What is sacroiliac pain?

Exercise can relieve sacroiliac back pain with abdominal and back strengthening exercises, and front and back rotation exercises.
Exercise can relieve sacroiliac back pain with abdominal and back strengthening exercises, and front and back rotation exercises.

Lower back pain affects many adults around the world. In the U.S., this is largely the result of our modern sedentary lifestyles and the work we do.

Lower back pain is not always caused by spinal cord issues. It can be caused by the inflammation of the joints in your lumbar area that hold the upper and lower body together. These are called the sacroiliac (SI) joints. If these joints become inflamed, they can cause pain that is similar to pain from a lower spinal injury.

Inflammation of these joints is most commonly caused by some of your muscles being stronger than others. This imbalance can strain your joints and irritate them.

If you’re experiencing pain in your hips, lower back, or down your leg, your doctor may provide you with some exercises. These exercises can help to even out your muscles’ strength and relieve your sacroiliac pain.

Symptoms of sacroiliac pain

Sacroiliac joint pain is caused by the inflammation of one or both of your sacroiliac joints. These joints are where your spine and your sacrum connect to your pelvis. The lower back pain that you feel when these joints are inflamed is similar to other conditions, like a herniated disc.

You might experience several of these symptoms if your sacroiliac joints are inflamed:

  • Pain in the lower back area
  • Pain in your buttocks
  • Pain that goes down your leg
  • Pain that gets worse after moving your hips
  • Pain that gets worse after long periods of sitting or standing

Causes of sacroiliac pain

The inflammation of your sacroiliac joints is known as sacroiliitis. The sacroiliac joints are the joints that hold your upper and lower torsos together by joining your spinal cord and the hips. They bear most of the load that we subject our bodies to. They can become inflamed for several reasons, such as:

Pregnancy creates a long-term extra load on the sacroiliac (SI) joints. Childbirth can also cause the SI joints to flare as they are stretched.

Although the SI joints are very durable, they are still susceptible to overuse injuries. Several sports activities or work conditions can cause inflammation, even in younger people and athletes.

Over time, SI joints can degenerate similarly to other joints in the body from overuse or chronic inflammation and cause osteoarthritis. This condition causes the bones in your joints to rub against each other.

Pyogenic sacroiliitis is an infection of the SI joint. It is commonly caused by the staphylococcus aureus, or staph, bacterium. This infection can result from pregnancy, sharing needles, trauma, or as a side effect of infection of another organ in the body.

Diagnosis for sacroiliac pain

Only a licensed healthcare professional can diagnose the medical condition that may be causing your sacroiliac pain.

The leading causes of sacroiliac pain are typically associated with the physical activities of the people who develop the condition. This group includes pretty much anyone whose movements put heavy strain on the SI joints over long periods.

They can be athletes, people of any age, women that are pregnant or have given birth, or someone who works as a manual laborer of some kind.

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Treatments for sacroiliac pain

Exercises for pain

Before performing any exercises, check with your doctor about your medical history and whether exercising might place you at risk of other health conditions. If your doctor says you can exercise, here are some sacroiliitis exercises you can do to relieve sacroiliac pain.

Abdominal and back strengthening

There are three major muscle groups in your abdomen and lower back that can be strengthened to relieve sacroiliac pain.

To strengthen the flat wall of muscle on the front of your abdomen called the rectus abdominis, perform a crunch with arms crossed across the chest. Perform three sets of 30 per day for three weeks to strengthen your abdominals.

The erector spinae is a group of muscles that keep your spine erect. There are several exercises you can do to strengthen these.

The simplest exercise is to perform a squat while holding a light-weight dumbbell in each hand. Bend at your hips, not with your back, and squat until you’re parallel to the floor. Stand up, reset your position, and repeat for three sets of 30 repetitions daily for three weeks.

The biceps femoris is your hamstring. To strengthen this group of muscles, you can use a resistance band placed around your ankles in the prone position.

Secure the band to something solid, or have a friend hold it for you while you curl your legs up towards your buttocks. Slowly lower them, and repeat. Do this for three sets of 30 repetitions every day for three weeks.

Front and back rotation exercises

You can strengthen some of the muscles surrounding your sacrum, normally referred to as your tailbone. These exercises can correct some of your alignment problems.

First, to strengthen the muscles in the front, stand with your back to the wall. On the side where the pain is, pull your heel back into the wall for seven to 10 seconds.

Next, place your foot on the side that hurts on a chair. Lean forward over the bent knee for three to seven seconds to stretch the hip flexors. Repeat these exercises three times daily for three weeks.

To strengthen the muscles surrounding your tailbone, stand facing the wall. Begin, on the side that hurts, by holding your leg out backward for seven to 10 seconds.

Second, while standing, place the foot opposite the side that hurts on a chair, and lean over your knee for three to seven seconds to stretch your hips. Repeat these exercises three times daily for three weeks.

Risks and complications of exercise for sacroiliac pain

If your sacroiliac pain is not caused by degeneration or bacteria, the exercises included here might improve your symptoms within three weeks.

If you’re experiencing severe pain in your hips, buttocks, legs or are having trouble going to the bathroom, you should immediately see your doctor.

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Medically Reviewed on 2/2/2021
References
Infection & Chemotherapy: "A Case of Acute Pyogenic Sacroiliitis and Bacteremia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus."

Journal of the Belgian Society of Radiology: "Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis."

Physical Therapy Scholarly Projects: "Sacroiliac Joint: An Overview."

Sports Health: "Low Back Pain in Young Athletes."

StatPearls: "Sacroiliitis."