Living in chronic pain from your sacroiliac joint (SI Joint) can have a huge impact on your life and make basic everyday activities hard to do. Trying treatments, but not seeing improvements for years can be even more discouraging. If you have been living with SI joint pain for a long time, then it may be time to talk to your doctor about finding relief. In this blog post, we’ll explore the causes of SI Joint Pain and discuss potential treatments that could help you find some relief from the discomfort.
As a general rule, SI joint pain can persist for years due to various factors, such as ligament laxity, degeneration, trauma, inflammation, or misalignment. Chronic biomechanical stress, repetitive motions, poor posture, or obesity can worsen the pain. Diagnosis requires a thorough physical exam, imaging studies, and ruling out other causes.
As someone who has been practicing chiropractic for over 30 years and trained as an ergonomist, I have the experience and expertise to guide you why you may have SI joint pain for years – and more importantly, great tips on how you may relieve this pain. I have written a book on posture, spoken on this subject on national TV, and have even engineered solutions to help people achieve better posture and comfort while sitting. Recently, I ran a successful Kickstarter campaign to fund the development of my latest project, a set of ergonomic seat cushions.
Sacroiliac Pain: The Basics
First things first, let’s talk about the SI joint. The sacroiliac (SI) joint connects the spine to the pelvis and plays a crucial role in maintaining spinal alignment and stability. When this joint becomes inflamed or misaligned, it can lead to debilitating pain and discomfort.
In my years of practice, I’ve found that the central mechanism for sitting without causing pain in the knees lies in a properly aligned spine and a balanced, strong core. A strong core is not just about having six-pack abs; it’s about the harmony of all the muscles in your torso working together to support and stabilize your spine.
So, how can we maintain spinal alignment and a strong core? Here are a few tips:
- Exercise regularly: Incorporate exercises that strengthen your core muscles, such as planks, bridges, and bird-dogs. Don’t forget to stretch your hip flexors and hamstrings to maintain flexibility.
- Practice good posture: Be mindful of your posture while sitting, standing, and walking. Keep your shoulders back, chest out, and engage your core muscles.
- Use an ergonomic seat cushion: I always advise using an expert-designed ergonomic seat cushion made with a natural latex top and a high-density base layer foam. This type of cushion provides the right balance of support and comfort to help maintain proper spinal alignment while sitting.
Now, you might be wondering why I specifically mentioned natural latex and high-density foam. The reason is simple: I never recommend memory foam as I believe that it lacks pressure support and resilience, and it is a toxic material that gets hot when you sit on it for long periods. Natural latex and high-density foam offer better support, durability, and breathability, making them the ideal choice for a comfortable and healthy sitting experience.
I’ve written a complete hands-on review about the best sitting position for sciatica, and here is what I tested best with my sciatica patients.
Understanding Sacroiliitis Problems
The sacroiliac (SI) joint is the connection between the sacrum, the triangular bone at the base of the spine, and the iliac bones on either side of the pelvis. The joint is responsible for bearing the weight of the upper body and transferring it to the lower extremities. When there is dysfunction or inflammation in the joint, it can lead to SI joint pain, which can be quite debilitating.
Common Causes of Sacroiliac Low Back Pain
- Trauma: Accidents, falls, or injuries can lead to SI joint pain by causing inflammation or misalignment in the joint.
- Pregnancy and childbirth: The hormonal changes and physical stress during pregnancy can cause the ligaments around the SI joint to loosen, leading to pain.
- Arthritis: Osteoarthritis, an age-related degeneration of the cartilage, can affect the SI joint and cause pain.
- Muscle imbalances: Weak or tight muscles around the pelvic region can put undue stress on the SI joint and cause pain.
Diagnosing Sacroiliac Joint Pain
SI joint pain can be challenging to diagnose, as its symptoms often mimic other conditions, such as lower back pain, hip pain, or sciatica. A chiropractor will typically use a combination of medical history, physical examination, and diagnostic tests, such as X-rays or MRI, to accurately diagnose the condition.
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Chiropractic Care for SI Joint Dysfunction
Chiropractic care can be highly effective in addressing SI joint pain. A chiropractor may use a combination of techniques to alleviate pain and restore joint function, including:
- Spinal manipulation: Gentle adjustments help realign the SI joint, reducing inflammation and pain.
- Soft tissue therapy: This may involve techniques such as myofascial release or trigger point therapy to address muscle imbalances contributing to SI joint pain.
- Exercise and rehabilitation: A chiropractor will recommend targeted exercises and stretches to strengthen and stabilize the muscles around the SI joint, promoting long-term relief.
- Shockwave therapy: Shockwave therapy has been increasingly used for the treatment of SI joint pain due to its efficacy and safety. The SI joint, which connects the sacrum and the ilium bones of the pelvis, is a crucial joint that bears the weight and stress of the upper body. SI joint pain is a common complaint among people of all ages and activity levels, and it can significantly interfere with daily activities and quality of life. Shockwave therapy involves the application of high-energy acoustic waves to the affected area, which can stimulate the body’s natural healing responses and reduce inflammation and pain. This non-invasive and medication-free treatment has been shown to be effective in reducing SI joint pain and improving mobility and function.
Prevention and Maintenance
Here are 3 of my recommendations:
Exercise for SI Joint Health
Incorporating targeted exercises into your daily routine can help strengthen the muscles surrounding your SI joint, providing stability and support. This can include low-impact activities such as walking, swimming, and yoga, as well as specific exercises that target the muscles in your lower back, hips, and pelvis. Be sure to consult with your chiropractor before starting any new exercise program to ensure it is safe and appropriate for your individual needs.
Importance of Proper Posture
Maintaining proper posture, both while sitting and standing, is crucial in preventing SI joint pain. Poor posture can lead to muscle imbalances and strain on the SI joint, which may result in pain and discomfort. Your chiropractor can provide guidance on correct posture and may recommend specific adjustments, stretches, or exercises to help correct any postural issues that may be contributing to your SI joint pain.
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Developing a Posture-Friendly Chair: Pointers and Suggestions
To effectively address your seating requirements, it’s imperative to consider various factors, one of which is chair personalization. Multiple methods can assist you in achieving this, such as integrating an ergonomic seat insert and lumbar support. These supplemental features ease pressure on your back and legs, augmenting comfort and posture during extended sitting sessions. Furthermore, confirm that your feet are level on the floor and that adequate room exists between your chair and desk. By implementing these tips, any standard stiff chair can be converted into an ergonomic refuge that supports long-term health and well-being.
Ergonomic Seating Support
I explain the concept of my ergonomic design on a TV show HERE
An ergonomic seat wedge (above) can be used to correctly position your spine and improve balance. This well-constructed natural latex seating support aids in developing core muscles while mitigating tension in other body regions, such as the shoulders and neck. Additionally, sitting upright is less taxing on your hips and knees, as it activates more muscle groups simultaneously compared to leaning back against a plush surface. This vertical posture prevents the formation of stress-triggering habits that people may inadvertently develop while working.
Regular Chiropractic Check-Ups
Scheduling regular chiropractic check-ups can help you stay on track with your prevention and maintenance plan. During these visits, your chiropractor can assess your SI joint function, evaluate your progress, and address any issues or concerns that may arise. By staying proactive with your joint health, you can help prevent the recurrence of SI joint pain and enjoy a more active and pain-free life.
Best Seat Cushion for SI Joint DiscomfortAxial Ergonomic Seat Cushion® | Seat Chair Wedge
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Best Seat Cushion for SI Joint DiscomfortAxial Ergonomic Seat Cushion® | Seat Chair Wedge
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Axial Designs™ Seat Cushion
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Isometric Grippy Vegan Leather
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Exploring the ‘Benefits’ and Risks of Spine Surgery (SI Joint Fusion or Fusion Surgery) in Long-Term Management of Chronic SI Joint Pain
As a chiropractor, I’ve seen my fair share of patients with chronic SI joint pain, and I’ve witnessed the agony it can cause. While I’m a strong advocate of non-surgical methods to manage pain, there are those rare and extreme cases where surgery might be considered. In those moments, SI joint fusion becomes a topic of interest. So, let’s dive into this joint venture (pun intended) and explore the benefits and risks of SI joint fusion with a touch of humor and humanity.
First, the benefits. Imagine you’ve been dealing with SI joint pain for years, and you’ve tried everything from physical therapy to medications, but nothing seems to give you lasting relief. Then, you hear about SI joint fusion, which has the potential to finally provide the pain relief you’ve been seeking. It’s like finding that one perfect pillow after years of restless nights!
SI joint fusion involves fusing the sacroiliac joint, thereby stabilizing it and reducing the pain caused by excessive movement. In some cases, patients experience significant pain relief after the surgery, enabling them to return to their daily activities with a newfound spring in their step.
Now, let’s talk risks. With any surgery, there are potential complications. Imagine going in for a haircut and coming out with a new hair color you never wanted. That’s how unexpected complications can be!
With SI joint fusion, some patients may develop an infection at the surgical site, nerve damage, or even blood clots. There’s also the possibility that the fusion doesn’t fully alleviate the pain or that it creates new pain in other areas. It’s like fixing a squeaky door only to discover a leaky faucet!
As a chiropractor, I’m always concerned about maintaining the body’s natural balance and alignment. Fusing the SI joint can potentially disrupt that harmony, so I’m careful to only recommend it in very extreme cases.
In conclusion, SI joint fusion is a bit like a wild rollercoaster ride – it has its thrills and chills! While it can provide significant pain relief for some patients, the risks and potential complications make it a choice that shouldn’t be taken lightly. As a chiropractor, I always encourage patients to explore non-surgical options before considering surgery, but in those rare cases where all other avenues have been exhausted, SI joint fusion may just be the ticket to a more comfortable life.
3 Tests to Tell You if Your Back Pain Is Caused by Si
The sacroiliac joint (or “si joint” for short) can be a sneaky little culprit when it comes to lower back pain. But how can you tell if your pain is actually stemming from this joint? Here are three simple tests you can do at home:
- Thigh Thrust Test: Lie on your back with your legs bent. Have someone push down on one knee while you push up with the other. If you feel pain in your lower back or buttocks, it could be your si joint.
- Compression Test: Lie on your side with the affected side up. Have someone push down on your hip while you push up. Again, if you feel pain in your lower back or buttocks, it could be your si joint.
- FABER Test: Lie on your back with the affected leg bent so that your ankle is resting on the opposite knee. Gently push down on the bent knee while pulling up on the ankle. If you feel pain in your lower back or buttocks, it could be your si joint.
Si Joint Pain Exercises to Avoid
If you’re dealing with chronic si joint pain, there are a few exercises you should avoid to prevent aggravating the joint further. These include:
- Deep squats: Putting too much pressure on your hips and lower back can exacerbate your pain.
- Leg presses: Similar to squats, this exercise can put too much pressure on your hips and lower back.
- Lateral lunges: This exercise can put too much stress on the sacroiliac joint and worsen your pain.
Instead, try low-impact exercises like swimming or walking to help relieve your pain.
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How to Unlock Si Joint by Yourself
While it’s always best to seek professional help when dealing with sacroiliac joint dysfunction, there are a few things you can try at home to unlock your si joint:
- SI Joint Mobilization: Lie on your back with your knees bent and feet flat on the ground. Cross one ankle over the opposite knee and gently pull the raised knee towards your opposite shoulder.
- Hip Flexor Stretch: Kneel on one knee with the other foot flat on the ground in front of you. Gently lean forward until you feel a stretch in the hip of the kneeling leg.
- Piriformis Stretch: Sit on the edge of a chair with your feet flat on the ground. Cross one ankle over the opposite knee and gently lean forward until you feel a stretch in your buttocks.
Sacroiliac Joint Dysfunction Self Test
If you suspect you may be dealing with sacroiliac joint dysfunction, there is a simple self-test you can try at home:
- Lie on your back with your knees bent and feet flat on the ground.
- Place a hand on the joint on your affected side (where your lower back meets your hip).
- Slowly lift your knee towards your chest while keeping your foot flat on the ground.
- If you feel pain or discomfort in your sacroiliac joint, you may have dysfunction.
Chronic Si Joint Pain
Chronic si joint pain can be caused by a variety of factors, including trauma to the lumbar spine or hips, sacroiliac joint dysfunction, and spine surgery such as fusion surgery. Spondylosis or spinal osteoarthritis can also cause si joint pain, especially in older adults.
But don’t worry, there are various ways to get pain relief from chronic si joint pain. As a chiropractor, I specialize in adjusting and mobilizing the sacroiliac joint to reduce inflammation and improve joint function. I also recommend exercises and stretches to strengthen the lower back muscles, which can provide long-term relief from lower back pain.
Although SI joint pain can be incredibly persistent and difficult to address, it is possible to recover from years of suffering and find relief. Many treatments are available that have proven effective in addressing this type of chronic pain and improving the quality of life. One valuable approach is the Feldenkrais Method® which incorporates body movements and assists participants in reducing pain and gaining healthy movement patterns.
Additionally, other therapies such as physical therapy, acupuncture, chiropractic care, massage therapy, exercise therapy and yoga have all been noted by doctors as helpful when treating SI joint pain. Regardless of what treatment you choose or your individual situation, understand that you don’t have to live with SI joint pain for years—you can find a solution that works for you. With patience, effort, and a caring tone of voice for yourself; you can find relief from SI joint pain.