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ARTICLES

Sacroiliac Joint (SIJ) Syndrome

These two sacroiliac joints (SIJ) are formed on either side of the sacrum (triangular shaped bone below the lumbar spine and above the coccyx), where it articulates with the pelvis. This area carries the weight of your entire abdomen, torso, head and arms.

The sacroiliac joint (SIJ) is a complex joint. Very little movement is possible at the joint compared to other joints in the body e.g. ball and socket or hinge joints.

Mechanisms of injury

  • The most common cause of injury to the SIJ seems to be trauma. Falls, especially off horses, account for a large percentage of cases. However any fall, stumble or even slipping on a wet surface may be enough to slightly dislodge this joint.
  • Motor vehicle accidents are another common cause, where the driver typically has one foot on the accelerator/break pedal and the other on the clutch. This asymmetry on impact causes the joint to shift.
  • Pregnancy and labour affect the SIJ due to hormonal releases to soften ligaments, preparing for the birth process. Many women need to wear special maternity SIJ belts during pregnancy
  • Scarring due to infection or abdominal surgery e.g. Caesars, affect the viscera and in turn causes misalignment of the SIJ.

Symptoms

  1. These can be very varied and often lead to this syndrome being misdiagnosed.
    1. Groin pain
    2. Pain directly over SIJ area. i.e. slightly lower than lumbar area and to one side
    3. Pain radiating into buttock/thigh
    4. Lower back pain - due to impact on lumbar spine i.e. facets and discs.
  2. Less obvious areas of pain
  3. - Headaches
    - Neck pains, specifically on rotating head to a certain side
    - Persistent pain between the shoulder blades
    - Persistent shoulder tendinosis that does not resolve with appropriate localized treatment
    - Foot pain i.e. chronic plantar fasciitis
    - Recurring unilateral calf or hamstring tears
    -Certain knee pains where x-rays are clear and no pathology can be located in the knee joint
    - Jaw clicking/pain (TMJ dysfunction) can sometimes be caused by a SIJ dysfunction

    Signs that the SIJ may be involved

    1. One leg appears shorter than the other i.e. slacks/pants hang unevenly
    2. R + L shoe sole wears unevenly
    3. Bra strap on one side slips off shoulder
    4. Patient complains of pain at night due to position and is unable to get comfortable.  Inclined to get up as soon as he wakes up rather than have a “lie in”
    5. Only able to cross one leg over the other when sitting on a chair e.g. R over L and not L over R
    6. Not able to sit cross legged on a floor
    7. Standing and walking is more comfortable than lying down
    8. Unable to stand on one leg to put shoe or socks on
    9. When lying flat on your back your feet are not symmetrical i.e. one foot may turn in or out more than the other
    10. Inability to strengthen your core muscle regardless of perseverance and correct instruction

    SIJ - an emotional joint

    Over the years I have found certain patients do not respond to the purely mechanical/osteopathic treatment of this syndrome.  As this joint forms part of our “base” or “grounding”, when there is any disruption of our “stability” i.e. major life changes, the SIJ tends to play up.

    Cranio - sacral therapy is extremely effective in treating the SIJ syndrome both on a mechanical and an emotional level

    1. Stimulating stem cells release with exercise, fasting, sleep, radiation protection and herbal extracts like stem enhance, AFA, chlorella, spirulina, cordyceps, polygonum multiflorum, astragalus, epimedium, ginseng, Echinacea, fucoidan, pterocarpus marsupium, pine bark proanthocyanidins, curcumin, pomegrante, lupeol, grapholide, vitamin D3, blueberry, carnosine and green tea. etc. Gradual improvement could be seen after 2-3 months.
    2. Autologous stem cell therapy at NeuroGen Brain&Spine Institute in Mumbai, India, www.neurogenbsi.com with Prof Alok Sharma or other similar facilities worldwide. Dramatic improvement could be seen after 2-3 months

    Conclusion

    This article serves to shed some light on this very interesting dysfunction. If you suspect that you might be suffering from a SIJ dysfunction contact a physiotherapist or cranio - sacral therapist.

    _____________________
    Charmaine Barr

    B.Sc. Physiotherapy (UOFS)
    Diploma Cranio-Sacral Therapy
    Cell: 082 802 2550