Mark McDonald

This week we’re going discuss the difference between the sacroiliac disorder and the iliosacral disorder of the back.

Back pain can be found in a variety of “flavors” and one of them is the problem with the sacroiliac joints. The sacroiliac joints move around several axes, and it can be a source of pain across multiple dimensions or an ongoing issue on one the axis. This means the joint can turn in a particular way whenever it is “stuck”. The joint could be unstable. This is to say it is prone to movement and cannot stabilize it self. This means that it is constantly in a position that is not physiologic. This kind of instability is difficult to cure as it requires constant adjustment, belting, the sacroiliac belt, which is a specific type of belt, and treatments such as the Prolotherapy (injections of dextrose in the joint to strengthen those ligaments) or in more severe cases, fusion using equipment like screws.

The sacroiliac joints is the most infrequent of the problems and is the most common. It’s a problem in the axis of the sacrum, which can be horizontal or oblique, and usually uses stabilizations and manipulation of muscle energy (a technique whereby the muscle strength of the patient restores the joint to its the normal position) or exercises that specifically rely on muscles for stabilizing the joint of the sacroiliac.

Iliosacral lesion on the other hand , are a result of problems with the innominate bone (also known as the ilium) that is also known as an “wing” from the pelvis. The wing is able to rotate in a forward direction, reverse it and slide up or down. It can be flared into or flared out. In this sense, needs to be diagnosed properly before the proper treatment can take place. A general manipulation can be helpful in cases where the joint isn’t unstable, but is simply “stuck”. However, in cases of iliosacral instabilities, the joint will require a variety of treatments.

In general, sacroiliac and iliosacral disorders don’t cause sciatica and leg pain. There are however instances where problems with the sacroiliac joint could trigger trigger points that are located in the glute medius and glute minimus, as well as the piriformis muscle , which could create a false sciatica, as well as pseudo sciatica. The majority of sciatica cases are caused by the spinal cord, however, there are instances where the sacroiliac joint may cause indirect pseudo sciatica. They are usually easily treated with trigger dry needling points stretching, foam roller, and trigger point dry needling treatment. Foam rollers are a method where the patient utilizes the form of a roller or ball comprised of foam to apply pressure on the muscles affected and relax them, thus reducing the pressure on the sciatic nerve’s roots.

As you can see, sacroiliac disorder and iliosacral dysfunction can go together, however it is important to determine the cause and whether it’s an instability or hypomobility (stuck) is crucial for the successful treatment. For more information about the iliosacral and sacroiliac instability, as hypomobility, do not be reluctant to reach out to Clinic for a complimentary consultation.