The SI Joint Syndrome: Is it the disc or the pelvis?

ISG blockade: What lies behind it

When patients come to us with severe pelvic pain, they often have one goal: they want their Lift ISG blockade Let it go. The feeling that something is „clogged“ in there is extremely real. Whether the joint itself is really blocked cannot be confirmed with certainty. The SI joint is secured by strong ligaments and moves only by a few millimeters.

What you feel as a stabbing block can have various causes. Often, an increased muscle tension around the pelvis is also involved. When the leg axes are not aligned, you may limp after a foot injury or the deep abdominal muscles are too weak. This creates an asymmetry. The nervous system registers an overload of the joint and switches the muscles around the pelvis (such as the piriformis muscle) into a state of intense tension to protect the region.

An SIJ syndrome, i.e., pain from the iliac-sacral joint, is more common than many people think: According to estimates, about one in six to one in three back pain originates from the iliac-sacral joint (15 to 30%; Barros et al., 2019). The diagnosis in an ISG syndrome is based on several provocation tests together, because individual tests are not all equally reliable from examiner to examiner.

Our Holistic Treatment Approach

Instead of simply pressing hard on the joint, at Physiotherapie Waidfuss we look at the true cause. We harmonize the muscle tension in the buttocks, check the statics of your feet and knees, and integrate targeted Nerve mobilization. Often it is the fascia tissue or an irritated nerve that triggers the pain. For very persistent muscle trigger points around the pelvis, we use gentle manual pressure techniques on request to relax the tissue and improve mobility around the pelvis.

The available data regarding the ISG syndrome are limited. A review of the literature on exercises (Mapinduzi et al., 2022, 12 studies) found that muscle-control exercises alone do not clearly reduce pain, but in combination with other measures they can significantly reduce pain and limitation in the short term. For manual therapy (Trager et al., 2024, (16 studies with 421 participants) showed a modest improvement in function; regarding pain, the effect is uncertain. The authors classify the statement of significance as low to very low.

Self-help: Everyday practical tips for a free ISG

• The gentle pelvic mobilization: Lie on your back. Bend your knees with your feet flat on the floor. Now let the painful leg fall outward (like a half butterfly) and slowly slide your heel along the floor toward your buttocks and back again. This mobilizes the SI joint completely without pressure.

• Avoid one-sided strain: When you're standing, consciously distribute your weight across both Feet. The typical "standing leg-to-leg" position at the supermarket checkout can further strain an irritated SI joint.

When should you have a medical or physical therapy consultation?

Get examined promptly if the pain radiates into the leg, numbness occurs in the thigh area, bladder or bowel function changes, or the symptoms do not improve even with increased activity over several weeks. These symptoms may indicate more than just IBS.

In addition to manual treatment, our Manual therapy aimed at restoring the pelvis to its original balance.

Your pelvic specialists in Zurich Are you plagued by stubborn SI joint syndrome and no longer know how to sit pain-free? The therapists of Physiotherapy Waidfuss In Zurich (Wipkingen and Höngg), it brings your pelvis back into balance. Schedule an appointment online today and take the first step towards a pain-free everyday life!

Sources

• Barros G et al. (2019): Sacroiliac Joint Dysfunction in Patients With Low Back Pain. Fed Pract. PubMed
• Mapinduzi J et al. (2022): Effectiveness of motor control exercises versus other musculoskeletal therapies in patients with pelvic girdle pain of sacroiliac joint origin: a systematic review with meta-analysis. J Back Musculoskelet Rehabil. PubMed
• Trager RJ et al. (2024): Efficacy of manual therapy for sacroiliac joint pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Man Manip Ther. PubMed