Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright November 15, 1989
Dear Dr. Horowitz:
I have often heard of the part of the body called the sacroiliac. What exactly is this and can it become slipped like we often hear? The reason I ask is that I was having some lower back pain and a friend, who is a nurse, told me I probably slipped my sacroiliac.
Answer:
A joint is where two bones meet each other. The Sacroiliac Joint is where the Sacrum meets the Ilium or Iliac Crest. The joint where these two bones meet is referred to as the Sacroiliac Joint. We have two of them, one on each side, just under the small “dimples” in the lower back near the top of the buttocks.
There is normally a small amount of motion (in most people under 40 years of age, after that the joint does get stiffer with advancing age) between the Sacrum and Ilium whenever the person moves, walks, twists, or bends.
If the movement between the two bones is full and free, there is usually no pain. If something goes wrong with the motion (too much, too little) then pain will usually be felt. This pain will be local over the buttocks, and the lower spine. Pain may be felt in the thigh, hip, or groin. Pain may also be felt down the leg and even into the foot, which is confusing and sometimes leads to an incorrect diagnosis of “Sciatica”, and therefore, results in the wrong treatment.
Getting up from a seated position, twisting to get out of a car, climbing stairs, and even doing simple things like bending to put on your shoes will be very painful, or sometimes impossible.
NUMEROUS CAUSES
The causes of “Sacroiliac Syndrome” are numerous. A twist during a sporting event, a fall, sleeping or sitting incorrectly or for too long, driving a long distance, or just a simple lack of exercise in that part of the spine, can all lead to this condition. Pregnancy can also lead to increased motion in the Sacroiliac joints and therefore an instability in the joints, or a difficult delivery can sometimes cause a “locking” or stiffening of the joints. Both of these situations will lead to pain.
Sometimes a person with other back problems will undergo surgery, and the time then spent in the hospital and the weeks of immobility will lead to a tightening of the ligaments which surround and support the Sacroiliac Joints. This will then cause the patient to return to his surgeon complaining that the pain is still present. The surgeon will examine the patient and declare that the operation was a success. What really has happened is the Sacroiliac Joint has stiffened and that is what is causing the pain.
Chiropractors are the experts when it comes to correcting most Sacroiliac Joint disorders. When the joint is unstable and the ligaments are not holding the joint properly, sometimes rest and/or a brace is required. However, most often the joint is too stiff and it has to be mobilized to restore the proper mechanics. Once this is done, pain relief is not too far behind.
I often say that Sacroiliac Joint disorders are a good news/bad news situation. The good news is that most of them are fairly easy to correct, and they usually respond within a few treatments. The bad news is that it tends to be a recurring problem. There are exercises which can be done to prevent the problem from recurring and these exercises should always be done after you have been “cured” of Sacroiliac Joint disorder.