During pregnancy, many women experience low back pain, especially as they progress further into their term. However, to properly treat the pain, it is important to distinguish if the pain is coming from their lumbar spine or their sacroiliac (SI) joint. The SI joint is where our pelvic bone (ilium) attaches to our spine (sacrum). The purpose of this joint is for shock absorption and for motion to occur smoothly between the pelvis and spine. This is one of the least mobile joints in our body, moving only about 2-3 millimeters.
During pregnancy, however, woman produces hormones that causes ligaments across this joint to loosen up to allow expansion of the birthing canal. Laxity increases as delivery of the baby nears and the SI joint relaxes further. When these ligaments loosen, the SI joint moves excessively and can cause pain felt in the low back and give a sensation as if your leg is giving out on you. Pain is usually felt primarily just below the dimples of our low back and is most exacerbated with activities requiring single leg standing such as getting in/out of cars, standing on one leg to put pants on, and when descending or ascending stairs. Muscles surrounding the hips and pelvic can get very tight due to increase demands for them to try to stabilize the joint, thus contributing to more pain.
Here at OSR, we use our integrated care philosophy to address SI joint dysfunction. Our medical department can prescribe chiropractic care to help realign the joint and PT/rehab to strength muscles to stabilize the SI joint and stretch those that may limit mobility and cause pain. A sacroiliac joint belt and/or trigger point injections may also be indicated. Our treatment is always based on medical necessity, but it is also important to look up your insurance benefits to know what is or is not covered. If you or someone you know are experiencing SI joint pain, give us a call and we can help you or them work on having a pain-free pregnancy!
WORKS CITED:
- Sharma, Ajit. Identification and Effectiveness of Physical Therapy Interventions for Sacroiliac Joint Dysfunction in Pregnanat and Nonpregnant Adults: A Systemic Review. https://journals.lww.com/jwhpt/Abstract/2014/09000/Identification_and_Effectiveness_of_Physical.4.aspx
- Voight, ML, Hoogenboom, BJ, Prentice, WE. (eds). Musculoskeletal Interventions, Techniques for Therapeutic Exercise, 2nd edition. McGraw-Hill Medical Publishing, 2007
- https://www.centralphysicaltherapy.com/Injuries-Conditions/Lower-Back/Lower-Back-Issues/Sacroiliac-Joint-Dysfunction-Patient-Guide/a~5821/article.html
