Systemic sacroiliac joints are made up of the sacrum, an inverted triangle-shaped bone in your lower back, articulating on either side with the pelvic bones. They are located at the level of the palpable bony prominences at buttock level. These joints are very important, as they distribute the weight of the upper body to each of the two legs. They are very solid and surrounded by many ligaments, but they are not immune to problems.

The sacroiliac joints, or SI joints as they are less commonly known, are the two joints that connect the ilium of the pelvis to the sacrum of the pelvis. spinal column.

Located at the bottom of the spine, to the right and left of the sacrum, in depth, they designate the bridge that connects the spine to the leg bones.

Note that this is a synovial joint with a fluid-containing joint capsule. It is initially well-developed in children, then thickens and fibers over time.

Understanding the sacroiliac joint

The sacroiliac joints are the true central pivot of the body and distribute the weight of the body between the top and bottom to support the spine.

The SI joints can make complex movements, depending on how the coccyx moves when carrying a load or bending forward.

The two SI joints are interdependent on each other, and are also dependent on the pubic symphysis.

Definition: Sacroiliac Syndrome

• When we define sacroiliac syndrome, we're talking about acute or chronic, dull, deep pain, often on one side only, directly at the joint.
• The onset of pain can also be sudden, but often appears insidiously.
• 50 to 60% of chronic, i.e. long-lasting, back pain is thought to be linked to this joint.

What are the causes?

• Joint stiffness.
• Lack of movement, locked joint.
• Inflammation and/or stretching of the ligaments surrounding the joint.
• Inequality of the lower limbs.
• Hyperlodosis, i.e. excessive arching of the back.
• A fall on the buttocks.
• A difficult childbirth.
• a lumbar sprain.
• excessive effort.

What are the treatments?

1. Make sure there is no more serious problem, as some forms of arthritis can affect this joint.
2. X-rays may be necessary to rule out any underlying problem other than lack of mobility.

• Inflammation reduction using ice (20 minutes/2 hours) and complementary therapies such as neurocryotherapy
• Manipulation is the treatment of choice for this condition, to restore full mobility to the joint.
• Soft tissue work (Active Release Techniques and Graston)
• Kinesio Taping
• Flexion and stretching exercises for thighs, buttocks and back.
• Exercises to strengthen and stabilize the region
• Medication (anti-inflammatory) as needed
• Cortisone injections as needed
• In the case of an acute ligament sprain in this region, orthopedic support (lumbar belt) for a short period may prove effective.

Prognosis

• Variable according to intensity, duration of implantation before treatment and number of previous episodes.
• On average, 6 to 8 weeks.

The clinical examination includes palpation and a number of manoeuvres and tests to assess joint function:

• Maneuvering the tripod.
• Maneuver to spread/clasp the iliac wings.
• Gansen maneuver
• Evaluate the absence of neurological symptoms (numbness, loss of strength) to differentiate sacroiliac syndrome from lumbosciatalgic disorders.

The practitioner must also check for the absence of systemic symptoms such as fever, cough or fatigue.

X-rays of the pelvis and sacroiliac joints are the first-line examination.

MRI of the sacroiliac joints enables early assessment of infectious or inflammatory involvement.