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Where does your back go when it “Goes out”?

One of the leading causes of a back “gone out” is sacroiliac (SI) joint dysfunction. This takes place when the sacroiliac joint rotates out of place or is inflamed for some other reason. The patient may be able to point to the time and activity when this occurred or may not be aware of the cause, but sure of the pain.


The sacrum is a triangular base of five fused vertebrae at the bottom of the spine. The ilium is part of the pelvis or hipbone. The sacroiliac joint is where the sacrum and ilium join together. This joint is supported by strong ligaments, which can become lengthened, weakened, and/or inflamed with misalignment of the SI joint.


What does SI joint pain feel like? Some symptoms can include pain on one side of the tailbone area, pain or tingling down the leg, increased pain with stairs, and referred pain to other areas of the back, hip, and buttock. This can mimic sciatic nerve pain.


Fortunately, treatment is available. Treatment must begin with ensuring that the SI joint is aligned, where an educated professional, such as a physical therapist, will do a few tests to check the symmetry of bony landmarks by palpation. If a pelvic rotation is detected, the professional will perform a manipulation or muscle energy techniques will be used to align the patient. These muscle energy techniques can be taught to the patient to be used during the time away from the professional if incidents of misalignment persist.


Once alignment is restored or in the case of inflammation of the joint without misalignment, pain and inflammation can be relieved with the use of modalities including ultrasound, electrical stimulation, low level laser, and iontophoresis. Most importantly, proper exercises to strengthen and stretch the surrounding ligaments and muscles are vital. This restores strength and stabilization to overstretched ligaments and restores muscle balance to keep the problem from recurring.


Depending on the severity of the problem, stabilization exercises may begin in the aquatic environment with transition to land-based activities. Land-based exercises will always be important as stretching and strengthening must continue at home. Our goal is not to keep you regularly dependent on professional assistance, but rather return to you the health and independence you had before your back ever “went out”. If you have any questions concerning SI joint dysfunction or its treatment, contact Progressive Physical Therapy at 301-729-3485.


Article submitted by Crystal Yoder, PTA

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