SIJ & Buttock Pain Treatment Guidelines?
While SIJ and buttock pain treatment will vary depending on your specific diagnosis, your physiotherapist will have the following aims.
PHASE I – SIJ Pain Relief & Joint Protection
While pain relievers or anti-inflammatory medications are often prescribed for acute SIJ dysfunction, they will not address the actual cause of SIJ pain. A healthcare practitioner who has a comprehensive understanding of the biomechanics and muscular control of your SIJ, pelvis and hip complex should thoroughly assess chronic cases of SIJ dysfunction. Managing your sacroiliac pain is the main reason that most people seek treatment for sacroiliac joint dysfunction. In truth, it was the final symptom that you developed and should be the first symptom to improve in most cases. If this is the case, the prevention of a recurrence becomes your priority.
You can often achieve natural short-term pain relief using ice or heat packs applied to your SIJ’s.
You are managing your inflammation. Sacroiliac joint inflammation is best eased via ice therapy and techniques or exercises that unload the inflammed structures. Your doctor may recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen. Some seronegative arthritis conditions can predispose you to sacroiliitis. Your doctor can arrange special blood tests to assist in diagnosis in these conditions. Prolonged morning stiffness is a common complaint. See Ankylosing Spondylitis.
SIJ Protection & Support
Sacroiliac joint instability occasionally requires additional passive support until your muscles successfully control the joint. Supportive taping is often beneficial during the initial pain reduction phase.
SIJ Stability Belt
You may manage longer-term instability with a sacroiliac joint stabilisation belt. However, an exercise protocol to specifically address your SIJ issue usually is more effective.
If you have any questions, please seek the advice of your SIJ physiotherapist.
PHASE II – Restoring Normal ROM and Strength. Early Hip Core Exercises.
As your SIJ pain and inflammation settle, your physiotherapist will turn their attention to restoring your normal pelvic joint alignment and normalising the dynamic muscle control that affects the SI Joints.
Your physiotherapist may commence you on a lower abdominal core stability program to facilitate your important muscles that dynamically control and stabilise your lower back and pelvis. They will also implement a similar activation and strength program that addresses your deep gluteal muscles. These muscles are sometimes referred to as your hip core muscles. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for your specific needs.
PHASE III – Restoring Full Function
Your physiotherapist will turn their attention to restoring your normal pelvic alignment and maintaining sacroiliac joint range of motion during more functionally stressful positions. They will also work on your muscle power, proprioception, balance and gait (walking pattern). Depending on your chosen sport or activities of daily living, your physiotherapist will aim to restore your SIJ function to allow you to return to your desired activities safely.
Everyone has different demands for their sacroiliac joints that determine what specific treatment goals you need to achieve. For some, it is simply to walk around the block. Others may wish to run a marathon. Your physiotherapist will tailor your sacroiliac joint rehabilitation to help you achieve your own functional goals.
PHASE IV – Preventing a Recurrence
Sacroiliac joint dysfunction does tend to return if a thorough muscle control program is not undertaken. The main reason it is thought to be chronic and specific muscle weakness. Your physiotherapist will assist you in identifying the best exercises for you to continue indefinitely or periodically.
In addition to your muscle control, your physiotherapist will assess your SIJ, spine, hip and lower limb biomechanics and correct any deficits that may predispose you to SIJ pain and dysfunction. Fine-tuning and maintenance of your sacroiliac joint stability and function are best achieved by addressing deficiencies and learning self-management techniques. Your SIJ physiotherapist will guide you.
More information: SIJ Pain & Dysfunction