Treating SI Joint Dysfunction in Children

ByAmee LaTour

Children with sharp, one-sided lower back pain that travels down the buttocks may be suffering from sacroiliac (SI) joint dysfunction. The condition is often caused by rigorous sports play in youth and is far more common in girls, given the general looseness of the developing female pelvic girdle.

The SI joints attach the large hip bones to the spine on each side. They typically allow for very little movement; SI joint dysfunction occurs when too much or too little movement is allowed. The repeated stresses of activities like dance or track and field, or impact injuries from sports like football or softball, can cause the joint to be either dislodged or locked in place.

SI joint dysfunction can be identified either by injecting a numbing agent into the joint to see if it stops the pain or by an assessment in which the child performs certain movements and indicates pain to an observing professional trained to identify SI joint dysfunction through movement patterns. This condition is increasingly thought to be a prevalent and overlooked cause of back pain in adults. It may also be prevalent among young people, whose bodies are still developing.

It may be frightening to imagine a child with a misaligned joint, but SI joint dysfunction may be very easily and safely treated among youth. One study sought to test the effectiveness of muscle energy technique in the realignment of the SI joint. Put simply, muscle energy technique involves the patient using his or her muscles to push against a counterforce. In the study, youth diagnosed with SI joint dysfunction did hip extension and flexion exercises while a physical therapist provided resistance. From a supine position, each patient first attempted to straighten their affected side's leg as the therapist resisted; this engaged the gluteus maximum muscle in the buttocks and pulled back on the pelvis. If this didn't realign the joint, the patients would attempt to re-bend the leg as the therapist resisted; this engaged the iliopsoas in the front of the hip and pulled the pelvis forward.

By using simple muscle engagement to change the position of the pelvis, 80% of the study's participants experienced significant relief of painful symptoms. 53% had complete, immediate resolution of pain. Average pain scale scores dropped nearly 4 points (within a 10-point scale) post-treatment. Of the 20% (9 patients) who did not experience relief, 2 had a spinal condition and 3 had histories of spinal surgeries. The full study can be viewed at http://thejns.org/doi/full/10.3171/2012.2.PEDS11220?prevSearch

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Is Your Back Pain Due to SI Joint Dysfunction?

A painful sacroiliac joint is one of the more common causes of mechanical low back pain. There are two SI joints, each located on either side of the sacrum.

These joints allow twisting movements when we move our legs.

There are many different terms for sacroiliac joint problems, including SI joint dysfunction, Sacroiliac joint strain, and joint inflammation (sacroiliitis). Each of these terms refers to a condition that causes pain in the sacroiliac joints from a variety of causes.

Sacroiliac joint dysfunction may occur when an SI joint is injured or irritated. This is seldom dangerous and rarely requires surgery.

There are many different causes of SI joint pain. These joints have a cartilage layer covering the bone which allows for some movement and acts as a shock absorber between the bones. When this cartilage is damaged or worn away, the bones begin to rub on each other, and degenerative arthritis (osteoarthritis) occurs. This is the most common cause of Sacroiliac joint dysfunction.

Pregnancy may be a factor in the development of joint problems. During pregnancy, hormones are released that lets ligaments relax. The relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear.

If a person has one leg which is shorter that the other, the abnormal alignment may cause joint pain.

SI joint dysfunction can also occur from trauma, such as injuries resulting from a fall or associated with a motor vehicle accident.

The most common symptom of SI joint dysfunction is pain in the low back that is aggravated by prolonged sitting, standing, and stair climbing.

The diagnosis is often overlooked.

The most accurate method of diagnosing joint dysfunction is by performing an injection that can numb the irritated area. An anesthetic material with a steroid can be injected directly into the SI joint. This is usually performed with X-ray guidance to verify that the injection is correctly placed in the joint.

If the anesthetic and steroid relieves the pain from inflammation within the joint, this helps to verify that the Sacroiliac joint is the source of the pain, and treatment can target the SI Joint specifically.

Call your physician to determine if your back pain is due to Sacroiliac Dysfunction.

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Bone and Joint Problems - Signs, Symptoms, Causes

ByLarry L. Taylor

Bone and joint problems were at one time thought to be a fact of life, things that simply accompanied the aging process. Now we know a little more about the problems. Here you will learn what we know about the symptoms and causes of bone and joint problems.

The early symptoms of bone and joint problems are aches, pains and stiffness. The later symptoms may include any of the following conditions:

• Osteoarthritis
• Rheumatoid arthritis
• Osteoporosis
• Frequent bone fractures
• Osteomalacia

Bone fractures in the elderly can be deadly. Complications can arise from surgery. The fracture may fail to heal properly leading to permanent disability.

There are risk factors and causes of weak bones and joints. Age is one of the risk factors, but as mentioned above, the problems are not caused by normal aging. Something else is going on.

Other than frequent fractures, the most common symptom of osteoporosis is a hunched appearance. The spine starts to curve in as though the head is too heavy to be held up any longer. People may also seem to shrink as this curvature occurs and for other reasons associated with unhealthy bones and joints.

Osteomalacia is a painful condition that is often mistaken for arthritis, especially when it affects the elderly. Not only is there pain in the bones and joints, there is also pain in the muscles.

Who's At Risk?

Osteoporosis is the most common bone disorder among post-menopausal women. It has been estimated that fractures occur due to osteoporosis every three minutes in the United Kingdom.

Men are not immune to the risks of osteoporosis. Current figures show that 1 in every 8 men over the age of 50 will have a fracture related to osteoporosis at some point in his lifetime. Even more men have osteoporosis, but are lucky enough to avoid a fracture.

What are the Causes?

The underlying cause of osteoporosis and osteomalacia is reduced bone density. Fractures occur because the bones are thinner and more brittle. In the case of arthritis, the underlying cause is loss of protective cartilage between the joints.

What Causes Reduced Bone Density?

Researchers have learned that many things can interfere with the production of new bone, which is an ongoing process throughout a person's life. The process may be slower with age, as most bodily processes are, but it should not stop completely.

One thing not only interferes with the production of new bone. It actually causes the breakdown of bones to get at the calcium stored within them. As you might suspect, lack of calcium in the diet will cause the body to break down bone to direct the mineral to other bodily function. But, there are many minerals stored in bones. So any mineral deficiency can lead to bone loss.

Lack of vitamin D will also cause unhealthy bones. Osteomalacia is actually the adult equivalent of rickets, caused by inadequate vitamin D intake.

Other causes of reduced bone density include physical inactivity, smoking cigarettes, excessive alcohol consumption and diseases that interfere with nutrient absorption. Endocrine and rheumatic diseases are examples.

How to Protect Your Bones

Now that you know more about the risk factors and causes, you would probably like to know what you can do to protect your bones. That is the subject of my next article. Please click the Bones and Joint Problems link below in the resource author box.

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