to avoid exercise that makes your symptoms worse.
Get the word of drug information
Explaining your pain to doctors can be challenging, and it may take some time to get your questions answered. Before consulting your doctor, it may be helpful to write down what pain you are experiencing and what is causing it. If the treatment your doctor suggests doesn't improve your condition, tell your doctor and don't give up until you find something that works.
Frequently asked questions
Finding exercises that restore the lumbar joint without making pain worse may take a bit of trial and error. Focus on strengthening the muscles that support the SI joint, especially the core, glutes, and thighs. If you are unsure of the correct exercise, don't hesitate to talk to your doctor.
Avoid standing exercises that put weight on the hips, such as leg lunges and other movements where only one leg is on the floor. Instead, try exercises where both feet are on the floor. You should also avoid high-impact exercises, such as running or jumping rope, and cardiovascular equipment, such as treadmills or stairs.
It depends. Some people benefit from light and light swimming movements. For others, some kicks, such as breaststroke and butterfly, can irritate the sacrum . If you find that swimming hurts you, try swimming on your back or keep walking on water.