Sacroiliac Joint Dysfunction

I've mentioned before that I've had intermittent hip pain since my last pregnancy. I had a spell for about a year where it didn't bother me (from August of 2009 to around May of 2010) so I thought it was something that I could just let work itself out. At some point, I realized that its become too much of a fixture in my life so I needed to do something about finding the root cause. On my birthday this year, it got really bad again so I became serious about addressing it.

I recently visited my naturopathic doctor/midwife who listened and poked around my hip and lower back to try to isolate where the pain was coming from. She mentioned the sacroiliac joint (a joint connecting the sacrum in the low back to the pelvic girdle. Its connected with ligaments and covered with cartilage). She then referred me to a physical therapist who specializes in lumbar-pelvic PT. While I'm waiting for an appointment with the PT, I've been doing some internet homework to try to figure out what is going on. With sacroiliac as a clue, I started my searches.

And this is what I found:

Another common cause of SI joint dysfunction is pregnancy. During pregnancy, hormones are released in the woman's body that allows ligaments to relax. This prepares the body for childbirth. 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. The additional weight and walking pattern (altered gait) associated with pregnancy also places additional stress on the SI joints.

Any condition that alters the normal walking pattern places increased stress on the SI joints. This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle, or foot. Patients with severe pain in the lower extremity often develop problems with either the lower back (lumbar spine) or SI joints. In most cases if the underlying problem is treated, the associated lumbar spine or SI joint dysfunction will also improve.

The most common symptom of SI joint dysfunction is pain. Patients often experience pain in the lower back or the back of the hips. Pain may also be present in the groin and thighs. In many cases, it can be difficult to determine the exact source of the pain. Inflammation and arthritis in the SI joint can also cause stiffness and a burning sensation in the pelvis. 1

Several things can aggravate the SI Joint too. Continual sitting or lying on the affected side will impinge nerves and skew the pelvis. Remember, the body will adopt a bad posture and accept it as normal after a period of time. The pain often worsens when riding in a car, sitting in a movie theater or putting weight on the hips while walking (for example, carrying a child). 2

As I read these findings, I was nodding along.

Pregnancy? Yes

Short leg? Yes (caused by scoliosis)

Pain in the low back, hip, thigh, and thigh, stiffness, burning, and difficulty determining the source of pain? yes, yes and yes.

Sitting or laying on the affected side aggravates? Yes

Worsened pain when carrying a child and walking? Yes (that's exactly what brought it on today, actually)

I'm still using chiropractic, yoga, massage and hip circles to address it. Hip circles, actually, make the most difference when my SI is tight and hurting. I'll have to remember to eat eggs for breakfast tomorrow and its probably time to make my grandma's famous baked custard because that's a mega dose of eggs and so good.

In addition to suggesting physical therapy, my naturopath suggested looking into craniosacral work. She also gave me a medical referral for massage. And she reminded me, which is embarrassing that I completely forgot, about homeopathic arnica for muscle soreness. I've also been seeing an Upper-Cervical chiropractor which is new and different for me than the typical pop and crack chiropractors I've been seeing.

At this point, my husband and I swearing off conceiving another baby. In my lower moments, I come close to despairing and giving up getting pregnant again ever. We even put the option of surgical sterilization on the table, which is a momentous and terrifying thought to me. In having those conversations, I realize in a new way how much I love and appreciate the children I have. I knew then that I can be happy being mother to my two and not regret having another. Still, if it is possible, I hope to recover enough that I can physically handle another one or two or three pregnancies and births. My hopes aren't so high so I can content myself with whatever that is coming my way.

Based on what Vanessa said on my blog page, I'm glad that I'm planning to put off more births. She told the story:

"That is what derailed my planned homebirth with Tess. It was excruciating and worse than any labor pain -at one point, I almost blacked out, threw up and peed myself from the pain. Thought I was in transition -except I was 1cm and 50% effac...ed. Saw an osteopath at 40+3 who tried her best to fix it, but couldn't really do anything. It took a long time to get better. I mainly saw the osteopath, but have also considered a chiropractor (and acupuncture) in case it comes up again in a future pregnancy."

I definitely hope I can avoid that. I have heard acupuncture being helpful for hip joint problems but I haven't pursued it yet either.

I'll update as I meet with and learn more from the physical therapist. I do hope that we can welcome additional biological children into our family and that it will not be at the expense of my physical well-being.

If you are interested in reading other posts that chronicle what I now know is SI joint dysfunction see the following posts (starting from earliest to most recent):

Belle's Birth Story: I describe the moment I felt my SI stretch abruptly.

Not a very interesting update: I describe the hip pain for the first time
Been Away: Started yoga at 3 months postpartum to be gentle on my hip (instead of returning to Irish dance)
Preparing to conceive again: I started wanting another baby but was feeling ambivalent because of my hip problems.
A remedy that might help my hip pain: I learned about lecithin to relieve joint pain
Check that Off the Bucket List: My husband and I took a massage class where he learned some strategies to help massage my hip when its hurting