Sacroiliac Sprain: Understanding the Pain Cycle

A joint is where two bones meet. The two sacroiliac or SI joints connect the spine, pelvis, and hips. This strong joint balances and transmits stress from the upper body to the pelvis and legs. The joints can suffer a sprain, causing pain and discomfort. There can also be the feeling of tightness wrapping around the waist and dull aching across the lower back as the surrounding muscles tighten up as a form of protection, also known as muscle guarding. A correct diagnosis is vital to avoid any potentially serious complications. Chiropractors are experts on neuromusculoskeletal problems and can treat, heal, and strengthen the body through various MET, mobilization, and manipulation techniques.

Sacroiliac Sprain

The main function is to balance the upper and lower body forces. The sacroiliac joints are surrounded by muscle, connective tissue, nerves designed to withstand large stresses, and a complex system of ligaments, further strengthening the joints.

Injury Causes

Sacroiliac sprains can be caused by direct trauma to the pelvis from a fall or automobile collision or jobs and sports that involve a lot of bending and twisting. However, sometimes there is no distinct cause. Common causes include:

• Repetitive microtrauma is excessive/repetitive movements like prolonged twisting, bending, or lifting at work, home, physical activities, and sports.
• The joint can be pushed out of alignment.
• Muscular imbalance or weakness in the muscles surrounding the sacroiliac joints can cause problems to develop over time, presenting little or no symptoms.
• The tissues around a sacroiliac joint also can be stretched or torn.
• Trauma such as a fall or road traffic accidents
• Problems with the hips, knees, and feet can generate increased pressure on the joint, which can become painful over time due to repetitive strain.
• Pregnancy hormones released to promote pelvis relaxation can increase the risk of SI sprain injury.

Excessive stress on the joint can cause microscopic damage to the ligaments surrounding the joint. The joint then becomes inflamed and presents with pain and sensations of discomfort. The body responds by contracting the muscles to prevent further damage. However, the muscle spasms may not stop, resulting in more pain. Referred pain is common from the muscles that go into spasm, with the most affected being the piriformis, gluteal/buttock, and psoas muscles.

Signs and Symptoms

• Tenderness over the affected joint and area.
• Pain symptoms on one or both sides above the joints and into the buttocks.
• Standing or working with increased weight on one leg increases pain symptoms.
• Pain after lifting or twisting that develops a little while later.
• Pain travels to the back of the leg, front of the thigh, and the groin.
• Pain gets worse when sitting and bending forward.
• Lying down eases the symptoms.
• Most cases report no loss of strength, tingling, or numbing sensations.

Chiropractic Treatment

Chiropractic treatment will relieve the pain symptoms, but there are stages of treatment, each with specific goals before moving to the next.

• The objective of the initial stage is to decrease pain and inflammation.
• The second stage is stabilizing and restoring proper musculoskeletal function.
• Rehabilitation and targeted stretches and exercises will be introduced as the treatment continues.
• In the maintenance stage, there should be no pain, and the individual should be able to perform normal daily activities and return to normal life.
• Recovery time for a sacroiliac sprain can be 4-6 weeks but can take months to heal completely.

Chiropractic Approach for Pain Relief

References

BIDWELL, A M. “Treatment of sacroiliac sprain by manipulation.” The Medical World vol. 65,1 (1947): 14-6.

Evans, P. “Sacroiliac sprain.” American family physician vol. 48,8 (1993): 1388; author replies 1390.

LeBlanc, K E. “Sacroiliac sprain: an overlooked cause of back pain.” American Family Physician vol. 46,5 (1992): 1459-63.

Sun, Chao, et al. “Cost and outcome analyses on the timing of first independent medical evaluation in patients with a work-related lumbosacral sprain.” Journal of Occupational and Environmental Medicine vol. 49,11 (2007): 1264-8. doi:10.1097/JOM.0b013e318156ecdb