The sacroiliac joint connects the sacrum to the pelvis and transmits force from the spine to the lower body. Sacroiliac joint dysfunction can cause low back pain and radiating hip or leg pain due to too much or too little movement at the joint. Diagnosis involves physical exams like Faber's test and imaging, while treatment includes rest, ice, medications, bracing, physical therapy exercises, and electrical modalities.

2.  The sacroiliac joint lies next to the bottom of the spine,
below the lumbar spine and above the tailbone (coccyx). It
connects the sacrum (the triangular bone at the bottom of
the spine) with the pelvis (iliac crest).
 The joint typically has the following characteristics:
1. Small and very strong, reinforced by strong ligaments that
surround it
2. Does not have much motion
3. Transmits all the forces of the upper body to the pelvis
(hips) and legs
4. Acts as a shock-absorbing structure
Brief Anatomy to refresh
your memory

3.  While it is not clear how the pain is caused, it is thought
that an alteration in the normal joint motion may be the
culprit that causes sacroiliac pain. This source of pain can
be caused by either:
 Too much movement (hypermobility or instability): The
pain is typically felt in the lower back and/or hip and
may radiate into groin area.
 Too little movement (hypomobility or fixation): The
pain is typically felt on one side of the low back or
buttocks, and can radiate down the leg. The pain usually
remains above the knee, but at times pain can extend to
the ankle or foot. The pain is similar to sciatica, or pain
that radiates down the sciatic nerve and is caused by
a radiculopathy.
SI Joint Dysfunction

4. 
 Low back pain
 LBA with radiculopathy
 Pain on one side of hip
 Ipsilateral pain in back
 Pain in posterior aspect of SI joint.
Signs and symptoms

5. 
 Physical examination
a. Palpation
In physical examination, try to determine if the sacroiliac joint is
the cause of pain through movement of the joint. If the movement
recreates the patient’s pain, and no other cause of pain can explain
the patient's pain and symptoms (such as a disc herniation on an
MRI scan), the sacroiliac joint may be the cause of the pain.
b. X-Rays
c. CT/MRI scan
d. Special tests
Fabers test/patricks test/figure 4 test
Accurate diagnosis

6. 
 The test is performed by having the tested leg flexed, abducted,
and externally rotated.
 If pain is elicited on the ipsilateral side anteriorly, it is
suggestive of a hip joint disorder on the same side.
 If pain is elicited on the contralateral side posteriorly around
the sacroiliac joint, it is suggestive of pain mediated by
dysfunction in that joint.
Fabers test

7. 
 Ice packs/hot packs/rest . Initial treatment
recommendations will typically include use of ice or cold
packs
 Apply in 15 to 20 minute intervals as needed to reduce
inflammation in the area, along with rest to reduce
irritation.
 Depending on the duration of sharp, intense pain, ice can
be continued anywhere between 2 days to 2 weeks. Once
the inflammation is less, gradual return to normal
activities may be advisable.
 Application of heat (such as a heat wrap or hot bath) may
help the healing process, but not during the acute, high
intense pain time frame.
Treatment

8. 
 Medications
a. Anaelgesics (acetaminophen)
b. NSAIDS (ibuprofen/naproxen)
c. Anaesthetic with steroid (lidocaine with
corticosteroid) to reduce inflammation and swelling
with associated pain.

9. 
 Supports/braces
When the SI joint is "hypermobile" or too loose, an
"orthotic" or brace about the size of a rather wide belt
can be wrapped around the waist and pulled snugly to
stabilize the area. This can sometimes be very helpful at
times when the joint is inflamed or painful. When it
calms down, the orthotic can be weaned away.

10. 
 Physiotherapeutic rehabilitation
a. Electrical modalities
b. Strengthening/stretching exercises
c. Hydrotherapy

11. 
 IFT
 TENS
 ULTRASOUND THERAPY
 LASER
 SWD
Electrical modalities

12. 
Exercises

13. 
Hydrotherapy