Have you ever suffered from pain in your lower back? Bending makes the pain worse and sitting in one place for too long can cause back pain? What if I were to tell you that the pain was not actually coming from the lower back but from two joints called the Sacroiliac joints. About 10% to 25% of low back pain patients are thought to be actually experiencing pain from the Sacroiliac joint (SIJ) because the pain and symptoms can closely mimic those of low back pain(1).

The SIJ’s are located on either side of the spine and join the pelvis to your tail bone. The joints themselves are typically very stable as they have significant ligament support as well as being surrounded by some of the strongest muscles in the body.

When dysfunction occurs at the SIJ it can cause pain around the lower back, shooting or stabbing pain, as well as tenderness around the area. Left unmonitored or if not treated correctly, the pain can linger and escalate, making everyday tasks like bending or sitting a nightmare.
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It's important to see a physio and get the proper diagnosis so that the correct treatment can be commenced straight away. The correct treatment will help to reduce the pain and symptoms so that you can get moving towards your regular lifestyle.

A physiotherapist will conduct a comprehensive physical examination to evaluate the contribution of the SIJ and surrounding structures. This includes a biomechanical assessment to identify key contributing factors and to rule out other structures like the back and hip.

Once a solid diagnosis has been formed, treatment will initially consist of symptomatic management. This could involve managing inflammation, joint mobilisation, strapping or wearing a special belt to get symptoms under control. From there strength and stability will be the primary goal for rehabilitation of the SIJ disfunction.
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It is pretty clear that SIJ disfunction needs a completely different treatment strategy compared to low back pain, this is why it is important to get the correct diagnosis so your pain can get the treatment tailored to it.

Despite the concept of piriformis syndrome being proposed over 80 years ago, the theory is still controversial, with some research questioning its existence entirely. One of the issues surrounding piriformis syndrome is the symptoms are similar to neurological pain referring from the back as well as many other conditions. Symptoms of piriformis syndrome are said to include numbness, or the feeling of pins and needles, pain around the hip and buttocks, an inability to sit for a prolonged period and pain in the buttocks that gets worse with hip movement. 

The theory behind the syndrome is that a taut or abnormally shaped piriformis muscle can compress the sciatic nerve (which passes by the piriformis) and cause sciatic pain. While there are currently no universally accepted tests to diagnose piriformis syndrome, some practitioners argue that stretching, activating or palpating the deep gluteal region and the piriformis can rule in or out piriformis syndrome. Of note however is a recent study found that ultrasound could potentially be a method of diagnosis for piriformis syndrome. This research showed that patients thought to have piriformis syndrome had an enlarged piriformis and sciatic nerve on their injured side, when compared to their asymptomatic side and to healthy volunteers. More research is needed into the topic however. On the basis that there are no reliable ways to diagnose piriformis syndrome, if a diagnosis is made, it is generally done so when all other sources of sciatic pain are excluded.
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Despite the exact pathophysiology of the syndrome being debated, the direction for treatment is relatively straight forward and is treated like most other muscular dysfunction syndromes. Myofascial release, stretching, massage, ergonomic modification, and trigger point release are some of the recommended treatment options for Piriformis syndrome.

Given the anatomy, it is reasonable to believe that piriformis has the possibility of irritating the sciatic nerve and causing sciatic neuralgia. At this stage however, there is no clear-cut diagnostic procedure to diagnose piriformis syndrome. The exception to this is a recent study that found ultrasound could potentially be a method of diagnosis for piriformis syndrome, however further supporting research is required. The diagnosis of piriformis syndrome could be made once all other probable sources of sciatic neuralgia are ruled out. Should this be the case then it would be reasonable to assume the presentation would respond to myofascial release, stretching, massage, ergonomic modification, and trigger point release.

​Have you or someone you know been told that exercise is bad for osteoarthritis? Have you had to give up your hobbies because of joint pain? Then this is an important article that could make the world of difference to you! 

An estimated 2.2 million Australians suffer from osteoarthritis and an estimated 30% of people aged above 50 experience hip or knee pain (1).

Shunning exercise because of osteoarthritis has significant negative mental and physical impact. Avoiding exercise can actually lead to more joint problems.
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This doesn’t even include the other chronic illnesses related to not exercising, which include type 2 diabetes, cardiovascular disease, and dementia.

 BY Ok, so what exercise should I do? Scientific research into the topic has found that on top of strengthening and cardiovascular exercise a type of training method called neuromuscular exercise has been shown to be effective. The neuromuscular training method, based on biomechanical and neuromuscular principles, aims to improve sensorimotor (body awareness) control, and achieve compensatory functional stability which counter any sense of being unstable on your limb. A more detailed explanation is that sensorimotor control is the ability to produce controlled movement through coordinated muscle activity, and functional stability is the ability of the joint to remain stable during physical activity (3).
 
Luca and Jayce are both GLA:D® accredited and experienced in running the Danish designed GLA:D ® neuromuscular exercise programme that combines strength, cardiovascular fitness and neuromuscular control.
 
To find out more about our GLA:D® programme call the clinic on 9533 5305 or visit our dedicated information page by clicking the button below.