Patients commonly receive physical therapy treatment for SI joint problems. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.
Treatment choices depend on whether the SI joint is stiff or loose. A stiff or “locked” joint responds best to mobilization, a form of stretching used to improve joint movement. Along with hands-on techniques used by the therapist, mobilization includes specific exercises to improve SI joint mobility. For conditions where the joint is too loose, such as arthritis or SI ligament injuries, stabilization treatments are chosen to hold the joint in correct alignment. Stabilization exercises involve posture and muscle training.
Therapy sessions may be scheduled two to three times each week for up to six weeks.
The goals of physical therapy are to help you
- learn ways to control symptoms and manage your condition
- learn correct posture and body movements to reduce SI joint strain
- obtain optimal movement and alignment of the SI joint
A sacroiliac belt may be issued to help stabilize a loose and painful SI joint. The belt wraps around the hips to squeeze and hold the SI joints together. This supports and stabilizes the pelvis and the SI joints. Learn more about back and neck braces.
SI Joint Injection
An injection into the SI joint using cortisone is helpful for calming pain and inflammation. The injection usually gives temporary relief for several weeks or months.
Surgery may become an option if all conservative methods of treatment fail. Surgery on the SI joint usually consists of a fusion of the joint (also called an “arthrodesis”). Fusing the two sides of a joint together to reduce pain has been used for many years as a treatment for arthritic joints.
An incision is made over the SI joint in the lower back. The joints are opened so the surgeon can see each joint surface. The articular cartilage lining the joints is removed from both surfaces. This leaves a fresh surface of bone instead of the normal cartilage. The bone surfaces are then held together until they heal or fuse. Without the articular cartilage of the joint, the body treats the two raw bone surfaces just like a fracture, and tries to heal them like any broken bone.
To hold the bones together, the surgeon will usually insert several metal screws across the joint. Bone graft may also be placed around the joint to help fuse it. The bone graft is usually removed from the pelvic bone right beside the SI joint.