Do you have a Sacroiliac Joint Problem? Learn about how we test for Sacroiliac joint (SI) problems
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- Опубликовано: 22 июл 2024
- Do you have a Sacroiliac Joint Problem? Learn more about this problem and how we screen for it at Apex.
The sacroiliac joint (SIJ) connects the sacrum with the pelvis on each side of the lower spine. The joint is the prime connection between the lower lumbar spine and the legs. The SIJ is relatively stable and has very limited motion.
Patients who present with this problem may have the following symptoms:
Pain reported on one side but can present on both in rare cases
Pain typically reported in the buttock and back of the thigh
More commonly found in young or middle age women.
Treatment can consist of: physical therapy exercises, manipulative or mobilizations to the SIJ, anti inflammatory medications and/or muscle relaxers, injection of the joint using anesthetic or in a small number of cases a SIJ fusion.
One of the key things is to make sure the lower lumbar spine or hip joints aren't the source of the problem. A thorough clinical evaluation should screen for both these areas. Since only %13 of patients with chronic low back pain have Sacroliac joint problems you must be careful to rule out the other possible sources of pain. At my clinic I use the McKenzie method to screen our patients for possible hip and lumbar problems.
After we have screened the lumbar and hip i use a series of 4 sacroiliac joint provocation tests described by the researcher Laslett. If 3 out of 4 of these tests are positive you most likely have a SI joint problem.
Coming soon! Check out our next video to learn more about how we treat SI joint problems!
Apex Orthopedic Rehabilitation I can’t find that video but really need it! Help please!
@@joyceramirez2979 I think this video does not exist
Trust me, this make ya feel instantly much older, so glad that it is treatable
Good luck!
Can SI hypermobility be fixed by surgery only? Thank you.
I have been three years with that problem exactly ,from today I try if I can find a solution thank
If that helps you see a physical Therapist that is McKenzie certified. If you need the website just reply back in the comments to find a certified Mackenzie physical therapist
Exactly I was about say it feels like in that pain in my tail bone
Superb
h do that test and it is positive but i have pain and felling of heat in s1 my history pain i have boulge and herinated disck in l5 s1
Faber test is another test for SI Joint dysfunction
Thank you so much for this video! I went to two doctors (urgent care & my PCP); none of them do these tests. The only test that one did was poking on my left buttock; but it didn’t hurt because the pain was deeper. First doctor said it was SI, and the second doc did nothing, but suspected it was recurrence of RA.
I’m usually very active, exercise regularly, but at one point I felt a slight pain on my left buttock after lifting something heavy. It went away for a few weeks, and came back with extreme pain, especially in the mornings when getting up from the bed. When I stand up from sitting, I felt like something very heavy in my pelvis. Almost like my pelvis couldn’t carry my own upper body weight; I’m a skinny person. I couldn’t even extend a arm (to reach something) that would cause the intense pain.
Can it go to the other side when first side resolves by itself? Thanks again!
Same story here.. 😭
I had an accident a year and a half ago when I was outside when my right leg slipped out from under me and I heard a pop. Along with the pop,I felt very warm on the right side and all the way through my back. They found that I had tore the IT band by the hip and major muscles along with the Gluteus Maxus to the back. Since then I continue to swell constantly in my hip all the way back where my SI joint hurts very bad. They didn’t find any fracture but they did see that there’s constant fluid coming from the SI joint. On the right-side my IT band tore there’s a large lump that doesn’t allow me to sleep on that side for over a year now. They can’t figure out why I’m continuing to swell and so much pain with my SI joint is. At times the fluid is constant and I can actually feel a sack of fluid in my lower back and have to massage it for it to go away. Would you have any suggestions. They have done MRIs and bone scans and can’t figure out why there’s fluid there. It’s getting old now😪. Constant swelling and pain. Can’t stand long and can’t drive more then an hour.
What have the doctors said about the swelling?
@Apex Orthopedic Rehabilitation: I am positive on all 4 😢 Can you PLEASE recommend something for stretching and fixing it on a daily basis? (I would visit but I live on another side of the world)
Thank you!
How did happen? Any trauma? Did you lifted heavy weight since pain started?
May I have the link to the treatment video ?
OMER I will make one soon.
Ok, ready for this question?
I’ve been diagnosed with, herniation at, L2-L3( no surgery) front of thigh pain, also, bilateral hip bursitis, tendinosis of both hamstrings, minimal spinal stenosis, osteoporosis of the spine, ANNDDDD, sacroiliac arthritis, am in constant pain, which should be treated?
I’m having, back of thigh pain, also, the butt, some groin pain, and spasms at the top of hip area, and, sciatic pain too!!!!
Maria Elena Marino that is many different areas of concern. I would concerned about a systemic problem and a rheumatologist evaluation might be a good idea. Feel free to provide some more details as far as who you have seen for these various problems. Thanks for the question!
I’ve been tested for rheumatoid arthritis ( 1 year ago) came back, negative! I was in a car accident, 2 years prior to all of these problems, but, will be getting checked again , for rheumatoid, thanks for answering so quickly🙏🏻
Maria Elena Marino no problem. Best of luck with your next appointment
My pain is off to the right at the top of my buttocks. It hurts at the bottom of my squat, and when I deadlift. No sciatica down my leg. I have used the McKenzie method and various things to no avail.
You may need someone to look at your squat form.
@@TheMualer you do need someone to look at your movement, your body biomechanics. Even elite weightlifters/athletes get slight form changes through their career let alone an amateur
Hey i have a aching below my lower back, below my s1 joint but more to the side.
I did the all the 4 test and non of them felt any pain.
Must the pain be very obvious? Because i didn't felt any pain at all. So can i confirm it is not a S1 joint problem?
If you don't you most likely don't. That Being said you have to bet put a fair amount of pressure when doing those tests and sometimes require someone else to help you with it
@@apexmovebetter
Hey thank you so much for the reply! 😊truly appreciate it!
Ya i did had someone to help me do it, and there was decent amount pressure applied but nothing very hard.
So i guess i'm confirmed i don't have an s1 joint problem.
But why is there aching somewhere below my s1 joint area, which is at the right side but above my buttocks.
If you use an SI joint belt and get relief and are able to function much better, does that necessarily mean the problem is with the SI joint?
In a way it gives evidence that it is probably si joint issue. It also May make you aware of your movements at the lumbar spine therefore giving you a sense of relief from pain
Hey there i only tested positive for the 3rd test, my physio suspects i have Piriformis Syndrome but wasnt sure weather that is isolated or wether it is related to a si joint problem, my left si isnt very mobile either. Any suggestions? Thankyou
Callum Cudahy I would just make sure you have ruled out the lower back being a source of any of your problems.
Apex Orthopedic Rehabilitation thankyou im going for a lumbar mri tomorrow to see
Tell us what the results are! Good luck!
Hey i'm a new subcriber of yours and i really like your videos because everything is said in details.
Also i'm curious to ask you a question
When i lift my leg off the ground, my lower back makes pop sound and it doesn't hurt at all. But i assume it is the s1 joint or sacrum i guess.
Basically this pop happens when i rest on the bed for quite some time and then i would do a leg raise, then a pop can be heard at the back.
And my doctor said it is nothing to worry about if the pop is not accompanied by a pain and that i should just ignore it.
So i just want to confirm with you if it is true it is nothing to worry about?
It is nothing to worry about. Lots of pops occur when joints change position. I agree with your doctor. Have a great weekend.
@@apexmovebetter
thank you so much for the reply!
Because i have been really curious to clear this doubt for quite some time.
"Also" can you confirm me this, whenever i get of the bed after some time of resting my s1 joint area makes a pop sound too.
And whenever i turn to the other side during my sleep it makes a pop sound too.
Also all this pops happens everyday, everytime whenever i rest on the bed for around 15mins or more it is enough to make the pop sound when make these movements i mentioned above.
Baiscally the popping sound are just alarming to me makes me really curious
It's so what my doctor said is really true? I want to double confirm thank you so much!
Hey can please you confirm my 2nd question for me, i'm still very curious thank you so much!!
@@Blue_Tsuki Just to clarify you want to know what the pop is from the s1 or sacrum?
If that is your question you have very little motion at SI joints and most likely from L5- S1 region. Very hard to tell. I hope this helps! The SI probably has more motion in hypermobility patients who have EDS and pregnant women.
@@apexmovebetter
so basically the popping sound that i hear is when i get up from the bed or when i twist my body while i'm sleeping, it happens like everytime "AFTER quite some time resting on the bed" but no pain associated with it.
So i just want to CONFIRM that i have nothing to worry about, just like my doctor said?
Since you are an expert i do like the confirm with you and continue my competitive sports soon.
along with the symptoms that you mention in your video , is it possible an SI joint problem could cause an IT band related symptoms aswell ? Can the SI joint problems agitate the TFL muscle and consequently pull on the IT band ?
Mike Kirk it could but I would be concerned that maybe some of these symptoms are coming from the lumbar spine. Location of pain or stiffness is not always the structure that is generating pain.
Apex Orthopedic Rehabilitation thanks for your reply , how is a lumber spine issue confirmed .... MRI ? Or by other means ?
Mike Kirk I do a series of movements that stress the lumbar spine in various positions to see if I reproduce the patients symptoms.
I been in this pain for about four years now I feel like it’s been my si joint all along instead of my syotica it’s been so painful that it makes me nasua
You may need a professional to make a proper diagnosis so you can get the necessary treatment.
Teresa, get an MRI for the SI joint
What if : 1 you have symptoms bilaterally(sciatica/cold feet) 2: laying on the L side is provocative to some degree and 3: extension based movements like bridges, bird dogs or prone on elbows are provocative. Possible SI joint/ lumbar pathology or a combination of the two? I have an MRI scheduled and recent x-rays show good vertebral alignment, no facet pathology and good disc space/height. I've had intermittent chronic symptoms x6 years and the MRI then(6 y/o) did no-show anything significant in so far as stenosis, any of the 3 spondy's or herniated disks, just mild arthritis and disk bulges L4-5. Normal findings for a 40 y/o man per the neurologist at the time. I have pain at the PSIS region and lumbo-pelvic junction, I can't tell if it's muscular or facet at the L4-5 level and L >R. Also lots of deep gluteal discomfort and at the iliac crest. I've seen many PT who are specialists in spine/orthopedics and the hips were ruled out as was anything disc related. Sitting, prolonged standing, and walking bring on the sciatica s/s but no issues squatting, lunging or going up/down stairs. I also have symptoms in my legs anteriorly and posteriorly as well into the groin, all to varying degrees and intensities. I am a PTA and feel posture, faulty movement and weak hip abd/adductors may contribute although I can single leg stand x1 min bilaterally w/o symptoms or hip drop but when walking my LLE does feel longer and I notice a tendency to shift my hips laterally to the L when walking. Have you ever come across anything like this in your practice?
let me know if you find out whats wrong. your symptoms sound exactly like mine and nobody can tell me whats wrong with me. mine started in sept '19
@@itzgood421 I have a suspicion my hips, the femoral heads, are not centered in the acetabulum or sockets. If the femur(s) are positioned anteriorly(forward) it can have symptoms similar to SI joint dysfunction amongst other things. See a PT and ask to be evaluated and check out hip centration exercises. I hope this helps.
Would an SI joint issue cause balance problems? I have cervical and lumbar stenosis, in the last year , I have terrible tailbone pain. I had a bad fall about 2 months ago at work tripping on a loose wire. Since then have tried get MRI but cannot lie flat, I have no balance and need to use a walker. The pain in the right SI joint almost makes me feel like I could pass out , it is that bad and goes all the way to the hip. I am at the end of my rope. My feet are also so numb constantly, that I can no longer drive. because I cannot feel the pedals. The neurosurgeon refuses to see me until I get an MRI. The worst of all is that I have no balance and cannot stand. Thanks for any insight you can provide.
It could cause balance problems but if You were having numbness in your feet You really need an MRI. I’m not denying you have an SI joint problem but you have something else coming on that should be explored with an MRI
@@apexmovebetter Thank you so much for your feedback!
@@plum_loco You’re welcome
@@plum_loco yout welcome!
2:33 save some time if you already know you have SI joint pain.
I've had this 18 years in misery being ignored by all doctors. I'm begging for an Si joint injection but no-one will listen. I hope I can convince a Dr to do the si joint injection if it doesn't work fuse it. I can't take anymore its destroyed my life and my families.
Danielle Mccarter How did they diagnose the SI joint?
@@apexmovebetter hey my left si joint hurts and I checked my leg length and my right leg is longer than the left
HandsUp ENT _ we often have leg length discrepancies but not all are related to SI issues
@@apexmovebetter I got a knot on my left si joint and he already fixed my leg and pelvis but it still hurts... What you think???
@@handsupent_7919 how did he fix your leg length what adjustment did he do what position? I have the same thing
Hii sir what Avoid in sacroiliitis
Keep up with gentle movements like walking , biking whatever does not increase your pain levels.
I'm female mom, Please I need your help where to go and which Doctor I need to go or PT or Chiropractor or Doctor specialist?!!
My symptoms are: I have pain around my pelvic ; exactly I couldn't sit comfortably around my rectum and my anus and around my tailbone , and same time my vagina muscles not working as normal like muscles closed not opening during intercourse is it vaginismus too!? I live in Illinois ,any advices, I appreciate it help me please 🙏🙏🥺
Sounds like a pelvic floor physical therapist is what you need. Have you seen your primary care for this yet?
I think this is the issue I'm having 😥 my problems didnt start until I had gastrointestinal fistulas (multiple) causing severe infection all in my abdomen.
Now in left with adhesion related disorder and all my organs are fused and not moved at all as they cant. As the adhesions are so severe.
Can adhesions cause issues with this joint?
Carly Archer I don’t think so but can be completely sure
Thank you. It was so severe it went through muscle decline my abdomen so wasn't sure.
I have reactive arthritis because of crohn's disease and osteoarthritis recently found in my shoulder.
Bad enough having chiari malformation and tmj. Now my sudden shooting pain just off centre from my tailbone it's like I need to push i can only relate them to spasm type feeling but I have a stoma?!
I have to pull my knee up to my chest to relieve it then after a while my hip area aches😫
I get a weird tingling in my really low back and it makes my leg go funny to the point I cant move my leg it's so uncomfortable. Thanks anyway hopefully they'll figure it out soon lol its weird when my leg goes completely dead and my back will zing if I try thinking about moving my toes lol my body is strange
I feel pain in all those four steps. I came to know about this “SI joint” lately. Please help me to find out, is it curable by Physiotgerapy? Any exercise or only through surgery. I started getting this pain after my pregnancy, as per MRI test, I have arthritis on my right side of the back. Please reply. Thank You heaps.
smritee dahal you may be able to treat it through a gentle flexibility And strengthening plan
Apex Orthopedic Rehabilitation for that I have to do Physiotgerapy exercise, right?
My right si joint hurts nd swells when I don't take pain killers...it then goes down my leg nd feels like sciatica which i have already suffered with last 8 months...i m confuse wt it is? Sciatica piriformis or si joint dysfunction....bcz my lower spine also hurts nd i cannot make balance if i walk properly...so i walk so weirdly
Possible lower lumbar problem ifyou are having balance problems.
@@apexmovebetter sir should i see a chiropractor?? bcoz exercises are not helping me now
@@destiny7664 do an MRI of the pelvis, it may be sacroiliitis
I can lift 200lb whenever I like, no worries,, it's walking or going uphill/upsteps that I can't do
It can be a form of stenosis.
@@apexmovebetter I looked up stenosis, I think you are right, Thankyou very much indeed ❤️
Can not hear.. get better mic
Will do
turn ur volume up genius
Give him a pillow, please.
silvano de lazzari I also saw he always kept his head up check for neck issues
Speak louder please
You are far far away. about what human body means!!
Sebi A a little confused
You are too far way about you talking!! Do you have a licence about what you talking? Just ask because i am very scary about your talks and all you do!! I dind learned in this way on my medical college!!!!
Sebi A this is a clinical prediction rule that is cited in the literature.
Stop. He's in a whole orthopedic office. And he's knowledgeable. Don't use someone else's platform to talk about your "come ups".
Troll.
@@katrinamcneil5395 thanks for your support.