Lower Back & Buttock Pain due to Poorly Functioning Pelvic Muscles
Chronic Dull Achy Lower Back pain that is felt right across the lower back is a common feature of Sacroiliac Joint Dysfunction. The Sacroiliac Joints are two joints on the left and right side of the lumbar spine that connect the sacrum spine to the pelvis. A problem arises when one of the joints become hypermobile meaning too mobile or loose leading to irritation of its adjoining ligament and joint structure. Such a problem can arise from poor lifting techniques, stepping over high fences, post pregnancy and landing on the ground from a small height. The patient notes constant lower back and buttock pain with relief achieved by sitting whilst hugging their knee to their chest.
Signs & Symptoms
Lower back Pain on both sides of the Lower Back, but worse on one side
Lower Back Pain often described as Dull achy that can also revert to being Sharp in nature
One sided buttock pain is also experienced
Symptoms are aggravated by standing and walking long durations, bending forward, going from being seated on a low chair to standing position, going up and down stairs, lifting an object such as a school bag up from a low table.
Lower back pain worsens as the day progresses, patient experiences pain at night especially if sleeping on their back.
Symptoms are eased with sitting down and sleeping on their least painful side which is greatly helped if a pillow is placed between their knees.
Pain across the lower back on bending the spine forwards and backwards into extension.
Patient reports instability and lack of control in large movements of the lower spine.
Notes apprehension and pain when getting into and out of bed.
In many cases the cause of Sacroiliac Joint Dysfunction is a weakness or break down in the Force Closure mechanism of the Sacroiliac joint. Force Closure describes the need for muscles of the pelvis to be constantly engaged during walking activities etc, in order to achieve correct closure of sacrum bone on the Ilium bone during movement. Weakness in these pelvic muscles leads to excessive mobility and Sacroiliac Joint pain. The muscles that need to be assessed by the Physical Therapist in order to diagnose if they are correctly working include; Tranverse Abdominis and Rectus Abdominis at the front of the pelvis, and the Gluteus Maximus, Erector Spinae and Gluteus Medius . These muscles need to be retrained to ensure they are correctly recruited during movement in order to strengthen and stabilise the Sacroiliac Joint.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles.
Contact Number: 0504 26672
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