Tag Archives: sacroiliac joint dysfunction

Sacroiliac Joint Chiropractic Procedures


 

Chiropractic is a form of alternative medicine primarily involved in the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system to restore and promote good health. It is based on a philosophy that true health comes from within. Therefore, chiropractic care is regarded as the first line of treatment for SI joint pain (sacroiliac joint dysfunction).

Patients suffering from lower back pain stemming from the sacroiliac joint need to be applied with chiropractic procedures so that they may get back to normal condition. Aside from relieving lower back pain, chiropractic procedure is also found to be effective for a variety of conditions including infantile colic, paediatric ear infections, migraine headaches, neck and shoulder pain, sciatic pain, carpal tunnel syndrome, fibromyalgia, premenstrual syndrome, irritable bowel syndrome, attention deficit disorder, and plantar fasciitis.

Poor, inadequate or incorrect function in the spine can cause irritation of the nerves that control posture and movement.  Such spinal irritation, which is usually due to accidents, poor diet, lack of exercise, poor posture, and anxiety, may result in the symptoms of discomfort, pain, and diseases indicating that the body is not functioning as it should be.

By manipulating specifically on the spine, chiropractors use different approaches to correct alignment problems and stimulate the joint movement receptors so that the body’s natural ability to heal by itself may be activated. Chiropractors do not promote the use of drugs or employ any surgical procedures. Rather, they use their own hands in adjusting the joints of the spine and extremities where there are signs of movement restrictions, to relieve pain and improve mobility. Through such manipulation, which is also called adjustment, the body’s own healing processes will then be able to get on with the task of improving its health. A typical adjustment involves applying a controlled but sudden force that produces painless popping noise, and improving the range of motion of the joint being treated.

There are varied chiropractic techniques available, with the majority of chiropractors mixing several methods, such as the Thompson technique; Gonstead and Maitland technique; activator technique, which concentrates on the mechanical aspects of the spine; Sacro-Occipital technique, which uses the spine as a torsion bar; applied Kinesiology, which focuses on muscle testing, and so many more.  But in general, most of the techniques involve high velocity, low amplitude thrusts.  But some chiropractors also employ the low velocity, high amplitude technique, which involves gentle, extended movements rather than the back-cracking classic method of spinal manipulation.  Such method is called spinal mobilization.

Aside from doing it by purely manual procedure, chiropractors may sometimes employ mechanically-assisted manipulations, using an activator, a small metal tool that applies force directly onto one vertebra.  In many cases, chiropractors integrate exercise and physical fitness, nutritional and dietary practices, postural advice on ergonomics, change in lifestyle to rule out unhealthy habits, massages, and osteopathy into their program of treatment.  Some chiropractors may even sedate their patients while manipulating the spinal joints; in which case, they seek the help of anaesthesiologists.

Chiropractic procedure is known as one of the safest types of health care in the world and has been proven to be a successful primary therapy for neuromusculoskeletal conditions such as SI joint pain and is a good alternative SI joint pain treatment.  Various studies reveal that it is even safer than most medical procedures used to treat the same conditions.

Can SI Joint Pain Be Accurately Diagnosed?


 

It is extremely difficult to accurately diagnose a sacroiliac joint dysfunction or better known as SI joint pain because its symptoms are very similar to other common pain conditions, such as muscle sprain, disc herniation, or “slipped disc”, and radiculopathy, or pain along the sciatic nerve that radiates down the leg. While research is still going on regarding this matter, therapists are still finding it hard to determine whether the pain comes from the joint surfaces or from the ligaments that hold these joints together.

To come up with a diagnosis, it needs a painstaking clinical examination using a thorough process, individualized specific approach that usually begins by obtaining the patient’s medical history, analysis of his injury, musculoskeletal examination on their spine and also pelvis.  An radiographic studies, such as bone scan, x-ray, CT or MRI scan may also be employed in the process to rule out other possible causes of their back pain.

Diagnosing SI joint pain

It is important to take into account all aspects of a patient’s history because his varied conditions may correlate with his medical background and age. Typically, the physician would want to know about the patient’s previous health record and on how and when the back pain occurred. He may also inquire about the patient’s positions or actions that triggered the pain, where and how long the pain lasts. Once the physician has obtained this information, he may proceed with a detailed physical examination, putting particular emphasis on the patient’s back. Usually, the physical examination involves testing the range of motion of the spine, and on the power, tone, sensation and reflexes in the legs; ascertaining the area of tenderness, and; evaluating the strength of the lower limb muscles.

The physician would usually do a “straight leg raise test” exercise on the patient. Straight leg raise, which is also called Lasègue test, is a test done by having the patient lie flat on a bed or table.  With his leg straight, the patient is ordered to raise his foot off the bed and suspend it in the air to test the function of his quadriceps muscle and its attachment to the shin bone.  If the patient felt pain travelling down his leg when it is lifted to 30° to 70° range, it is likely that his sciatic nerve is irritated.

However, it should be noted that not all low back pains are caused by sacroiliac joint dysfunction. It can also be due to kidney and urinary tract infection, kidney stones, peptic ulcer, disorders of the pancreas, or problems with the hip.  Because of this uncertainty and unreliability of clinical examination, therefore, therapists resort to employing sacroiliac joint injection as a diagnostic tool to locate the source of, and mitigate the pain. Sacroiliac injection is a procedure of long lasting steroid in the sacroiliac joints to reduce the inflammation or swelling of tissue in the joint space, and temporarily eliminates pain by filling the sacroiliac joint with an anaesthetic medication that numbs the joint, the ligaments, and the joint capsule around the sacroiliac joint.  Along with the steroidal medications, doctors also inject a numbing treatment similar to the ones used in a dentist’s office into the sacroiliac joints during the procedure that lasts between thirty minutes to an hour to complete. The degree of relief experienced after the injection may help determine whether to rule out or confirm the joint as the source of pain.  Once the doctor is certain beyond question that the sacroiliac joint is the origin or the cause of pain, he may recommend other procedures to reduce the pain for a longer period. Sacroiliac injections are performed using a fluoroscope, an imaging machine that allows the doctor to see real-time moving images of the internal structures of the patient.

Causes of Sacroiliac Joint Pain


 

Sacroiliac Pain, which is also called Sacroiliac Joint Dysfunction, is often characterized by lower back pain or weakness in the legs and buttocks. As people age, the characteristics of their sacroiliac joints also change. These joints may become stiff and locked up, due to a prolonged sitting position or injuries. Although specific causes of sacroiliac joint pain are still uncertain, research is ongoing to determine whether the pain comes from the joint surfaces or from the ligaments that hold these joints together. Nevertheless, experts have identified and divided the causes of sacroiliac joint pain into four categories, namely;

Traumatic injury.  This occurs when the sacroiliac joint is affected by a sudden impact or fall where ligaments that support the joint are damaged. A common source of traumatic injury on sacrum or pelvis is falling backward or sideways onto a hard surface.

Biomechanical.  Repetitive movements due to exercise, increased sports activity, driving, and chronic dynamic bending and twisting have greater tendency to result in SI joint pains. When 1 of the joints become restricted or locked up by bending or twisting movements, it often results in pain. This pain, which can be sudden, tends to be localized to one side of the sacrum. Some of the most common biomechanical problems are: muscle imbalance, twisted pelvis, overpronation, and leg length discrepancy. An uneven leg length or strength imbalances in opposing muscles causes misalignment of the sacroiliac joints.

Hormonal changes.  Women are more susceptible to sacroiliac joint pain than men because of child-bearing. As a pregnancy progresses, hormonal changes cause the ligaments of a woman’s pelvis to become lax in preparation for the passage of the baby. This laxity and weight gain can cause pressure on the sacroiliac joint.  The pain is usually localized to one side of the extreme lower back.  In addition, women may experience same hormonal change during menstruation, but to a lesser degree.

Inflammatory joint disease. There are a number of inflammatory arthritides that usually target the sacroiliac joints and create an unpleasant cycle, the most common of which is the Ankylosing Spondylitis. It is a form of chronic, degenerative arthritis that affects the sacroiliac joints, spine, and other joints of the body. Its cause still remains uncertain, although heredity is considered a factor. Degenerative arthritis are normally found to be more likely a result of the locking of joints, which deprives oxygen and nutrients from the cartilage of joint hyaline, which then causes waste products building up in and around the joint. Other arthritides that usually attack the sacroiliac joints are psoriatic arthritis, Reiter’s syndrome and enteropathic arthritis. Besides, acidic foods, alcohol, and caffeine can cause inflammation conditions within the joints.

Sacroiliac joint inflammation can be a difficult problem to diagnose for a few reasons like, other problems can cause similar symptoms, or, that examinations cannot isolate just the sacroiliac joint. But then there are simple ways to treat SI joint pain at home, namely:  it is advisable to rest from any activities which cause pain; take anti-inflammatory medications; apply a warm-pack around the muscles that have tightened up, and; try wearing a sacroiliac back belt.

However, it would be better to see a doctor, physical therapist, or chiropractor if you are experiencing sacroiliac joint pain because living with the pain without addressing its causes could seriously injure your SI joints.

Sacroiliac Joint Dysfunction Treatment Options


 

SI joint pain, which is also known as sacroiliitis, sacroiliac joint inflammation, sacroiliac joint syndrome, and sacroiliac joint strain, is a common cause of mechanical low back pain, a pain that can be a nuisance that restricts the sufferer’s movement and daily activities like sitting, standing, walking, and even sleeping.  Painful though it may be, there are, fortunately, many ways to treat sacroiliac joint dysfunction. However, before applying any treatment, a sufferer should refrain from doing activities that may cause him pain. Sufferers of sacroiliac joint dysfunction usually heal well with appropriate physiotherapy.

Treatment of sacroiliac joint dysfunction begins with an examination by a physician prescribing non-surgical treatment to eliminate any disorder that may be serious enough to warrant surgery.  Initially, he may prescribe over-the-counter medications, like ibuprofen, acetaminophen, and naproxen, to remedy the pain and inflammation. The doctor may further order the patient to take sufficient rest from all activities that cause pain; avoid sitting for prolonged periods; take anti-inflammatory medications; apply a warm-pack around the muscles that have tightened up, and; wear a sacroiliac joint belt. However, if these medications do not work for the patient, the doctor may then prescribe corticosteroids, drugs that can be taken orally or as an injection into the sacroiliac joint.

In addition, especially after a sacroiliac injury, it is necessary that the sufferer use a sacroiliac joint belt, a supportive device used to ease sacroiliac pain or discomfort. Consisting usually of a flat nylon or elastic, woven fibre webbing material with additional side pulls, the belt is worn strapped snugly around the hips of the patient suffering from sacroiliac joint pain. The sacroiliac belt braces the pelvis and compresses the SI joint to alleviate pain in the lower back and re-establishes the joint’s natural movement.

Aside from wearing a sacroiliac belt, an SI dysfunction sufferer may also seek the help of a physical therapist to design for him a specific program which he may work out on to ease his pain.  Even as sacroiliac joints support the upper body, constant standing and sitting can cause it stress; but indulging oneself in physical therapy, such as specific range of motion and stretching exercises, can considerably ease such stress on the sacroiliac joints as well as the abdominal and back muscles. Besides, physical therapy helps maintain joint flexibility, which is significant as the patient gets older.

Other sacroiliac joint dysfunction treatments that a patient can take advantage of include interventional pain management techniques, and ice and heat treatment.

Interventional pain management technique is the area of Pain Medicine that involves a minimally invasive approach to control pain, which deploys state-of-the-art treatment strategies to diminish discomfort and restore quality of life.  Its goals are to decrease pain, increase physical function, decrease or abolish the use of medications, avoidance of surgery in some cases, and return the patient to an enjoyable and active lifestyle.

Meanwhile, using ice and heat treatment alternately may help relieve pain and swelling. Ice therapy proofed to be very useful especially for pains in back muscle and when applied during the 48 hours period following suspected injury. The ice reduces swelling, provides minor relief basically through the numbing of local tissue, and help slows down the neurological impulses around the area which then forces the nerves transmitting less pain signals to your brain. On the other hand, heat therapy increases circulation in the affected area.  If ice treatment should be applied within the first 48 hours, heat application should be done 48 hours normally following a injury, because applying it too fast will only cause swelling and also discomfort around the injured place.

Usually, most patients respond well to these non-surgical Sacroiliac Joint Dysfunction treatments.  However, should these fail to work for a particular patient he should consult a physician regarding other options.

What is Sacroiliitis?


 

Sacroiliitis is sometimes knowned as or termed with sacroiliac joint dysfunction and also SI joint pain because both terms are very closely relates to sacroiliac pain, leg pain and low back pain.  But then, the two conditions have their own differences.  Sacroiliac joint dysfunction refers to the condition where the joints are locked, and with high mobility could dislocate partially or hypomobility which means very minimal movements. While sacroiliitis refers to inflammation in sacroiliac joint that could or maybe not caused by SI joint pain.

Sacroiliitis is normally an inflammation on both or one sacroiliac joints that are located on either side of the lower spine or sacrum that connects to the iliac bone in the hip.  It is normally characterized by severe pain and stiffness in the shoulders, buttocks or lower back, especially in the morning or when seated for a very long  period of time, and this pain may even extend down to the groin, to one or both legs, and even to the feet. Other signs and symptoms include pain that worsens with walking, and inflammation in one or both eyes (uveitis or iritis). Because of the high severity pain caused by sacroiliitis, range of motion becomes restricted.  Sacroiliitis makes it very difficult for the patient to sit, walk, stand, sleep, or bending over. This can be brought on by several factors, which includes trauma or acute injury to the area due to an accident or act of violence, pregnancy, osteomyelitis, skin infections, urinary tract infections, arthritis, endocarditis and also intravenous drug misuse or abuse.

Sacroiliitis, which may be accompanied by other symptoms like fever, skin conditions, and diarrhea, is often linked as part of characterized inflammatory conditions and diseases of the spinal column called spondyloarthropathy. These conditions includepsoriatic arthritis, ankylosing spondylitis, arthritis or reactive arthritis and which can be related to bowel inflammation diseases, which includes ulcerative colitis, Crohn’s disease, or osteoarthritis among others and which is often aggravated by prolonged standing, stair climbing, bearing weight more on one leg than the other, running, large strides, and extreme postures.  Diagnosis of sacroiliitis is difficult because it may be confused for other general lower back pain and conditions, and diagnostic tests to eliminate other conditions are oftentimes costly, although they are well worth the expense.  Complications of sacroiliitis can also be very serious, like difficulty in breathing, spine deformities, lung infections, and heart problems.

Treatment of this disease may involve a combination of rest, physical therapy, and medications. Perhaps rest is one of the simplest and best remedy for a sufferer of sacroiliitis.  Maintaining good posture and refraining from activities that aggravate pain can considerably reduce the inflammation in sacroiliac joint.

In therapy, a physician usually guides his patient learn range of motion and stretching exercises to maintain joint flexibility, and strengthening exercises to enhance stability of the patient’s muscles.  In addition, the type of treatment a physician recommends depends largely on the signs and symptoms that occur in the patient, as well as on the basic cause of his sacroiliitis.  Medications typically include pain relievers, muscle relaxants, corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs), and TNF (or tumor necrosis factor) inhibitors.

However, should other methods cannot relieve the pain, the physician may suggest surgical and other procedures, such as radiofrequency denervation, electrical stimulation, and joint fusion.