Sacroiliac joint pain - aftercare

More about Your Problem

The main purpose of the joint is to connect the spine and the pelvis. As a result, there is very little movement at the sacroiliac joint. 

Listed below are the major reasons for pain around the sacroiliac joint:

• Muscle tightness
• Pregnancy: the pelvis widens to prepare for birth, stretching the ligaments -- strong, flexible tissue that connects bone to bone
• Different types of arthritis that causes SIJ pain
• Difference in leg lengths
• Wearing away of the cartilage (cushion) between the bones
• Trauma from impact, such as landing hard on buttocks 

Although, SIJ pain can be caused by trauma, this type of injury more often develops over a long period of time.

What to Expect

Symptoms of sacroiliac joint dysfunction include:

• Pain in the lower back, usually only on one side
• Hip pain
• Discomfort with bending over or standing after sitting for long periods
• Improvement in pain when lying down 

Your doctor may move your legs and hips around in different positions to help diagnose a SIJ dysfunction. Your doctor may also need to take x-rays or do a CT scan.

Symptom Relief

Follow these steps for the first few days or weeks after your injury or when starting treatment for SIJ pain:

• Rest: Keep activity to minimum, and stop movements or activity that worsen the pain.
• Ice your lower back or upper buttocks for about 20 minutes 2 - 3 times a day. Do not apply ice directly to the skin.
• Use a heating pad to help loosen any tight muscles and relieve soreness.
• Massage the muscles in the lower back, buttocks, and thigh.
• Take pain medication. 

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store without a prescription.

• Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle or by your health care provider. 

If this is a chronic problem, your doctor may order:

• An injection to help with pain and inflammation. These injections can be repeated over time if necessary.
• Medicines that may help

Activity

When treating an injury, keep activity to a minimum. The more time the injury has to heal, the better. For support during activity, you can use a sacroiliac belt or lumbar brace. 

Physical therapy is an important part of the healing process. It will help improve pain and increase strength. Talk to your doctor or physical therapist for exercises to practice. 

Here is an example of an exercise for your lower back:

• Lay flat on your back with your knees bent and feet flat on the ground.
• Slowly, begin to rotate your knees to the right side of your body. Stop when you feel pain or discomfort.
• Slowly rotate back toward the left side of your body until you feel pain.
• Rest in the starting position.
• Repeat 10 times.

The best way to get rid of SIJ pain is to stick to a care plan. The more you rest, ice, and practice exercises, the quicker your symptoms will improve or your injury will heal.

Follow-up

Your doctor may need to follow up if the pain is not going away as expected. Talk to your doctor about:

• X-ray and imaging tests you may need
• Blood tests that may help diagnose the cause

When to Call the Doctor

Call the doctor if you have:

• Sudden numbness or tingling in your lower back and hips
• Weakness or numbness in your legs
• Sudden increase in pain or discomfort
• Slower than expected healing
• Fever

Alternate Names

SIJ pain - aftercare; SIJ dysfunction - aftercare; SIJ strain - aftercare; SIJ subluxation -aftercare; SIJ syndrome - aftercare

References

Isaac Z, Devine J. Sacroiliac joint dysfunction. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicineand Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 47.

Update Date: 8/25/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.