The sacroiliac joint is the joint that connects the lower spine to the pelvic bone. It acts by cushioning the forces generated by the movement of the legs towards the spine, e.g. when jumping.
In pregnant women, it plays an important role in childbirth; a low movement of this joint helps to widen the area where the head passes through the pelvic ring, facilitating the birth of the newborn.
Although it is more common with advancing age, it can occur at any age and affects men and women equally.
Repeated trauma during sport, incorrect posture and osteoarthrosis are the most common triggers. Other causes: falls, kicking in the air, pelvic torsion and ankylopoietic spondylitis.
It manifests with pain in the lower back. The pain may be worse when sitting, turning and standing for long periods of time. It is usually accompanied by reactive contraction of the lumbar and buttock muscles.
Diagnosis is clinical, by questioning the causative agents and the movements that increase or trigger the pain. Physical examination with specific movements of the legs over the pelvic joint reveals this syndrome. Imaging tests such as a CT-scan and/or MRI can help in the diagnosis. The disappearance of pain when painkillers are administered directly to the sacroiliac joint is the most confirmatory diagnostic test.
Physiotherapy helps the recovery process, which is usually lengthy. It is advisable to avoid long periods of sitting, to stand up regularly to lengthen the spine, and to do exercises to strengthen the stabilising muscles of the pelvis.
Treatment is based on pain control and avoidance of the triggering cause when known. Local analgesics are usually injected into the ligaments of the sacroiliac joint or directly into the joint space. In addition, corticosteroids and local anaesthetics may be injected to enhance pain control.
