If you’ve ever felt a nagging, persistent ache in your lower back or hips, you know how frustrating it can be to pinpoint the exact cause. One common but often overlooked source of this discomfort is the sacroiliac (SI) joint. You have two SI joints, located where your pelvis connects to either side of the base of the spine, and their main job is to absorb shock between your upper body and your legs.
Nearly anyone can develop sacroiliac joint pain, but it can be tricky to identify on your own. The symptoms often mimic other conditions, like a herniated disc or sciatica. Because the symptoms can be so varied, a clinician without special expertise might not immediately diagnose it.
Physical therapists, with their specialized knowledge of the musculoskeletal system, are uniquely equipped to identify and treat issues related to SI joint pain, meaning relief may be only a few miles away.
What does pain in the SI joint feel like?
SI joint dysfunction can manifest in several ways: the pain can range from a dull, constant ache to a sharp, stabbing sensation. The location and intensity of the pain often depend on what’s causing the joint to become irritated, whether it’s too much movement (hypermobility) or not enough (hypomobility).
Common symptoms of SI joint pain include:
- Lower back pain: This is the most frequent symptom. The pain is typically felt on one side of the lower back, just below the waistline. In some cases, it can affect both sides.
- Buttocks and hip pain: A deep ache in the buttocks or hip area is very common. You might feel this pain on one or both sides.
- Radiating pain: Pain from the SI joint(s) isn’t always confined to your back and hip. It can travel down the back of your leg, usually stopping at the knee. This radiating back pain can feel like a sharp, shooting pain or a dull throb. Sometimes, it can also radiate up the spine.
- Numbness or tingling: You might feel a sensation of numbness, tingling, or weakness in your leg.
- Pain that worsens with activity: Certain movements can aggravate SI joint pain. This includes standing for long periods, walking upstairs, running, or even just rolling over in bed. Sitting for a long time can also make the pain worse, and you might feel particularly stiff when you first stand up.
Is it SI joint pain or sciatica?
Because SI joint dysfunction can cause radiating leg pain, it’s often mistaken for sciatica. Sciatica is pain that results from the compression or irritation of the sciatic nerve, which runs from your lower back down each leg.
While the symptoms can feel similar, there are some key differences:
- Location of pain: Sciatica pain typically radiates from the lower back, through the buttock, and down the entire back of the leg, often reaching the foot. SI joint pain that radiates usually stops at the knee.
- Additional nerve-related symptoms: Sciatica often comes with more distinct neurological symptoms, such as a “pins-and-needles” sensation, weakness, or numbness that follows the path of the sciatic nerve all the way to the foot.
- Pain origin: The source of sciatica is the sciatic nerve itself. The source of SI joint pain is the joint. A physical therapist can perform specific tests to stress the SI joint and determine if it’s the true origin of your discomfort.
Distinguishing between back and hip pain from the SI joint and other conditions is crucial for effective treatment. An accurate diagnosis is the first step toward feeling better.
How to help SI joint pain
When you’re dealing with SI joint pain, your first instinct might be to push through it. However, one of the most effective initial steps is to rest the joint as much as possible. This can be challenging, as nearly every activity involves the SI joint in some way, including sitting for extended periods, standing, and walking.
In addition to rest, here are some ideas for at-home treatments you can try to manage your symptoms:
- Ice and heat: Apply an ice pack to the affected area for 15-20 minutes at a time to reduce inflammation and numb the pain. Some symptoms may benefit from warmth or heat to help relax muscles, although heat will make inflammation worse.
- Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce both pain and inflammation.
- Gentle stretches: Simple stretches can help relieve tension in the lower back, hip, and glute muscles. A knee-to-chest stretch or a single knee hug can be particularly beneficial. Be careful not to overdo it; the goal is gentle relief, not more pain.
- Improve your posture: Pay attention to how you sit and stand. When sitting, try to keep your feet flat on the floor and your back supported. Avoid crossing your legs, which can put stress on the SI joint.
While these at-home remedies can provide temporary relief, they may not address the underlying cause of your symptoms. For the best chance at full recovery, seeing a physical therapist is often a good first step.
Physical therapists help treat SI joint pain
If your pain persists, a physical therapist can offer the specialized care you need. At Franklin Rehabilitation, our physical therapists have both the knowledge and experience to diagnose and treat complex musculoskeletal conditions, including SI joint dysfunction.
And although physical therapy isn’t an instant cure, you can often start seeing the results quickly. Your journey to relief may look like this:
- Comprehensive evaluation: Your first visit will involve a thorough assessment of your symptoms. Your therapist will discuss how you’re feeling, review your medical history, and perform a physical examination. This includes specific tests designed to isolate the SI joint and rule out other causes of your back and hip pain.
- Personalized treatment plan: Based on your evaluation, your therapist will create a customized treatment plan not just to mask symptoms but actually correct the underlying issues causing your pain.
- Manual therapy: Your physical therapist may use hands-on techniques to gently mobilize the SI joint. These techniques can help restore normal movement if the joint is too stiff or use other methods to stabilize it if it’s too loose.
- Therapeutic exercises: You’ll be guided through a series of exercises designed to strengthen the muscles that support your SI joint, including your core, glutes, and lower back. These exercises are crucial for providing long-term stability and preventing future flare-ups.
- Education and prevention: A key part of physical therapy is learning how to manage your condition independently. Your therapist will teach you proper body mechanics for daily activities, strategies to avoid aggravating the joint, and a home exercise program to maintain your progress.
With the right guidance, you can regain mobility, reduce your pain, and get back to the activities you love.
Start your journey to relief
Living with SI joint pain can be draining, but you don’t have to manage it alone. The expert physical therapists at Franklin Rehabilitation are here to provide the diagnosis and treatment you need to feel better. We can help you understand the source of your pain and create a path toward lasting relief.
If you’re tired of dealing with persistent lower back and hip pain, call our clinic or request your appointment at Franklin Rehabilitation online today.