Not only can Sacroiliac problems be extremely painful they can be challenging to diagnose and really limiting to our ability to do almost anything. And, they’re often very different from one person to another. 

Sacroiliac pain often starts in the lower back and buttock and can radiate into the hip, the goin, or even the upper thigh. Many doctors mistaken it for a bulging disc. The pain is usually on one side but can be on both sides. There can even be some numbness or tingling down into the leg.

The symptoms tend to show up with any stress to the pelvis and this can happen with sitting, standing, in bed, while walking, or climbing stairs.

What is the Sacroiliac?

The Sacroiliac or SI joints are located on both sides of the tailbone or sacrum  between the sacrum and the two pelvic Iliac bones. These joints provide stability that allow us to sit and walk. The joints have less mobility than other joints, but provide more stability. When the joints become injured or unstable it poses challenges since we rely on their stability any time we sit, stand or walk. 

As a chiropractor I see a tremendous interplay with and relationship between the SI joints of the pelvis and the junction of the mid and lower back as well as the very bottom of the spine. 

If the lower mid back tightens up it causes a tightening of one or both SI joints. Like any joint that is supposed to move, a restriction of the SI joint on one or both sides leads to problems. 

Since these joints bear the weight of your entire upper body and should move with every step any imbalance of the SI joints seems to have a magnified effect. Sometimes the pain is not felt at the SI joints at all.

3 Reasons Sacroiliac Problems are Devastating

The Sacroiliac joints are unlike any other joint in the spine or the rest of the body. We can’t really sense their movement since it is very small but any significant alteration in motion or stability has significant consequences. 

Reason #1: Your Pelvis is Your Foundation: The SI joints in the back and the pubic joint in the front forms a ring on which the weight of your entire body rests. As soon as you sit up in the morning you are resting your entire body weight on your pelvis and sacroiliac joints. In fact there is more stress on these joints sitting than there is standing. 

Bending forward even a little puts tremendous additional stress on the SI joints. This holds true both in a sitting and standing position. Walking also increases the demands on these joints. And, any kind of twisting to an injured SI joint magnifies the stress to the area many times over. 

Because of all this it can be incredibly challenging to take enough stress off of the Sacroiliac joints for a long enough time to heal. 

Reason #2: Sacroiliac Joints Pass Stress to Other Areas: Perhaps more than any other area problems in the Sacroiliac Joints cause a chain reaction of compensations in areas above, below, and on the other side. If you do not have smooth motion in your Sacroiliac Joints there is significant added stress to the lumbar spine above and to the last 2 discs in the low back. Uneven motion of the Sacroiliac Joints also puts added stress on the hip joints. I believe this imbalance is one reason we see so many hip replacements in the absence of significant trauma. And, a problem in one SI joint will cause a problem in the opposite SI joint over time. 

This makes it especially important to resolve any SI joints because over time it will cause a chain reaction of compensations and problems in other areas, making it an even more complex and challenging problem to solve. 

Reason #3: Few Practitioners Understand How to Correct the Sacroiliac:The Sacroiliac Joint is very different from any other joint in your spine. Very few practitioners, chiropractors included understand how to help correct SI problems. And, medicine is far worse. Their care options include injections, radiofrequency ablation which destroys nerves, and surgical fusion. Some recommend exercises involving stretching and strengthening. While these can be valuable adjuncts it’s important to realize there are no muscles that cross this joint so no stretching or strengthening is going to directly help this issue. 

In my experience a good percentage of SI problems are caused by problems elsewhere so that even though the pain is localized at the SI joint this is not the area that needs care. 

Your pelvis is your foundation. If it is not level and strong you will have problems. Sometimes the pain will be localized to the pelvis but often the symptoms arise in other areas from the hips to the lower back. If your pelvis is unlevel it will create adaptations all the way to your upper neck. 

If you were building a house you would want to ensure your foundation is strong and level.

In your vehicle you want your wheels balanced and the front end aligned to ensure a smooth ride and long lasting tires. 

Your Sacroiliac Joints and Pelvis are your foundation. Don’t ignore problems there as they will only magnify over time. 

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