The SI joint is responsible for approximately 15-30 percent of lower back and radiating leg pain. Symptoms of SI dysfunction are very similar to disk herniation and disc compression symptoms, making diagnostics often difficult. The main function of the SI joint is to absorb shock between the trunk, pelvis, and lower extremities. Females are the most susceptible to SI dysfunction due to their anatomy and are even more at risk during or post pregnancy. Occupations that place repetitive stress on the SI joint, gait abnormalities and postural abnormalities also make individuals more at risk for experiencing SI dysfunction and inflammation. Multiple tests should be performed to increase accuracy of SI dysfunction diagnosis. These tests include positional and tenderness palpation tests. Further diagnostic imaging tests can rule out lumbar spine abnormalities for further confirmation of SI dysfunction diagnosis. Accurate diagnosis is important to in finding the most efficient treatment options.
Decreasing inflammation and restoring motion, as well as, proper function is a starting point for treatment of SI dysfunction and pain. An initial period of rest or reducing the amount of activity, steroidal injections, chiropractic care and participation in physical therapy treatment (which may or may not require a pelvic floor component) could be recommended for the healing process. Upon completing Physical therapy treatments, figuring out how to activate your transverse abdominis muscle, find a neutral pelvis while strengthening the core and lower extremity muscles is crucial. It is important to remember that everyone will respond to all treatment differently and approaches must be specific to that individual. Giving feedback to your care providers is strongly encouraged. Upon the course of treatment, individuals must also be aware that compliance with postural corrections, specific exercise plans, exercise modifications and all other recommended treatment by their Doctor and Physical Therapist be followed for the most optimal opportunity to healing.