Sacroiliac joint problems cause pain

Your sacroiliac joint: Probably part of your problem

10/11/2019

The sacroiliac joint can cause so many problems if it doesn't work right.

One thing I specialize in is the sacroiliac joint. The sacrum is at the base of your spine. Your ilium is your hips. They come together to form the sacroiliac joint.

You can read older blog entries on the sacroiliac joint for a basic understanding. I recently attended another seminar which addressed the way the muscles of the body relate to this joint and how that relates to the ligaments that hold the joint together.

Basically, the joint is held together by ligaments. In a sacroiliac joint injury, the ligaments are stretched. The joint becomes hyper-mobile. In an attempt to stabilize the joint, the body will activate a multitude of muscles and people will experience this as a multitude of symptoms. Some of them include:

back spasms, tight low back, back stiffness
buttock pain and tightness
if unaddressed, this can result in sciatica

Image copyright Sacro Occipital Research Society International ®

But there are so many muscles that attach to the pelvis that symptoms far away from the pelvis can actually be being caused by this sacroiliac joint problem. Some of these symptoms are:

Shoulder pain
Neck pain
Foot/ankle pain
IT band syndrome
knee pain
hip pain
elbow pain
wrist pain
headaches
temporomandibular joint (TMJ) problems/TMD

Ultimately, the joint needs to be stabilized. It needs to be held together. This is contrary to much of the "standard of care" thinking in orthopedics, physical therapy and chiropractic, which focuses on mobilization of joints. Mobilizing the joint may give temporary relief, but ultimately it creates a perpetual problem with no end because the joint cannot heal.

SOT blocks to correct the sacroiliac joint

SOT® wedge-shaped blocks are placed under the pelvis to correct the sacroiliac joint.

Part of the way I decrease mobility in the joint is using wedged-shaped blocks that are placed under the pelvis. They help close the joint and compress the ligaments together. Sometimes this is enough to resolve the issue. Other times, patients need extra support. This is done by having the patient wear a trochanteric belt. Worn around the pelvis, it helps hold the joint together so the muscles don't have to. The muscles are then able to relax and the pain goes away. Exercises can also be given to strengthen some of the weak muscles that contributed to the injury occurring in the first place. Healing of the joint can take 4-6 weeks. Sometimes additional nutritional support can be given to help the joint heal.

So many of my patients have sacroiliac joint problems and this is one of my specialties. If you would like to know more or set up an appointment, call the office at 727-509-3760 or send an email to [email protected]. You can also schedule appointments online.

26 Comments

Author

I'm a Chiropractic Physician, Psychotherapist and researcher. I'm interested in helping people live their lives to their full potential. That could be simply without pain. Or it could be without more complicated physical or mental health problems. Or it could be getting help in making changes in their life so that they can achieve their dreams.

Maigan LaVallie

4/19/2021 01:27:22 am

2 back to back pregnancies
My si joint click in and out and an experiencing elbow pain, shoulder pain , leg pain mostly on one side.

Ann-Marie Mignone

1/9/2023 07:18:35 pm

I just wanted to say thank you as this article is the best I’ve found in actually touching all bases with what problems SI joint dysfunction can come with. The photo is also extremely helpful. Been having issues finding sources which connect IT band syndrome and SI joint hypermobility together.

Was curious. Are the injured IT band and SI joint usually opposite from one another?

Dan Tuttle

1/9/2023 09:46:56 pm

Hi, good question! Yes, the IT band is often opposite the injured SI joint, but not always. You can also have both sides involved.

banii link

1/22/2023 02:20:10 pm

I never remembered to be the way that the whole body's models would be an enormous part to check too while treating carpal passage issue. Ideally, I can search for the best hand physiotherapy treatment now that I as of now experience torment in the left wrist. It could at this point be an indication of that issue, and I truly need it watched out for by an expert at the earliest entryway before it could disintegrate.

Dr. Tuttle

1/31/2023 12:53:03 pm

Carpel tunnel problems can be a symptom of an underlying sacroiliac joint problem. You need to treat both the wrist and the rest of the body including the SI joint.

Abha

4/1/2023 11:38:13 pm

Curious to know- does Prolotherapy teat SI joint? My pain got worse after physiotherapy and chiropractic- pain is now radiating to shoulder neck and arms! Pain is consistent and becomes worse after walking and seating! I got two injections of Prolotherapy. But pain is same ! Prior to prolo I got one cortisol in lower hip joint! Back is becoming worse! Any suggestions for better treatment?

4/2/2023 06:11:16 am

Prolotherapy may cause temporary soreness but after a few days it should be better. SI joint pain can spread to other areas of the body. Chiropractic and physiotherapy are broad terms. It may be that the specific chiropractic or physiotherapy methods were not what you body needed but another method or technique could still be helpful. But there may be something else going on that would be making you treatment resistant. I can't make diagnosis or medical recommendations over the internet. But if you haven't done so, you might want to find a doctor and see what they think about doing imaging of the SI joint area. If that has been done, it's a long list of other things that might be stopping it from getting better. I can't comment on that without knowing more about the case.

abha

4/14/2023 11:05:35 pm

thank you doctor - my diagnosis is SI joint OA and shoulder tendinosis & bursitis - but pain does not go away for over a year now. I go chiro, physio and prolo.

gerry ryan

1/28/2024 01:51:23 am

went to chiropractor for 12months with little relief only relief i got was from si joint injections getting my si joint fused next months.I have pain in lumber,hips.buttocks, thighs,knees ,calves and feet

1/28/2024 06:25:51 am

Many chiropractors try to mobilize the joint which may give temporary relief but perpetuate the hypermobility. You should find one who does Sacro Occipital Technique which understands the hypermobility issue. You would also benefit from wearing a trochanteric belt. I like the Serola belt.

Another thing to consider is prolotherapy. It is a dextrose solution and NOT a steroid which is likely what you were getting. It causes the ligaments to tighten and heal. For extreme cases of SI joint dysfunction I will recommend this. Often osteopaths offer this. Look for someone with experience.

Beyond that, PRP and stem cell are still options before surgery, which I do not recommend.

There may also be a nutritional component to your problem. Gut issues, thyroid problems, low pH are just a few of the things can all lead to lax ligaments.

You could also have a dental or cranial problem perpetuating this. Poor orthodontics, improper fillings or bite restorations can make it impossible for the cranium to balance and the sacroiliac joint will not hold in place. Many chiropractors don't have the knowledge to address cranial issues.

I would try these things before permanently fusing a joint.

Nick

1/29/2024 12:39:41 pm

I was going to get SI join fusion but had my should repaired first. My doctor said it’s not a painful surgery, I’m still debating whether to do it, if you could share your experience after your fusion surgery it would be much appreciated.

5/15/2023 09:59:06 pm

I’ve had lower back to mid back pain, neck, hips, butt, and now right shoulder pain for almost a year and a half. I’ve been to about 8 doctors including the Mayo Clinic in Jax. They diagnosed me with dysfunctional si joints, I’ve been doing physical therapy for over 4 months and now doing it myself with a lot of different exercises. My physical therapist doesn’t know if it’s my si joints thinks it’s an autoimmune problem but I’ve been tested for RA and AS it was negative. I’ve had 2 epidurals, 4 facet joint injections, and 2 cortisone shots in my hips. They helped for about 5-10 days and prednisone worked great but couldn’t stay on it too long! I need help who to see next as I’m still in pain at night sleeping, getting up, out of car, and can’t even go up stairs! Maybe surgery to fuse so joints? Who does this Orthopedic?

5/16/2023 02:20:44 pm

Hi Nick, thanks for your comment. I cannot offer specific medical advice as you are not my patient and I have not seen you. Based on what you are saying, your physical therapist may be right and someone can still have systemic inflammation in the body causing the SI joint to be unstable and that wouldn't show up on an RA or AS test. An hsCRP test is a good marker of inflammation in the body. Epidurals and steroids don't heal the sprained ligaments of a sacroiliac joints nor do facet joint injections since that is a different joint. I would suggest trying a chiropractor who could make an accurate diagnosis. If they are trained in SOT that is idea or Applied Kinesiology would also be good. If you could find an osteopath who actually practices classical osteopathy that could also be good. Another option would be prolotherapy injections which would help the ligaments heal but they are NOT steroids. I also find a certain subset of sacroiliac joint patients have mental health issues especially a history of trauma. For that I use EMDR which I can do because I am both a chiropractor and licensed psychotherapist. People with long standing SI joint issues that fail all other therapies are rapidly resolved with EMDR because the problem was being driven by emotional factors and not physical ones. I would strongly discourage you from pursuing joint fusion as that will lock the ability of the SI joint to function its job of moving cerebrospinal fluid throughout the body which is an essential part of living. It will also not solve issues of systemic inflammation or psychological distress and if they are there you could quite possibly end up with a problem somewhere else in your body.

5/16/2023 06:28:52 pm

Thank you Doctor, my hscrp blood test came back in range. The last neurosurgeon I saw noticed in my X-rays my pelvis was off about an inch or so. I’ve had adjustments and a lift in the leg that’s a little long.I believe this started back about 2 years ago when I stepped into a boat compartment hyperextending my hip! I’m interested in doing the items you listed, do you give prolotherapy injections?

Eric

8/26/2024 05:38:04 am

See this video - https://www.youtube.com/watch?v=MvmtE9ruF_s

8/26/2024 05:53:43 am

Thank you for your comment. This video links to medical treatments that I have not found necessary in treating any patient with SI joint dysfunction. Steroid injections don't correct causes of joint dysfunction and can cause other joint problems. Fusion of the joint will interfere with movement of cerebrospinal fluid, a phenomena which is now being linked to all sorts of neurological disorders. Also the diagnostic procedures used here do not involved neurological analysis of the SI joint.

5/17/2023 12:59:10 pm

Nick,

Without seeing you I really can't offer much guidance other than what I have suggested you look in to. SI joints get unhappy for lots of reasons and need to be managed on an individual basis. I do not do prolotherapy injections as that is outside my scope of practice.

5/19/2023 06:17:56 am

Thanks again Doc, I’m going to follow your suggestions. I wish I lived closer to your office, I appreciate your help!

Catherine I Weber

6/3/2023 10:35:34 am

Interestingly, it was Google and for a shoulder in sexual alien joint connection. I recently started deleting the MVR there a. I'm hoping it will help reduce the stress end resolve past trauma's and promote healing.. I constantly shrug up my left shoulder and I think that pulls the joint up. And my left side near hip always hurts along with right tightness of IT band. What Dr. Tuttle is saying here describes me to a T.

6/5/2023 03:35:16 pm

Catherine,

Thanks for your comment, which I think may have had some voice transcription errors, but I get the gist of it. Glad you found some understanding and validation in my blog. Will be interesting to see how your body responds to EMDR. Don't expect full results until you have fully reprocessed the memory.

Jessica

7/13/2023 08:19:34 am

I have not been diagnosed with SI joint dysfunction but my symptoms seem to match up to what is mentioned in this article. My pain has been worsening for the past 2 years and I barely sought medical help last year because it’s been getting debilitating to leave my house since I have to go down some stairs. The doctors at the hospitals suggested I see a neurologist after X-ray, CT scan and MRI imaging of my spine showed no abnormalities, since I thought it was a herniated disc. One of my symptoms is bladder incontinence as well which has led me to rely on adult diapers. I finally saw a neurologist two months ago and they did an EMG test which also came back normal. So I still have no diagnosis. Now I’m going to see an ortho because my hip snapped three months ago related to my chronic back pain that has caused me to rely on walking with a cane. I told my doctor that I believe it might be SI joint dysfunction since all imaging of my spine and nerve test shows that it’s not a spinal disc or nerve issue. I can’t take large steps when I walk. My torso and shoulders joints feel weak after I get up from bed. I cannot squat lower down to a toilet because my hip snapped recently after doing so. I get sharp pains that feel like fire down my lumbar area when I try to catch my balance after something throws me off as I walk. I cannot squat and try to lift myself up from that position because my leg muscles start to shake and feel weak. Is this something a SI joint dysfunction patient normally deals with if their situation is severe?

7/13/2023 10:38:06 am

Hi Jessica, thank you for your comment. It could be SI joint dysfunction but it needs to be differentiated from other conditions that could also be at play. You need a doctor who has the ability to look at your whole situation holistically and rule out other things. You have, in part, already done this. But you need a good doctor who has experience dealing with these kind of things.

Brandon Canale

9/25/2023 10:07:56 am

Dr. Tuttle,
It has taken me years to find something that addresses my shoulder and hip pain. So far, the SI belt and SI exercises have resolved my hip and shoulder pain in less than a week. Expect a lunch for you an your office if my healing continues the way it has been going.

Thank you so much for your post!

Rachel

10/18/2023 05:19:12 am

Hi Doc.
I’ve struggled with SI joint pain since my first and only pregnancy 7 yrs ago. I’m 40 yrs old and a multisport adventure racer so I do a lot of trail running and mountain biking. I can usually relieve the pain when the joint starts hurting by pulling the knee to my chest but am interested to know what muscles need to be stronger to prevent the joint causing pain in the first place.

Qulter link

1/30/2024 04:55:18 am

I cannot squat and try https://officialovostore.com/ to lift myself up from that position because my leg muscles start to shake and feel weak. Is this something a SI joint dysfunction patient normally deals with if their situation is severe?

James link

2/28/2024 04:28:17 am

Are you wondering what part of your brain might be involved in the problem you are having? Yeah, there's an app for that!
https://officialovostore.com/half-sleeves/

DR. DAN TUTTLE, DC, LCSW

Dr. Tuttle's Blog

Your sacroiliac joint: Probably part of your problem

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