Sacroiliac (SI) joint dysfunction is a common contributor to low back pain. In this interview with physical therapist Valerie Phelps, PT, ScD, she explains what sacroiliac joint dysfunction is, how to identify it and what to do about it.
Q. Where is the sacroiliac joint?
A. The sacroiliac (SI) joint is located in the pelvis. It links the iliac bone (pelvis) to the sacrum (the lowest part of the spine, just above the tailbone).
Q. What is sacroiliac joint dysfunction?
A. The SI joint is designed to take on load and transfer it from the spine to the legs and reverse. It is what we call a “mobile stabilizer.” When the loads through the SI joint are too great, or the ligaments that hold it together become lax (such as in pregnancy), the joint becomes “too mobile.” This can lead to pain in the pelvic ring, and sometimes even in the low back or legs. It leads to an “unstable” foundation for the spine and legs, altering movement patterns and often causing a sense of weakness.
Q. What is the difference between muscle pain in the low back and low back pain caused by SI joint dysfunction?
A. Very often there is little difference in the sense of pain because these regions are so interrelated. One could say that pain above the iliac crest/sacrum “belongs” to the low back, where pain below the iliac crest or along the sides of the sacrum are related to the SI joints.
Q. How would a person know if their pain is due to muscle pain or if it’s caused by SI joint dysfunction?
A. In general, muscle pain due to a strain should only last a few days, such as after a long walk or a good workout. Heat often makes it feel better. In instances of a recent SI irritation (from too much motion, or sometimes a “locked” joint) the muscles will respond in a “splinting” type fashion; in this case they are trying to support the joint, and painful spasm of the muscles can be experienced. In longstanding SI joint pain, muscle pain can actually become part of the problem. They have been in a protective “splinting” for so long they develop trigger points and fibrous bands that will respond well to dry needling or manual therapy press and stretch techniques. In both recent and longstanding cases, the underlying problem still needs to be addressed, which is where the SI-LOC can be helpful.
Q. How long should someone wear the SI-LOC if they’re experiencing pain due to SI joint dysfunction?
A. People experiencing pain due to SI joint dysfunction can wear the SI-LOC Support Belt 24 hours a day, 7 days a week for 300 to 500 days (the length of time it takes the ligaments to “turn over” and shorten). The SI-LOC is meant to be what we call an “external stabilizer,” which people need when they can’t internally stabilize. It very simply holds the wedge-shaped joint at the lower aspect of the joint, much like an ice cream cone holds a scoop of ice cream.
Q. What sets the SI-LOC belt apart from other support belts?
A. It is simple, it can be worn next to the skin, and it’s invisible under the clothes.
Learn more about the SI-LOC Support Belt
Valerie Phelps, PT, ScD, is a physical therapist and the founder and director of Advanced Physical Therapy. She is also the founder of the U.S. branch of the International Academy of Orthopedic Medicine (IAOM) where she serves as education director.
