• Dr. Jason Scoppa

How to Fix SI Joint Pain

If you haven't already checked out or last post about the Most Common Causes of SI Joint Pain, definitely check that out first! Dr. Scoppa specializes in SI joint pain and dysfunction, and many of his patient base suffer from joint hypermobility. Proper assessment of the SI joint takes into account the fact that the SI joint can be either hyper or hypo mobile. Meaning that it can either have too much motion or too little motion occurring within the joint. The vast majority of practitioners assume all joints are not moving enough, and induce motion into the joint. However, it is our experience that this will make patients worse over time, given that most people with SI joint pain are actually suffering from a SI joint that is already moving too much (hyper mobile). Here we go go through a brief explanation of how to fix SI joint pain.

  1. Stop gapping/shearing the SI joint: The SI joints are supposed to move slightly, but only slightly. Even as recently as 20 years ago it was medical consensus that the SI joints were fused, which we now know is not the case, but that's how little motion occurs naturally in the SI joint. So when we create alot of motion within the SI joint, problems such as SI joint pain occur. Limiting the amount of stretch or shear within the SI joint, especially when healing, can really help stabilize the joint.

  2. SI support belt: Sometimes a patient needs help stabilizing the SI joint. An SI belt is worn between the iliac crest and the femur, and it acts to lightly compress the connection between the sacrum and ilium (the SI joint!). This compression increases the amount of proprioception within the joint, creating stability and allowing surrounding musculature to "let go". We like the Serola brand SI belt the best.

  3. Strengthen the posterior chain: By strengthening the posterior musculature in the low back, glutes, and hamstrings, and getting them to fire together as a unit, it provides support for the SI joint. We go through an exercise we like for this purpose in the video above, which can really help in how to fix SI joint pain, in the medium to long term.

  4. Work with a professional who understands the SI joint: As we described above, find someone that is actually assessing for whether your SI joint needs more motions, less motion, or whether it's even an issue at all! Those certified in SOT chiropractic or AK chiropractic are typically good places to start.

  5. Prolotherapy: If we are doing all of the above, and using our in-house techniques without successfully being able to stabilize the SI joint, we have found prolotherapy into the SI joint to be a great adjunctive treatment. We don't recommend this as a first step, since it doesn't often correct the underlying dysfunctional patterns, but it can be a useful tool. An irritant is injected into the SI joint, which causing the ligaments to contract, therefore causing stability within the joint space.

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