Lower Back Pain with Walking, Standing & Sleeping - Sacroiliac Joint Pain?

Dull achy pain along the lower Back, that can be occasionally severe on certain movements, is a common feature of Sacroiliac Joint Pain. The Sacroiliac joints are two joints situated in our very lower back that join the pelvic to the lower spine. Lumbar Spine pain and sacroiliac Joint pain are very often confused because both have similar symptoms, however there are a number of important examination tests that the Physical therapists needs to carry out in order to differentiate both conditions.

We get Lower Back Pain from the Sacroiliac when the joint becomes unstable or excessively mobile with weak Force closure. Force closure is the required ‘tight fit’ of the sacrum bone and it’s adjoining Ilium bone of the pelvic, that is needed for joint stability in order to transfer load through the Sacroiliac Joint. When there is excessive movement and reduced stability or compression of the joint, stress occurs thus aggravating a pain response from its ligaments and synovial fluid.

Common Signs & Symptoms

  • Dull Achy Lower Back Pain that is worse on one side

  • Achy pain radiates into the Buttock

  • Can experience sudden darts of sharp Lower back pain intermittently throughout the day

  • Aggravated by Standing, Walking, climbing stairs, Lifting objects and getting up out of low chairs.

  • Night-time pain when turning in bed and cannot lay on their spine due to pain

  • Gets worse as the day goes on

  • Pain bending forward when putting on socks on feet

  • Symptoms relieved when sitting for a period of time

  • Difficulty getting into and out of bed and into their car

Treatment & Management

The stability of the sacroiliac joints is provided by the Lumbar spine muscles, the Gluteal muscles and the deep abdominal muscles. These muscles provide a self-bracing effect that should naturally stabilize and tighten the joint. However if the sacrum and Ilium bones of the sacroiliac joint are not moving correctly against each other then this results in weak activation of these muscles. Hence retraining muscles to work correctly to tighten the joint is an important strategy for successful treatment of this condition. Additionally, if a restriction or stiffness of either the Ilium bone or sacrum bone of the sacroiliac joint is present then graded joint mobilization are used to encourage correct movement followed by exercise. Manual mobilisation treatment is always graded on the current pain that the patient is experiencing from the joint.

Tomás Ryan is a Registerd Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672 Email your queries to: tomaspryan@gmail.com

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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