SI Joint Pain
SacroIliac Joint Pain Isn't A Joint Problem

SI Joint Pain is a very problematic pain dynamic.  It hurts.  It hurts to move.

It's a different kind of pain from, say, wrist tendonitis.

Doctors focus on and treat the sacroiliac joint itself when it hurts.

But when the sacroiliac joint is hurting, it's just a symptom of a larger problem.  So when the doctor give corticosteroid or PRP injections...the chances of a lasting benefit are very small.

What Causes SI Joint Pain?

SI Joint Pain is caused by something. It doesn't just show up out of the blue for no reason.

Sacroiliac joint pain is not one of the causes of low back and hip pain and everything in between (the SI is right there between the two).

Said another way, doctors treat symptoms, so they only look at the painful joint...as if that is the cause of the painful joint.

Symptoms show up because of Causes.

Can SI Joint cause hip pain?  No, it can't.  A joint is just a joint.  But the factors that cause SI joint pain can cause hip pain.


So, what causes sacro-iliac joint pain?

• The tendonitis dynamic, specifically Hip Tendonitis
• Pelvic misalignment
• Dysfunction at the foot/lower leg, for instance, Achilles Tendonitis and/or Plantar Fasciitis

The Tendonitis Dynamic

Tendonitis can show up anywhere.  It's a dynamic made up of multiple factors:

• too tight muscle and connective tissue
• chronic inflammation
• nutritional lack

When there is hip tendonitis in play, that means one or more (always more) muscles in the hip are too tight, and they are pulling on things too much.

This can:

• pull the pelvis and/or sacrum out of proper alignment (see the 'pelvic misalignment' section below.
• And/or, too tight structures in the low back can pull things out of whack.
• And/or, too tight muscles can compress the SI joint, so it's grinding on itself 24/7, and moreso when you move.  Eventually, that starts to hurt.  
• Then the joint gets locked into an irritated, aggravated, painful state.

With the tendonitis dynamic, we're always in a state of Downward Spiral, until we do effective self care or other hip treatment to push our body and mechanical function back into an upwards spiral of less tightness and less pain.

How can you have less sacro-iliac pain if you don't remove the cause of the pain, i.e. chronic tightness and joint compression??

Pelvic Misalignment

The pelvis can be pushed or pulled out of alignment by two primary scenarios:

• Impact, like a fall or sports collision
• Too tight muscles and muscle imbalance

Impact can literally knock the pelvis out of alignment.  It doesn't have to be an 'injury' per se (although it can be but that's a whole other larger pain problem).

An impact can knock alignment askew, and/or cause muscles to lock up tight to 'guard and protect', and that can cause a pelvic alignment.

Too tight muscles can be caused by impact trauma, but also by years and decades of poor posture, sedentary lifestyle, driving, certain repetitive job-related postures/movements, etc.

Oh, and of course, pregnancy can throw the pelvis for a loop. More on that farther down the page.

Dysfunction At The Foot and/or Lower Leg

Osteopaths and some PT's will look at the whole body if you have pain at or near your sacro-iliac joint.

They'll look at your pelvic alignment, and they'll look at your lower leg function.

When muscles aren't working correctly, they don't absorb force like they're supposed to.

That force still has to go somewhere....up to your knee, or up to your hips.

Achilles Tendonitis can cause SI joint pain.  If it is the cause, you have to reverse the achilles tendonitis if you want to actually cure the SI problem.

SI Joint Pain And Hip Tendonitis

It's common for pain at the sacroiliac joint to show up with hip tendonitis.

If you have hip tendonitis, you have too tight muscles and connective tissue in the entire glutes, sacrum, and low back area.

Joints will compress and become painful.  

It is important to note that you can have:

• SI joint pain AND hip joint pain
• SI joint pain WITHOUT any hip joint or hip tendonitis symptoms

Having both joints (or area around one or both joints) hurting is a pretty obvious scenario.

But what stumps an embarrassingly large percentage of doctors (pretty much all of them) and most PT's and related professionals, is when you have SI symptoms but NO hip symptoms.

You can have active hip tendonitis factors in play even without any pain.

If your SI issue is CAUSED by hip tendonitis, then you have to effectively reverse the hip problem so that compressive pressures will be removed from the sacroiliac joint.

SI Joint Pain And Lower Back Pain

Muscles of the low back are intimately connected to the sacrum and the iliac crest(s).  And the glutes.

There's A LOT going on in the lower back and hips, all working together and connected by big muscles, STRONG connective tissue layers, torqe, force, gravity, compression, etc.

The tighter things get, the more:

• the sacrum can get pulled out of alignment (compressing or be pulled apart)
• one or both iliac/pelvis bones can get pulled out of alignment
  
• The sacro-iliac joint can get compressed, or pulled apart, or both

Like hip tendonitis being an invisible cause of sacroiliac joint pain, low pack pain (or more accurately, the causes of low back pain) can cause SI joint irritation and pain.

SI Joint Pain Pregnancy

If you are or were pregnant with SI joint pain pregnancy is a common cause.

Partly because the growing baby is literally pushing the pelvis apart, and partly because the pregnant body produces a hormone called Relaxin, which tells ligaments to stretch.

The pressure pushing against 'relaxing' ligaments forces/allows the sacroiliac joint to separate to a degree.

Lots of other things are going on there too, different forces and pressures and pulls.  Plus the body moving around...there's lots going on there.

Specific to the SI structure, when the aligned or misaligned sacrum pulls away from the aligned or misaligned pelvis bone...that's going to cause pain and problem. 

And inflammation process (which releases a chemical that enhances your sensitivity to pain).

And a brain that thinks there's an injury happening, so it kicks in defensive mechanism (more inflammation, more tightness, more pain).

A REALLY good PT or osteopath can help keep things aligned/straight.  Massage therapy can help in general.

SI joint pain pregnancy is not fun to go through (or so they tell me), but there's no stopping the Relaxin (and you wouldn't want to).

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