Sacroiliac Joint Dysfunction
While there are many conditions that refer pain to the area of the S.I. joint, the S.I. joint itself can also be the source of an individuals pain.
Presentation/Signs and symptoms:
Patients usually report a dull ache that is present in the low back, although rarely above the belt-line and usually below the posterior superior iliac spine (PSIS) in a 3x10cm rectangular pattern. It can radiate into the pelvis, groin, or gluteal regions, thigh, and calf. Unlike individuals with low back pain, individuals with SI joint dysfunction have been found to have minimal to no symptoms in the ischial tuberosity region.
Some causes include:
Pathogenesis:
The anatomical source of pain can include the joint area itself, as well as the ligaments of the SI joint. Arthritic pain may occur due to loosening of ligaments or injury to the irregular articular surfaces.
Risk Factors:
Relative Tests and measures to rule in/out conditions:
Standing forward flexion
Gillet Test
Gaenslen's Test
Pain provocation tests (click here for video example): Distraction test, Compression test, Thigh Thrust (P4), Sacral
thrust
References:
1. Dressendorfer R, Granado MJ. Sacroiliac Joint Dysfunction. In: Richman S, ed. Ipswich, Massachusetts: EBSCO Publishing; 2012:7p.
2. van der Wurff P, Buijs EJ, Groen GJ. Intensity mapping of pain referral areas in sacroiliac joint pain patients. J Manipulative Physiol Ther 2006; 29 (3):
190-195.
3. Forst SL, Wheeler MT, Fortin JD, Vilensky JA. The sacroiliac joint: anatomy, physiology and clinical significantce. Pain Physician 2006; 9(1):61-67.
Presentation/Signs and symptoms:
Patients usually report a dull ache that is present in the low back, although rarely above the belt-line and usually below the posterior superior iliac spine (PSIS) in a 3x10cm rectangular pattern. It can radiate into the pelvis, groin, or gluteal regions, thigh, and calf. Unlike individuals with low back pain, individuals with SI joint dysfunction have been found to have minimal to no symptoms in the ischial tuberosity region.
Some causes include:
- Direct fall on or sever trauma to the hip, sacrum, or buttocks that causes pelvic torsion
- Asymmetric laxity of the SI joint during pregnancy
- Spinal curvature, unilateral lower extremity pain on weight bearing
- Leg length discrepancy that causes abnormal posturing
- Lumbosacral dysfunction that alters gait pattern
- Degenerative osteoarthritis that alters SI joint mobility
- Repetitive rotational motions
Pathogenesis:
The anatomical source of pain can include the joint area itself, as well as the ligaments of the SI joint. Arthritic pain may occur due to loosening of ligaments or injury to the irregular articular surfaces.
Risk Factors:
- Over 50 years of age
- Female
- individuals participating in sporting activities that involve significant throwing, kicking, or unilateral loading, specifically Rowing.
Relative Tests and measures to rule in/out conditions:
- Gait/locomotion - observe gait mechanics for faulty mechanics or asymmetry that may indicate restriction or weakness
- Joint integrity and mobility - palpation of the SI joint in addition to lumbar and hip joint mobility
- Posture
- Range of motion
- Special Tests :
Standing forward flexion
Gillet Test
Gaenslen's Test
Pain provocation tests (click here for video example): Distraction test, Compression test, Thigh Thrust (P4), Sacral
thrust
References:
1. Dressendorfer R, Granado MJ. Sacroiliac Joint Dysfunction. In: Richman S, ed. Ipswich, Massachusetts: EBSCO Publishing; 2012:7p.
2. van der Wurff P, Buijs EJ, Groen GJ. Intensity mapping of pain referral areas in sacroiliac joint pain patients. J Manipulative Physiol Ther 2006; 29 (3):
190-195.
3. Forst SL, Wheeler MT, Fortin JD, Vilensky JA. The sacroiliac joint: anatomy, physiology and clinical significantce. Pain Physician 2006; 9(1):61-67.