So by this point we have covered 2 of the top causes for back pain & sciatica, low back pain and sciatica caused by herniated discs, and spinal stenosis. The third cause of back pain & sciatica symptoms that is fairly common is called sacroiliac joint dysfunction (or SIJ dysfunction for short). Sacro- for the sacrum, which is the base of the spine, and -iliac for a part of the pelvis, the big crest that forms the waist bones. The sciatic nerve passes very close to this joint as it travels down the leg, so any problems here can easily have a negative impact on the nerve and lead to sciatic pain in your legs.
When it comes to back pain and sciatica, SIJ dysfunction is a diagnosis of exclusion. In other words you need to rule out any other source of the symptoms before declaring it the culprit. This condition is also less straightforward to detect since the problem doesn’t usually show up on x-ray or MRI. One way to get an accurate diagnosis of SIJ dysfunction requires getting pain killer injected right into the joint. If the back pain stops following the injection, then the SIJ is the cause. The other method for diagnosing this problem is with a physical testing.
SIJ dysfunction can also present a bit differently depending on what is wrong with the joint. If the SIJ is moving too much (hypermobility), then the pain is often located in the lower back, hip, and groin area. When the SIJ moves too little (hypomobility) the pain can show up in low back, buttocks, and down the leg. When SIJ dysfunction is an issue, younger people typically develop the hypermobility issue and older adults present with a hypomobility problem.
Signs that a back pain & sciatica problem may be caused by SIJ dysfunction include:
Worsening pain with sitting for a long time
Worsening pain with twisting to one side
Worsening pain when going from sitting to standing
The feeling of one leg being twisted, off balance, or heavy
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Exercises for SIJ dysfunction focus mainly on building up the strength of the muscles that stabilize the area and improving the flexibility of the muscles that attach to the spine and pelvis, otherwise known as your core muscles. Deficits in either area can lead to sort a muscular imbalance. This would put increased tension on one side of the SIJ and contribute to pain and symptoms in the area and down the leg.