To Bend or Not to Bend? Physical Therapy Relief for Sacroiliac Joint Pain Is the Answer
The sacroiliac joint is formed where the lower spine and pelvis meet. It is the connection of the sacrum,the last bone of the spine, and the ilium, the two wide bones that form the waist. Sacroiliac joint problems can make it painful to bend forward. People with sacroiliac joint pain may find it difficult to work over a counter, bend over a sink to shave or brush their teeth, make a bed, or even wash dishes.

The sacroiliac joint can be treated with surgery, braces, injections, or physical therapy. In this study, the authors wanted to find out whether physical therapy alone would give some relief to people with sacroiliac joint pain.

Sixty-nine patients were diagnosed with sacroiliac joint dysfunction through a series of tests. Fifty-five of the patients (80 percent) were women, and 14 (20 percent) were men. Their average age was 40. 

All of the patients were treated by the same physical therapist. The goal of therapy was to create movement in the sacroiliac joint and strengthen the muscles around it. Patients exercised to stabilize the pelvis and strengthen the abdomen. They also learned good bending and lifting techniques, and which activities to avoid.

Two years after treatment, 95 percent of the patients rated their treatment results as good or excellent. Only 5 percent said their results were fair or poor. Patients who were still having a lot of pain after the physical therapy treatments ended (5 percent) had chronic pain--pain that lasted at least 50 days--before treatments began.

After having physical therapy, everyone could do at least the same activities they were doing before treatments started. Thirty people had problems with routine activities before getting treatment. Of these, 22 returned to all their normal activities with treatment. Only six patients reported no change in ability to do activities after treatment. Once again, these patients had chronic pain.

The authors conclude that physical therapy can have excellent long-term results when the therapist has experience treating the sacroiliac joint. The results seem to be better for patients who haven't been in pain for a long time. However, patients with chronic pain may also see some improvement. For patients who don't get any relief from physical therapy, surgery or injections may be suggested.

Rick C. Sasso, MD. Sacroiliac Joint Dysfunction: A Long-Term Follow-Up Study. In Orthopedics. May 2001. Vol. 24. No. 5. Pp. 457-460.