Sacroiliac instability is one of the worst consequences of any type of SIJ pathology. Instability in the sacroiliac joint is a dire problem that typically leads to functional disability, since the patient will have a very difficult time performing basic physical activities.
Joint instability in the sacroiliac structure can come about from a wide range of possible causations. It can also be treated using several completely different approaches to care, including conservative and surgical interventions, depending on the underlying source of instability.
This discussion provides an understandable definition of sacroiliac joint instability. We will discuss its potential causes, as well as the best treatments for various types of unstable sacroiliac joint issues.
Sacroiliac Instability Defined and Explained
The sacroiliac joint is one of the strongest and most stable in the entire human body. This stability is crucial, since the joint must bear the entire mass of the upper body as weight transfers from one leg to the other when we stand, walk or run. In order to provide such stability, the sacroiliac is a marvel of organic engineering, being regulated by ultra-durable connective tissues that mitigate stress and set parameters on exactly how and how much the joint can move in any particular circumstance.
When the joint becomes unstable, it is no longer properly regulated in its range of movement. The joint might become too tense and susceptible to injury from stresses or more commonly, may become too lax and become functionally unsound. When the joint is unstable, it may be painful and potentially impossible for the patient to perform many basic physical acts, such as bearing weight and walking.
Causes of Sacroiliac Instability
Instability can result from a variety of possible scenarios, including all of the following conditions listed below:
Injury to the sacroiliac joint might damage the regulating soft tissues or produce fracture. Either condition can result in minor to extreme examples of instability of the SIJ.
Sacroiliac joint dysfunction due to ligamentous laxity can result in an unstable joint and painful functionality. Overly lax sacroiliac joints tend to be unstable much more often than overly tense joints.
Diseases that attack the sacroiliac can traumatize the joint and make it unstable. The most common include ankylosing spondylitis and rheumatoid arthritis.
Extreme degeneration of the sacroiliac joint is rare, but may result in micro or macro instability of the joint structure.
Treatment for Sacroiliac Instability
For instability conditions which can be managed conservatively, including ligamentous dysfunction and some forms of injury, physical therapy is the gold standard for rehabilitative care. Performing particular exercises and stretches can help to improve joint strength and function without the need for dramatic medical intervention.
Prolotherapy has been used to stabilize ligaments in some case of sacroiliac joint dysfunction and resulting laxity or over-tensioning leading to minor instability.
Sacroiliac joint fusion surgery can be used to bind the joint together, forming a solid and stable bond that will be capable of performing all normal physical activities once healed. The timeline for full healing of these procedures is quite long and does require substantial postoperative rehabilitation therapy. However, for serious instability, SIJ fusion represents the best hope for resumption of normal function, as well as the most logical path towards pain relief.