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The Gist: What is Sacroiliac Joint Dysfunction?

Also known as: SIJ dysfunction, sacroiliitis, "Upper butt pain", one sided low back pain

Sacroiliac joint dysfunction is the pain in your low back or hip due to too much or too little movement in joints of your pelvis. It can occur on one or both sides. Typically, you will feel sharp, stabbing pain that is pinpoint in nature directly over the joint. You may experience pain and difficulty bending over or standing up, or pain with prolonged sitting, standing, or walking.

The anatomy of Sacroiliac Joint Dysfunction

The sacroiliac joint (SIJ) is the joint where the pelvis meets the sacrum in the low back. You may recognize them as the dimples in the low back and hip area.

During and after pregnancy, this joint can become painful and inflamed, typically due to hyper or hypo mobility. This means the joint either moves too much or not enough. When the joint moves too much, it can affect the symmetry of the pelvis, which can cause a forward or backward rotation of one side of the pelvis. When the joint moves too little, it can cause stiffness in the pelvis and difficulty moving.

Who gets Sacroiliac Joint Dysfunction? When does it occur for women?

During pregnancy and breastfeeding, a woman's hormones change, which can affect the laxity of the joints, including the SIJ. A patient can "sprain" the SIJ fairly easily. For example, excessive walking, exercising incorrectly, bending and lifting with poor form, or taking a weird step off a curb. It can start anywhere from week 12-39, but it will typically arise in the middle to late second trimester.

You may also experience sacroiliac joint dysfunction after delivery. It will typically arise 6-12 weeks after delivery, during which time your uterus has returned to its former size, you return to other activities and continue to bend and lift a growing baby. It is more common in breastfeeding moms as breastfeeding continues to affect your hormones.

The Origin Way: Physical therapy for Sacroiliac Joint Dysfunction

At Origin, we have extensive knowledge of the pregnant and postpartum body and what it makes it different. We treat SIJ dysfunction with a combination of manual therapy techniques, stabilization exercises, and education on body mechanics.

As the body changes during pregnancy and after, the way it moves must change as well. Sometimes, simply changing the way you stand up, walk, or get out of bed can make a huge difference. We also have extensive knowledge of the belts and belly bands available that can often alleviate symptoms, and can make a recommendation based on your needs.

How long does it take?

Typically, we will see you in some capacity for the duration of your pregnancy as the posture of your pelvis and low back continues to change. After delivery, you can start seeing results in as quickly as a couple visits, but we will typically work together for 6-12 weeks, as true strength gains take about 2 months. That said, your plan of care is personalized and designed to fit your needs and goals.

What to expect in the future

Because your hormones remain irregular until breastfeeding is stopped, SIJ dysfunction may flare up from time to time even after your pain and symptoms have resolved.

Our goal is to give you the tools and education to turn what could have been a 3 week flare into a 3 hour flare. We will arm you with the stretches, exercises, and movement strategies to quickly resolve any symptoms that creep back up.

Additional Reading and Sources

Huec, Jean Charles Le, et al. "The Sacro-Iliac Joint: A Potentially Painful Enigma. Update on the Diagnosis and Treatment of Pain from Micro-Trauma." Orthopaedics & Traumatology: Surgery & Research, Elsevier Masson, 4 Jan. 2019, www.sciencedirect.com/science/article/pii/S1877056818303190?via=ihub

Bertuit, J, Van Lint, CE, Rooze, M, Feipel, V. Pregnancy and pelvic girdle pain: Analysis of pelvic belt on pain. J Clin Nurs. 2018; 27: e129& - e137, https://doi.org/10.1111/jocn.13888

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