Sacroiliac joint sprain is a common cause of lower back pain. It is the result of damage or tears to the ligaments that hold the sacroiliac joint (SI joint) together (Ligaments are the tissue that connects the bones at the joint). A sacroiliac joint sprain is usually the result of sacroiliac joint injury, were a stretching movement causes a sprain, not too different from an ankle sprain.
What causes a Sacroiliac Joint Sprain?
The sprain is caused by injury to the sacroiliac joint, usually due to twisting, falling and even direct impact can result in a force strong enough to force the SI joint out of it’s normal position and therefore cause the surrounding ligaments to stretch and tear.
It is also common for women to develop sacroiliac joint sprain during pregnancy, as the body releases hormones to that allow ligaments to relax and prepares the pelvis and body for childbirth. The relaxation of the sacroiliac ligaments holding the SI joint often leads to an increase in the movement of the sacroiliac joint, which in-turn increases the pressure on the ligaments surrounding the SI joint, resulting in stretching and tearing of the SI ligaments and consequently developing SI pain.
Condition that alters the normal walking gait can often increase the stress on the SI joints and lead to sacroiliac joint sprain. These include leg length discrepancy (where one leg is longer than the other), or pain in the hip, knee, ankle or foot. Pain in the lower limb usually leads to a change in the way we walk, which often results in lower back pain or SI pain, due to the change of our biomechanics.
Symptoms of Sacroiliac Joint Sprain
Pain is usually the most common symptom, usually patients feel the pain in their lower back, but sometime the pain is also felt in the buttock, hip, groin and back of thighs.
Pain is worse in the morning and after long periods of inactivity, this is usually due to the build-up of inflammation. Which also explains why moving around gently can be helpful for their SI pain.
Stiffness is also noted by the majority of patients with sacroiliac joint sprain.
What happens to the ligaments in a Sacroiliac Joint Sprain?
Ligament tissue mainly made up of collagen fibres and are arranged in a longitudinal pattern to resist the stress that is placed upon the ligament. The arrangement of the collagen fibres means that usually a great deal of force is required to damage ligaments. This doesn’t mean that sacroiliac joint sprains are only caused in major collision sports, as its very common for most people to get minor ligament tears with repetitive movements, specially if there are underlying problems or conditions.
In a minor sacroiliac joint sprain, there is damage to a a few collagen fibres, which will produce a local inflammatory response. This is usually characterised by mild SI pain and/or lower back pain. The more extensive the damage to the ligament the strong the inflammatory response and therefore the worse the pain.
How is it Diagnosed?
Most often sacroiliac joint injuries are not revealed on a plain x-ray or an MRI.
There are a number of clinical examination tests that your clinician can perform to help confirm the diagnosis. These test are focused on reproducing the pain to determine that it originates from the SI ligaments.
Treatment of Sacroiliac Joint Sprain
Even minor injuries to the sacroiliac ligaments can take quite some time to heal. On average ligaments can take up to 6 months to heal and as the SI joint is a weight-bearing joint and a significant amount of stress is always applied to it during standing, walking and even when seating down, getting better can be very tedious and frustrating.
You might want to consider visiting a Physical therapist, such as an Osteopath, Physiotherapist or Chiropractor, to help manage the pain. Depending on the severity of the sacroiliac joint sprain it might take between between 2 weeks to 8 weeks to bring the SI pain under control. This however does not mean the the SI sprain has healed and its important to follow the exercises and stretches given to allow the SI ligaments to heal completely.
The first line of treatment in most causes is usually to place a cold pack on the effected area, this will help reduce the inflammation and therefore reduce the pain. Oral anti-inflammatory medication can help with controlling your pain, but remember that they will only reduce the symptoms and not remove the cause of the SI pain.