Pain can be like a roaring lion that grabs our attention and then pretty much paralyzes us in our tracks. I know I have spent many blog posts sharing fact after fact with you to show you the realities of the limitations of how we diagnose and treat SI joint pain, and what we do with it.
I know that information is really hard to digest and can be frustrating. Believe me. I have been frustrated for years. When a few of us formed the Non-Profit Sacroiliac Joint Dysfunction Foundation back in 2011 and I started to learn all the holes within the diagnosis and treatment of SIJ Pain, the more frustrated I became!
It became very very clear that there were a lot of errors and disagreements among professionals about what caused the pain and how that needs to be “fixed”.
It became very clear through my own journey, education, and exposure to all these top professionals that there was a good reason so many of us with SIJ pain felt like we weren’t getting the help we needed. It’s because we weren’t! It’s time to say goodbye to outdated information and hello to evidence-based solutions for getting rid of that mind-numbing pain. Let’s dive in and discover the best ways to tame SI joint pain.
SI Joint Pain: A QUICK Overview
SI joint pain refers to discomfort and inflammation in the sacroiliac joint. Which is located in the lower back where the spine meets the pelvis. The sacroiliac joint is a weight-bearing joint that transfers forces between the spine and the lower extremities. It has a small degree of motion, think millimeters, but it does move.
Symptoms of SI joint pain can vary from person to person but often include lower back pain, hip pain, and discomfort in the buttocks and legs. The pain can be dull and achy or sharp and stabbing. It is usually worse with prolonged sitting, standing, or walking.
Diagnosing SI joint pain can be challenging as the symptoms often overlap with other conditions. Diagnostic criteria are also not able to tell us why the joint hurts, just that it does. Healthcare professionals will typically perform a thorough history and physical examination and should rule out red flags and tissue injury. Imaging tests, such as X-rays or MRI scans, should be used to rule out other potential causes.
Treatment for SI joint pain usually begins with conservative measures such as rest, ice, physical therapy, and medications to reduce inflammation and pain. If conservative treatments “fail”, more advanced options like injections or minimally invasive surgical procedures are usually offered but aren’t always helpful. Read on to see why and what is!
Ruling Out Red Flags & Serious Tissue Issues
Before diving into ways to tame SI joint pain, it’s important to rule out any red flags or serious tissue issues. While SI joint pain is often a common musculoskeletal issue, there are instances where it may be a symptom of a more serious underlying condition. If you’re experiencing persistent and severe SI joint pain, make sure red flags or potential serious tissue issues are ruled out.
Red flags that may indicate a more serious issue include: unexplained weight loss, fever, loss of bowel or bladder control, loss of sensation or motor control, or a history of cancer or recent infection. These symptoms may suggest an infection, tumor, or other systemic condition that requires immediate medical attention.
Additionally, certain conditions such as ankylosing spondylitis, osteomyelitis, or spinal fractures can present with symptoms similar to SI joint pain. These conditions need to be ruled out before focusing on specific treatment options for SI joint pain. We wanna treat the right thing! Not chase ghosts.
Remember, it may be challenging to get treatment. So be informed, and know what you need. If you need help getting ready to talk to your team, book a consult with me. We can get you armed and ready before you go.
Chronic Pain SI Joint Pain Is More About Sensitivity Than Damage
It’s easy to feel like there must be something seriously wrong with your body when you’re experiencing ongoing pain. However, it’s important to understand that chronic SI joint pain is often more about sensitivity than actual damage to the joint.
The body’s nervous system is incredibly complex, and sometimes it can become hypersensitive to certain stimuli. In the case of SI joint pain, the nerves around the joint may become sensitized, causing them to send danger signals to the brain even when there isn’t any structural damage. This is known as central sensitization.
Central sensitization can occur as a result of various factors, including prolonged inflammation, repeated trauma, or even psychological stress. The brain essentially becomes “wired” to send out pain, even when the original cause of the pain has resolved. This is why chronic SI joint pain can persist long after an injury or inflammation has healed.
Understanding that chronic SI joint pain is more about sensitivity than damage can be a game-changer in how you approach treatment. It means that focusing solely on fixing the joint itself may not be the most effective solution. Instead, addressing the central sensitization and retraining the nervous system’s response to pain will be more beneficial.
BUT My SI Joint is out of alignment, hypermobile, dislocated…
I really want to focus on solutions here, but I need to let you know these explanations of why you have pain are hurting you. These explanations are keeping you stuck spending money on treatments that are highly unlikely to fix your pain. They can increase your pain though. The links at the bottom of the page give detailed information about why these explanations are outdated and should no longer be used. In short, they are biologically inaccurate. Stories (explanations) like these lead to a fragile and fear-based mindset which increases the likelihood we will have pain. These narratives actually increase nervous system hypervigilance.
The Body is Strong and Adaptable
Our bodies are truly amazing and resilient. When it comes to SI joint pain, it’s important to remember just how strong and adaptable our bodies can be. The human body is constantly evolving and finding ways to cope with challenges and injuries, like scoliosis or leg length differences.
Even if you’re dealing with chronic SI joint pain, it doesn’t mean that your body is weak or broken. In fact, it’s quite the opposite. Our bodies have an incredible ability to heal and adapt, even in the face of ongoing pain.
When you experience SI joint pain, your body goes into protection mode. It tries to stabilize the joint and protect it from further damage. It may do this by tightening the muscles around the joint or adjusting your posture to alleviate stress. While these adaptations are meant to be protective, they can sometimes exacerbate the pain.
It’s important to recognize that pain is by various factors, including stress, sleep, habits, and overall health. By prioritizing self-care, managing stress, getting enough sleep, and adopting healthy habits, you can create an optimal environment for your body to heal and thrive.
But here’s the good news: your body has the capacity to change. I promise you that healing will take more than just addressing the physical aspect of your pain.
Treatment: The Goldilocks Principle
Now that you have a better understanding of SI joint pain and have ruled out any serious underlying issues, it’s time to explore the various treatment options available. When it comes to treating SI joint pain, it’s important to strike the right balance – not too much and not too little. This is where the Goldilocks Principle comes into play.
The Goldilocks Principle, often referred to as the “just right” principle, suggests that finding the perfect balance is crucial for achieving optimal results. In the context of treating chronic SI joint pain. Our goal is to calm our nervous system and create a safe environment for our nervous system and tissues so that our SI joint will stop hurting! We must go beyond physical therapy, massage, stretching, lotions, potions, and pills if we want to heal. Those pieces are helpful, but they are not the solution.
You will need to find your “just right” in terms of the following
- Medications
- Sleep
- Stress management
- Movement
- Activities
- Rest
- Mental Health
- Pacing
- Various Treatment Options from the least to the most invasive.
Remember, the Goldilocks Principle reminds us that it’s all about finding the right balance. You are working to find safety and balanced loads: emotionally, physically, and mentally. You don’t want to overload your body with excessive treatments that could potentially do more harm than good. At the same time, you don’t want to do too little. This goes for each and every item I listed above. Balance with the mental, emotional, and physical loads we bear is when and where we find pain relief. Physical Therapy can be great, but it can also load us up with a lot of unnecessary weight.
Finding your ” just right” takes time and an experienced leader, but it is possible! With the right combination of interventions tailored to your specific needs, you can find that “just right” balance and effectively manage/heal your SI joint pain. If you want more help finding your balance, get in touch with me to see if coaching is right for you.
Being Active in Your Own Care
Ultimately you are the best person to treat yourself. Of course, we need assistance developing our plans and understanding what we need. However, those with chronic SI pain who self-manage, are the ones that get free from pain the fastest.
Chronic pain is a beast to bear. Medicine is failing us terribly because no one can make a pill or an exercise to correct a nervous system that has been jacked up. We are the ones who can “fix’ that. Being told how fragile and breakable we are drives us in the wrong direction. Too much too soon in terms of movement and exercise also drives us further into pain. Not enough movement or challenge also keeps us in pain. Ignoring the role of feelings, stress, emotions, and behaviors in conjunction with our pain will continue to keep missing the points that help us heal.
All those areas must be addressed to heal. Just like if we only address our mental health around our pain, that won’t solve our pain either! It has to be the whole person, all the things on that list.
Now you know
So now you know what you need to tame that miserable SI pain. It is possible. I know, I did it. I’ve helped others do it. You can do it too. Please, just stop wasting time doing all the things that aren’t working. If it were going to heal you, it would have done so by now. It’s okay to keep doing things that help, but if you aren’t better – it’s time to try something different.
You do know the definition of insanity, right?
Doing the same thing over and over expecting a different result.
Let’s get this pain under control, shall we? Contact me, I can help.
More reading on SI Joint Pain
The Mysterious SI Joint Explained
Tell Me How to Diagnose My SI Joint Pain
The Myths of Physical Therapy and Pain
The Ultimate Guide To Treatment Options For SIJ Pain
Mark Laslett, PhD ( huge researcher in SI Joint Dysfunction pain has a lot to share as he has continued to learn and research) https://www.youtube.com/watch?v=80A0WezSD2k
Changing the Narrative in Diagnosis and Management of Pain in the Sacroiliac Joint Area https://academic.oup.com/ptj/article/99/11/1511/5540027
