The relationship of the sacroiliac joint, stabilization musculature, and lumbo-pelvic instability

Abstract

The sacroiliac (SI) joints as a source of low-back trouble need very little justification to pain specialists. Pain from the SI joints has been proven to cause not only low-back pain, but also groin and thigh pain (Schwarzer et al., 1995). This pain distribution and palpable tenderness caudal to the posterior superior iliac spine are fairly reliable indicators that the pain generator is the SI joint (Fortin, 1998). Surprisingly, traditional orthopedic tests are not very reliable. Joint motion palpation tests are also unreliable if used alone. It is hypothesized that lumbo-pelvic pain can be due to overloading of the ligaments of the pelvic ring and/or lumbo-pelvic junction during activities in which loads have to be transferred between legs and trunk (Mens et al., 1996, 1999; Snijders et al., 1993). It has been shown that insufficiency can arise due to poor function of stabilization musculature (O’Sullivan et al., 2002). This is a particularly important problem in women following childbirth in whom posterior pelvic pain is such a common disorder (Mens et al., 2001).