Sacroiliac Joint Dysfunction: Low Back And Leg Pain

The sacroiliac joint, also known as the SI joint, connects the lower spine to the pelvis. Alongside robust ligaments, the joint facilitates the transfer of power along our back and supports us to perform complex movements like weight-bearing, walking, and running.

By nature, the SI joint is not very flexible. Damage or degeneration of the SI joint can be significantly detrimental to a patient’s quality of life.

Mild cases can be resolved with conservative treatment. However, in cases of long term wear and tear, severe degeneration of the joint can lead to a serious loss in the lower back’s stability and mobility. 

Causes of Sacroiliac Joint Dysfunction

There are a few known factors that can lead to pain in the back, specifically in the sacroiliac joint. Some of them include:

• Injury in an accident or trauma which can displace the SI joint and lead to immense pain.
• Poor proprioception adds excess pressure onto the SI joint and ligaments, which can lead to overloading of the joint.
• Sudden forceful exertion on the SI joint, typical of high-intensity contact sports like football and rugby, increases the risk of SI blockage.

Chronic pain in the sacroiliac joint is more commonly associated with:

• Long term wear and tear of the SI joint, also called arthrosis, leading to weakening of the joint and surrounding ligaments. 
• Loosening of the symphysis during pregnancy, leading to instability of the pelvic girdle and increased risk of developing pain in the SI joint.
• Infections and associated inherent pre-existing conditions, like rheumatic diseases, can make certain patients more susceptible to symptoms.

Note: Bechtrew’s disease is a rheumatic disease that leads to chronic inflammation in the SI joint at a young age. The first symptom of this condition is pain in the back while sleeping.

• Broken bones or herniated discs can result in weakening of the muscles, which increases the chances of degeneration of the SI joint.

SI Joint Dysfunction Symptoms

Patients typically suffer from a range of symptoms, most commonly including:

• Intense pain in the area of the SI (lower back).
• Radiating pain in the lumbar spine and legs.
• Feelings of paralysis or numbness in the legs.
• Patients often complain of bladder and bowel emptying disorders.
• Severely restricted mobility – a patient’s back is stiff and the intensity of the pain significantly increases, with movement, during the day. 
• Pain initially occurs upon exertion. However, in chronic cases, the pain can become consistent and debilitating to a patient’s quality of life.
• In the long term, this eventuates into osteoarthritic pain and can persist even when the body is at rest.

Early detection of the condition is often the best prognosis as it can significantly improve outcomes. Immediate medical treatment is highly advised.

Diagnosis of Sacroiliac Joint Dysfunction

A complete patient history and physical examination provide critical information. A medical professional can conduct typical tests to detect stress in the sacroiliac joint and also indicate the possible involvement of the sciatic nerve.

A blood test may be conducted if ankylosing spondylitis, which is a type of spinal inflammatory arthritis, is suspected. Sophisticated imaging technology, such as X-rays and CT scans, can detect possible herniated discs, vertebral fractures or spinal dislocations. These can also be instrumental in studying the long term progression of the condition.

SI Joint Dysfunction Treatment

Treatment typically involves relieving the pain and inflammation and managing the symptoms of the disease. The ultimate goal is to curb the progression of the disease and prevent long term wear and tear of the SI joint.

• Rehabilitation And Physiotherapy
  • Regulated physiotherapy helps with targeted muscle training and is a proven effective treatment path.
  • The prescribed exercises can help promote the reorganization of the muscles and are the most effective option to slow the progression of the disease. 
  • Encouraging healthy proprioception and strengthening of the lower back muscles helps prevent long term degeneration and manage the pain.

• Prescribed Painkillers
  • Painkillers, such as Ibuprofen or Panadol, can be used to alleviate pain and discomfort in patients.
  • In cases of inflammation, a professional may prescribe the patient with anti-inflammatory medication.
  • In advanced patients, localized cortisone injections may be necessary to prevent excess pressure build-up due to the inflammation.
  • Importantly, painkillers only temporarily treat the pain without addressing the underlying condition. In addition, tolerance may occur where the effectiveness of the drugs decrease as well as other potential side effects.
• Heat And Infrared Application

Used regularly, heat and infrared therapy on the lower back can aid treatment and provide relief. Heat is often applied to relieve the pain in the sciatica.

• SI Blockage Therapy

Doctors or physiotherapists will often use one of two methods to relieve SI blockages in the spine.

• Mobilization – Carefully stretching the joint to improve mobility.
• Manipulation – Releasing the blockage briefly by exerting force on the affected joint.
• Medical Back Braces

It is highly recommended that ample support to the SI joint is provided through the use of a medical back brace. The targeted compression, that braces provide, boosts circulation and reduces the possibility of effusions and edema. 

Wearing a Bauerfeind brace, like the SacroLoc, can be instrumental in treatment, by providing enhanced stability, proprioception and medical-grade compression. This is not found in simple neoprene braces and has proven to be more effective. 

ORTHOSIS: Pain Relief for Sacroiliac Joint Dysfunction

Bauerfeind’s SacroLoc back brace effectively stabilizes the sacroiliac joint and supports the pelvic region. The brace features a two-part gel cushion which massages the trigger points around the sacroiliac joints and the muscles surrounding it.

The compression helps to increase blood circulation and boost recovery. As a result of supporting the pelvic region, the brace also relieves the lower back and reduces the pain experienced by patients.

Unique and adjustable tensioning straps are featured on the SacroLoc to allow patients to straighten the pelvis and ensures that the brace is fitted perfectly to the contours of the patient’s body.

The brace is anatomically designed to adapt to everyday movement and can be easily worn under everyday clothing. Daily use of a medical back brace is proven to be effective in prognosis and managing long term progression.

In more severe cases, A LumboLoc Forte with the sacral insert can help alleviate more severe cases of pain 

Lumbago: Chronic Lower Back Pain

The lumbar region of the back is instrumental in providing stability and facilitating the transfer of power to the lower body. It allows for complex movements like bending, walking and running. Overexertion and poor proprioception often lead to patients experiencing pain in the lower back area, also known as lumbar pain.

In mild cases, targeted treatment can lead to complete recovery. However, long term neglect and degeneration can lead to chronic pain in the lower back. Chronic pain is fairly common and affects people of all ages.

Low Back Pain Causes

There are several factors that can cause pain in the lower back. Some of them include:

• Overexertion and stress
• Poor and unhealthy proprioception
• Lack of exercise and being overweight can lead to excessive stress on the lumbar region.
• Overworking or performing high-intensity physical activity
• Injury or accident trauma
• Lumbago – pain in the surrounding muscles and joints of the lower back

Long term neglect and degeneration of the lower back can lead to chronic lower back pain. A patient can sometimes experience pain for more than 12 consecutive weeks.

Symptoms of Chronic Lower Back Pain

Chronic pain conditions have a range of symptoms, depending on the severity of the degeneration. Some of the most commonly known symptoms include:

• Pain in the lower back, i.e. sharp, stinging and intense pain in the lower section of the spine.
• Severely restricted mobility– where paralysis and numbness in the legs may be experienced, and often it may get too difficult to stand up which results in a drop in life quality.
• Chronic pain lasting more than 12 weeks, resulting in the development of persistent pain, also referred to as “pain memory”, where symptoms of discomfort and pain remain even if the root causes are relieved.
• Tense muscles in the entire lumbar spine area, which add rigidity to movement.

Immediate medical treatment is advised to manage the condition and prevent further degeneration. The earlier the diagnosis, the better the prognosis.

Diagnosis of Chronic Lower Back Pain

A professional medical practitioner is the best point of contact for an effective diagnosis and treatment plan. The physician begins with complete patient history and a physical examination to identify the stressors. Sophisticated imaging technology, including X-Rays, CT scans and MRI’s, can be used to determine the extent of damage and progression of the lower back pain.

Chronic Lower Back Pain (Low Back Pain) Treatment

Treatment for chronic lower back pain, revolve around managing the root cause of pain and providing relief from symptoms. An effective guide to follow involves:

• Lifestyle Changes

Lifestyle changes in the early stages of the condition can help slow down the progression. Avoiding stressful activities, such as physically intensive work, training and lifting heavy loads, can be effective measures a patient can implement in their daily lives.

Taking breaks to stretch between long hours at the desk can help stretch the muscles and also provide some relief from stress. Reducing body weight and obesity can further reduce the strain on the back.

• Rehabilitation And Physiotherapy

Regulated physiotherapy exercises help with targeted muscle training and is a proven effective treatment path. Prescribed exercises can help promote the reorganization of the muscles and are the most effective option to curb the disease. Encouraging healthy proprioception and strengthening of the muscles in the back helps prevent long term degeneration and relieves lower back pain.

• Prescribed Painkillers

Prescribed painkillers, including Ibuprofen and Panadol, are often used to alleviate pain and discomfort in patients. In cases of inflammation in the back, anti-inflammatory medication is also recommended however as with many medications, tolerance may occur where the effectiveness of the drugs decreases as well as other potential side effects.

• Medical Back Braces

It is highly recommended that ample support to the back is provided through the use of a medical back brace. The targeted compression and support that braces provide can help boost stability and muscle activation and reduce the possibility of further injury. Additionally a comfortable and well designed back brace should also reduce the need for reliance on painkillers with medical studies* showing by up to 52% as well as 4.8 fewer sick days due to back pain.

Wearing a Bauerfeind back support, like the LumboTrain and LumboLoc, can be instrumental in treatment as it provides enhanced stability, proprioception and medical-grade compression. This advanced technology cannot be found in simple neoprene braces and has proven to be more effective.

• Surgical Intervention

Operative surgery is considered only in extreme cases where symptoms are persistent, and all conservative treatments have been exhausted. In chronic conditions of bone growth, surgery might be needed to restore mobility within the back.

What is the Best Back Brace to Get Rid of Chronic Lower Back Pain?

Medical back braces can help prevent the development of lumbar pain, as well as effectively manage the pain. 

Bauerfeind’s LumboTrain back brace features a massaging gel pad that relieves pain in the lower back area. Anatomically contoured to the spine’s natural curvature, the LumboTrain helps with postural adjustment and provides all-day comfort. The medical-grade compression engineered into the LumboTrain’s material boosts blood circulation, thus improving prognosis. 

For patients with advanced symptoms, the LumboLoc helps straighten the lumbar spine and relieves stress from the vertebral discs. The brace incorporates individually adjustable aluminum rods that provide the lower back with added stability and support. The gentle, breathable material can be easily adjusted to fit the needs of a patient’s daily life.

Disc Herniation: Cause of lower back pain 

Lower back pain can arise from a variety of different causes. Most people assume that the pain is stemming from the muscles or joints in the back or that they are experiencing sciatica pain. Often, however, a herniated disc is responsible for the back pain. 

In cases where low back pain caused by a disc herniation is coupled with other symptoms, such as loss of muscle function, immediate action must be taken to avoid substantial damage. 

If the symptoms are less acute and a diagnosis is made early enough, a herniated disc can commonly be treated without surgery. 

Chiropractic or physiotherapy, along with medical back braces or orthoses, can be used during the rehabilitation process for pain relief caused by disc herniation and can potentially reduce its overall severity. Many people who have experienced one or more disc herniations in their life live relatively pain-free with the condition without surgical intervention.

Intervertebral discs – shock absorber of the spine

The intervertebral discs act as shock absorbers for the spine. They sit between each vertebral body to create a buffer for any force or friction applied to the spinal column, ensuring that there is an even distribution of the pressure. 

Each intervertebral disc is made up of a fibrous ring of tissue with a gel-like core. As a natural progression, the intervertebral discs degrades over the lifetime: their height shortens which leads to reduced cushioning effect on the spinal column. The disc tissue can lose its structure and migrate outwards, causing friction against the spinal cord. outwards, with the potential to collide/impact on the spinal cord.

Herniated disc injury: Ruptured, Bulging and Herniated Disc 

Herniated disc injuries commonly happen when the back receives a jolt in a car accident or due to excessive physical exercise in improper form. There are varying degrees of injury to an intervertebral disc, from a milder case of a disc protrusion where the tissue just bulges, to a more severe scenario where the gel-like core of the disc exits its structure as a full herniation or prolapse. Herniation of the C6-C7 intervertebral disc is most common, pinching the nerve and causing nerve root pain.

Disc injuries, including disc protrusions or herniations, can go undetected for long time periods as the discs do not produce severe pain themselves. When the herniated disc matter compresses a neighboring nerve root, intense pain can occur, which can hinder or be aggravated by normal movements. 

The lumbar spine, the area of the lower back, more commonly experiences disc herniations, compared to the mid or upper spine. Factors that increase the vulnerability of the disc prolapse include heavy physical activity, poor posture, inactivity and obesity, all increasing the risk of damage to the disc tissue.

Symptoms of a herniated disc

The site of a herniated disc in the spine can often be gauged by where the pain is experienced. If the herniated disc tissue pushes on the lumbar spinal nerves, pain is felt in the low back, versus a cervical disc herniation that will give pain in the neck region. 

The symptoms from a herniated disc, however, do not necessarily remain isolated to the site of the injury. In the case of a lumbar disc herniation, for example, the pain can travel down into the legs and toes causing foot pain.

Increased pressure within the spinal column, caused by sneezing, coughing or defecating, can increase the intensity of the pain. Additional symptoms can also occur in the legs, such as tingling or weakness of the leg muscles. If the sufferer has an accident involving their bladder or bowel function, emergency intervention is required. Untreated herniated discs can cause urinary problems, 

Treatment for a herniated disc

It is a common misconception that every intervertebral disc herniation must be treated with surgery. More conservative therapies; including chiropractor, physiotherapy, medical braces or orthoses and pain-relieving medication can help in faster recovery of back injuries. 

The rate of surgery performed on disc herniations is continually decreasing and commonly used for ongoing and more severe cases. Medical experts have now started advising patients of herniated disc to undertake a multi-disciplinary approach with light activities (instead of advising strict bed rest), dieting and weight loss as well as utilizing medical aids to reduce pain.

How do I relieve herniated disc pain at home?

Analgesic and anti-inflammatory medications, along with using a herniated disc heating pad are commonly suggested to enable sufferers to perform the movements required of their daily activities.

Prescribed rehabilitation exercises can be utilized and are recommended from the time that physical movement is virtually pain-free, along with remedial massage using essential oils or hydrotherapy. In the absence of any complications, a typical course of chiropractic or physiotherapy treatment for a herniated disc is completed in six to eight weeks, with rehabilitative exercises to be continued thereafter. 

In order to provide support, pain relief and enhance the sufferer’s capabilities during their treatment and rehabilitation period, the use of medical braces and orthoses can be advantageous. Bauerfeind’s extensive range of back braces can be used throughout the rehabilitation process of disc herniation, accommodating to all severity levels. If conservative care for the herniated disc is unsuccessful in improving the condition, surgery is likely to be prescribed.

As with any surgery, intervertebral disc surgery has its risks. Intestinal paralysis, nerve irritation or complications of scarring can be associated with disc surgery. Other more general risks of wound healing complications and thrombosis are also likely. 

Herniated Disc Surgery 

Surgical intervention for an intervertebral disc is intended to minimize ongoing consequential damage caused by the herniation. For instance, the pressure produced on the nerves that control the bowel and bladder function due to disc herniation can cause urinary and fecal issues. Prolonged pressure on motor nerves can also lead to muscle weakening or even paralysis. 

A discectomy (the surgical removal of part of or the whole disc) helps in decreasing the pressure on the surrounding nerve roots to relieve pain and avoid permanent nerve damage. 

Shortly following disc surgery, rehabilitative therapies are usually offered to encourage muscle activation for support and to restore normal movement patterns. 

Rehabilitation exercises should be continued regularly with the assistance of back supports for several weeks following surgery for optimal recovery. Back supports will help to stabilize the spine whilst providing support to the back muscles during daily activity. 

Back brace for disc herniation and stabilization of the lumbar spine

Medical back braces or orthoses can be a valuable part of a therapy plan for a herniated disc. Bauerfeind’s LumboTrain® Back Brace provides effective support to the lower portion of the spine for pain relief and to optimize recovery. The brace features a gel pad with massaging nubs over the lower back region, which work to relieve muscle tension. The LumboTrain’s breathable, hypoallergenic material is flexible and conforms to the body’s contours, making it both comfortable and supportive to wear for extended periods.  

For more severe cases, the LumboLoc Forte with lumbar insert provides advanced pain relief and significantly stabilizes the lumbar spine. Flexible aluminum stays are featured to further support the back and facilitate correct posture in the lumbar spine.