Understanding Medical Problems

3 Tips For Managing Hypermobile Sacroiliac Joints

Hypermobility in the sacroiliac (SI) joints, typically manifests as pain and inflammation that is easily confused with low back pain. Once diagnosed, there are several approaches that can help you minimize or eliminate pain.

Use Several Pain Management Strategies

Since the pain associated with hypermobile SI joints is ongoing, you will need to use multiple techniques to keep the pain manageable. Over-the-counter or prescription anti-inflammatory medications are a staple in reducing day-to-day pain and inflammation. Depending on the extent of your pain and how your doctor prefers to address chronic pain, they may be willing to treat you with steroids and/or milder forms of narcotics with less abuse potential, such as tramadol. If your only problem is your SI joints and it is not a symptom of inflammatory arthritis, steroid injections might be a better option since they can specifically target the SI joint. Other pain relief tactics you can use include lidocaine cream or patches, which are available in 4% concentration, but higher concentrations are available by prescription.

Work On Strengthening Muscles

Whether you attend physical therapy or are attempting to improve pain on your own, the goal is to improve the strength of specific muscles that support the SI joints. The hip abductors and glutes are important for providing support to the SI joints, and laxity in these muscles can be a culprit for "loose" SI joints. The easiest way to work your hip abductors is to use exercise bands and perform movements that move your legs away from the midline of your body. For example, you might sit in a chair and place an exercise band above your knees. Spread your knees apart, away from each other. This type of movement works on your abductors. Similar movements can be done standing, like walking across the room sideways with bands above your knee. If possible, squats, donkey kicks, and pelvic trusts can work the glutes.

Consider Surgery

Some people successfully manage their SI joint hypermobility by strengthening the supporting muscles, but this is not always helpful. Surgery is an option to help manage ongoing pain and limitations. For hypermobility, the surgical approach used is SI joint fusion. The joint can be fused by using inserting metal pins into the sacrum and ilium, which holds the two bones together. The pins are hollow, so over time, bone grows into the pins (either naturally or with a bone graft), making them more stable. Fusion to fix hypermobility requires precision. It was generally believed the SI joints had no movement, but in reality, the joint allows for slight movement. An SI joint that is tightly fused, could eventually contribute to problems associated with a hypomobile SI joint.

In milder cases of SI joint hypermobility, you may be able manage pain with physical therapy. Fortunately, with more recognition of SI joint pain as an ongoing problem, there are surgical approaches to help achieve long-term relief. Contact an orthopedic doctor for help.