If you suffer from low back pain, it may be due to a dysfunction in the sacroiliac (SI) joint. Diagnosis of sacroiliac joint dysfunction can be difficult because of the anatomic complexity of this area of the body. Sacroiliac joint pain can easily be mistaken for other conditions such as a strained piriformis muscle, which is a small muscle located deep in the buttock; or sciatic nerve pain.
Because of the challenge of diagnosing sacroiliac joint dysfunction, it can be difficult to achieve an effective cure. In this article, we’ll explore common in-clinic treatments along with red light therapy and other effective home remedies for sacroiliac joint pain.
Note: Learn more about natural healing remedies and red light therapy in the Platinum Therapy Lights blog.
What Does the Sacroiliac Joint Do, and Why Does It Hurt?
The sacroiliac joints, which are located in the right and left sides of the lower back, link the pelvis and lower spine. These are among the largest joints in the body, and their primary function is to distribute body weight and maintain stability.
The SI joint isn’t as much about movement (like the knee) as it is about balancing forces. The SI joint, which is located in the center of the pelvis between the first and second sacral vertebrae and the iliac bone, actually takes the greatest load of any joint in the body. It’s technically two joints—one on each side of the sacrum.
The weight of the entire upper body is carried along the spine and focuses its force in the SI joint. At the same time, the forces coming up from the ground (via the foot, knee, and hip joints) are exerted upward.
The sacroiliac joint sits squarely in the middle of the body, balancing the opposing upward and downward forces. As you might imagine, these forces can be tremendous, especially if you're engaged in strenuous physical activity, or carry a lot of excess weight.
If anything goes wrong with the SI joint, the result is mild to severe pain. That, in turn, can cause you to compensate for the pain, which can lead to posture problems, abnormal gait, and widespread pain. If you are experiencing pain in your legs, lower back, or upper back (from a pulled muscle, sprain, or other injuries), and it has not been linked to the SI joint, be aware that it could impact the SI’s functioning in the future, if gait/mobility compensation continues.
What Are the Main Causes of Sacroiliac Joint Pain?
The sacroiliac joint is supported by strong ligaments and muscles. Injury, osteoarthritis, chronic inflammation, poor biomechanics (when movement in the pelvis is not the same on both sides, such as compensating for an old knee injury), and the relatively sudden effects of pregnancy can cause an imbalance of tightness/looseness in the muscles and ligaments in the pelvic region.
This imbalance can impede normal mobility, causing extra friction on the cartilage (the tough cushion found in all joints), potentially exposing nerve endings, and eventually, even causing bones to rub together.
The trouble with chronic (lasting more than three months) SI joint dysfunction is that it can affect normal activities and lead to unwanted gait and posture changes. The ultimate result is increased chronic pain in the low back area and other joints, especially when you change positions, sleep on your side, walk, run, or climb stairs.
What are the Common Treatments for Sacroiliac Pain?
Physical therapy (PT) is one of the most common ways of treating SI joint dysfunction. The intent is to stabilize and strengthen the musculature in the pelvic and lower back area, increase and balance muscular flexibility, and encourage normal biomechanics. Exercises commonly used in PT include core-conditioning exercises, which involve strengthening trunk muscles that are collectively known as "the core”; and stretching exercises.
Many physical therapists will recommend the use of a pelvic belt or girdle during exercise and daily activities. Pelvic belts compress the area to help increase stability; they also reduce the mobility of the sacroiliac joint in hypermobile patients—that is, patients with excessive mobility in a joint that causes abnormal wear and discomfort. Pelvic belts can be worn whether the condition is acute (sudden and short-lived) or chronic (long-term).
SI joint pain can be managed with non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, and/or muscle relaxants. Neither is suitable for long-term use, however.
Corticosteroid injections may reduce inflammation and ease symptoms of SI joint dysfunction.
Surgery (Sacroiliac joint fusion) is usually a last resort, reserved for cases of extreme chronic SI joint pain that does not respond to any nonsurgical treatments.
There are a few ways you can treat SI joint pain at home, using effective remedies that include both strengthening exercises and red light therapy.
Treating Sacroiliac Joint Pain with Red Light
The human body is highly responsive to light. We feel awake when the wavelengths of natural sunlight (or artificial light) enter the retinas; and when we’re exposed to too much blue light from electronics exposure after dark, we may find it hard to sleep. In terms of overall health, no other light compares to the deep penetrating effects of red and near-infrared (NIR) light.
Red light therapy, which is an umbrella term for red light and NIR light, is also known as low-level light therapy (LLLT) and photobiomodulation. Wavelengths of light, which are measured in nanometers (nm), range from 630nm to 660nm (red light), and from 800nm to 850nm (NIR light). Thousands of independent studies confirm that red and NIR light in the “therapeutic window” of 630-850nm have innumerable positive effects on the body.
Treating SI joint pain with red light is a revolutionary therapeutic method. Although only one study specifically looked at the effects of red light on sacroiliac joint dysfunction, the treatment has seen great success in clinical trials focused on osteoarthritis and other conditions of chronic pain and loss of mobility.
Red light therapy can be used on acute and chronic SI joint pain, as well as neuropathic pain caused by damage to nerves. It has shown great therapeutic potential in clinical trials focused on pain management. It is highly effective, free from side effects, and natural, and can be self-administered in your own home.
What Is Red Light Therapy?
Red light therapy involves shining concentrated wavelengths of red or near-infrared light onto the skin. As light photons are absorbed into the skin and underlying tissue, they stimulate energy production within mitochondria, which are the energy producers within most cells of the body. Much like photosynthesis in plants, mitochondria convert raw materials into fuel for the body.
For a variety of reasons, including chronic inflammation, mitochondria may become unable to perform their needed functions, which is often referred to as mitochondrial dysfunction. This results in depleted cells that cannot repair themselves, replicate successfully, or function normally.
Red light energizes cells, allowing healing to begin at the cellular level and stimulating healing of connective tissue and muscles in the treatment area. Red light has been successfully used for a wide variety of conditions, which you can read about in articles on the PlatinumLED blog.
How Does Red Light Treat Sacroiliac Pain?
Let’s explore the many reasons red light can become a valuable addition to your SI joint pain treatment plan.
Reducing inflammation is one of the best ways to “reset” the body’s normal healing mechanisms. This might seem like a paradox because inflammation is a normal and necessary immune response to healing—but that is for acute injuries and conditions. If inflammation becomes chronic, it backfires and actually prevents healing. Chronic inflammation must be halted for the body to heal.
The longer, deeper-penetrating wavelengths of NIR light are especially beneficial for reducing inflammation deeper in the body, such as at the sacroiliac joint. This was the focus of a 2012 study by researchers from Brazil, who investigated the effects of LLLT on rats with experimentally induced knee inflammation. The study revealed a measurable reduction in inflammation after treatment with red light.
Red light therapy stimulates the formation of capillaries in the treated area to bring nutrients and energy to cells, and effectively remove cell-damaging waste. As shown in a study on patients with heel pain, this results in increased blood flow and ultimately faster healing.
Also, according to a study by researchers from Hungary, red light therapy has shown an ability to reduce knee pain and improve microcirculation in patients with osteoarthritis.
Pain, both in the sacroiliac area and elsewhere in the body, is one of the reasons that the SI joint can continue to degrade. After an injury, gait or other mobility compensation could cause an imbalance in the body that aggravates the condition.
A 2011 study by researchers from Japan involved nine patients who were suffering from SI joint pain. The researchers treated each patient with ten sessions of 830nm wavelengths administered over five weeks. After the study, eight patients showed significant improvement in pain, and six showed increased trunk mobility.
In an Israeli study on osteoarthritis, elderly patients with osteoarthritic knee pain and disability were treated with red and NIR light therapy. After receiving two 15-minute sessions daily for ten days, the patients experienced a significant 50 percent reduction in pain, as well as functional improvement.
A review of clinical trials by researchers from the University of Ottawa in Canada focused on rheumatoid arthritis. The researchers found that red light therapy reduced pain by 70 percent in rheumatoid arthritis sufferers. Patients also saw significant increases in palm flexibility and a reduction in morning stiffness.
Sciatic nerve pain is often mistaken for sacroiliac joint pain because of the area's anatomical complexity. A 2014 study on sciatica pain by researchers from Iran found that treatment with 660nm red light offered neuropathic pain relief in test rats.
Lower back pain, which is often caused by sacroiliac joint dysfunction, can worsen by compensation of body mechanics to alleviate discomfort in the lumbar area. One study by researchers from Canada involved forty patients with low back pain. NIR light at 800nm and higher was found to reduce chronic back pain by 50 percent over six weeks of treatment.
Improved Cellular Metabolism
Red light stimulates cellular energy production in the skin and outer muscles and ligaments. Because near-infrared waves are longer, they stimulate cells deeper within the body.
Stimulating mitochondrial functioning means improved cellular energy production, leading to peak performance in all aspects of cellular functioning. This is essential for healing.
Increased Collagen Production
Collagen is a fibrous protein that provides structure to much of the body. It is most often associated with the skin but is also present in muscle and connective tissue. Red light therapy stimulates collagen production, which may help regrow cartilage within the SI joint.
People often believe that cartilage is impossible to regrow in adults, but a 2015 study suggests otherwise. The study, by researchers from Brazil, found that red light accelerates cellular activity in fibroblasts, which are the cells responsible for repairing cartilage. The researchers concluded that red light stimulates the synthesis of Type 3 collagen, which has shown beneficial outcomes (such as cartilage regrowth) in rats with osteoarthritis.
Now that we’ve discussed how red light therapy can be used to treat SI joint pain, we’ll explore other complementary practices that can reduce pain and help restore normal mobility.
Treating Sacroiliac Joint Pain at Home with Red Light
Before treating sacroiliac joint pain at home, it’s important to get a thorough medical exam that could rule out other conditions. You may also want to see a physical therapist and perform exercises to strengthen the muscles around the SI joint. Once you have those measures in place you may want to support your body’s natural healing mechanisms and reduce pain using red light therapy.
What You Need
For best results, you’ll need a high-output panel such as those in the PlatinumLED BIOMAX series. These panels deliver the intensity of light needed for deep absorption into the body’s tissues and are available in a variety of sizes for both targeted and full-body treatments.
The panel should be large enough to give you therapeutic value across the entire pelvis. This will minimize treatment time since sacroiliac joint pain could be localized to one joint or both.
Use a panel that emits both red and NIR light: ideally, 630nm, 660nm, 810nm, 830nm, and 850nm. Red light effectively treats tissue just under the surface of the skin including the buttocks, hamstrings, and lower back muscles. NIR light absorbs deeply, even through bone, and into painful nerves, muscles, and ligaments.
What to Do
It’s important to understand that red light is not a quick fix. Like many natural therapies, it focuses on supporting the body’s own healing processes, rather than on symptoms alone. Chronic sacroiliac joint pain could take several months of consistent treatment, preferably along with the physical exercises covered in the next section.
Commit to several relaxing 15- to 20-minute sessions per week for one to six months. After the initial treatment, even if you've experienced significant pain relief, you may continue with treatments as a preventive measure. Red light therapy can benefit your entire body and may help with muscle recovery and pain relief.
Other Home Treatments for Sacroiliac Joint Pain
The main goals of an exercise-based approach are to relieve pain, increase flexibility, and correct biomechanical functioning, including correcting muscle imbalances and asymmetry. For example, someone who suffers from ongoing knee pain from an injury may be favoring that leg; over time, this alters the person's gait and directly affects the sacroiliac joint.
The muscles that surround the sacroiliac joint provide stability of the pelvis as well as muscular forces that allow for movement. The primary muscles that connect to the sacroiliac joint ligaments include:
- Piriformis, connecting the lower spine and the upper part of the femur at the hip joint;
- Biceps femoris, the outer muscle of the hamstring, running from the lower part of the pelvis to the outside of the knee;
- Gluteus maximus, the largest muscle in the buttocks, extending from the back of the pelvis to the outer part of the upper thigh;
- Latissimus dorsi, one of the largest muscles in the back, reaching from the seventh thoracic vertebra (T7) region to the lower tip of the shoulder blade.
Any of these muscles can be strained during exercise or injury. An imbalance in strength and/or function among these muscles will affect the others. Balancing, strengthening, and improving flexibility may help minimize sacroiliac joint pain and can offer pain relief.
It’s recommended that you perform these exercises under the supervision of a qualified professional who can instruct you on proper form, and always consult your doctor before starting on any exercise regimen.
Sacroiliac-friendly exercises include those focused on flexibility, as well as stability exercises, which help restore normal range of motion and stabilizes the core to improve biomechanics.
Flexibility exercises lengthen overly tight muscles and ligaments and reduce muscle tension. It’s important to first determine whether the anterior (front) or posterior (rear) muscles or ligaments are overly tight to avoid stretching those that are already loose.
Be sure to warm up before stretching. Never bounce into your stretch; always stretch slowly and gently, never to the point of pain.
- Hamstring stretch: lengthens/loosens the back of the thigh;
- Quadriceps stretch: lengthens/loosens the front of the thigh;
- Hip adductor stretch: lengthens/loosens the inside of the thigh;
- Cobra pose: lengthens/loosens the lower abs;
- Lying down, single knee-to-chest stretch: lengthens/loosens the lower back.
Stability exercises are a key part of physical therapy. They strengthen the core muscles that ensure proper alignment and balance the opposing upper-body and lower-body forces in the pelvis. Here are a few exercises you may do with your physical therapist:
Note: The below is not medical advice, but simply a few examples of the general types of exercises you could do with a therapist or doctor’s guidance.
- The forearm plank pose strengthens your back, abdominals, chest, shoulders, and neck. This potent core-strengthening exercise can also dramatically improve posture. Place your forearms on the floor with your elbows aligned below your shoulders and your arms parallel to your body at shoulder width. Ground your toes into the floor and squeeze your glutes to stabilize your body as you lift your legs so that your body is in a straight line from your heels to the top of your head (without lifting your butt). Hold for 20 seconds, breathing deeply. As you gain strength, hold the pose for as long as you can without compromising your form.
- Hip abductor exercises strengthen the outer hips. Lie on your back with knees slightly bent, with a resistance band around your knees. Keeping your lower back arched, gently push your knees apart, feeling the resistance in your outer thighs and buttocks. Hold for 5 seconds, and repeat for 10 sets.
- Hip adductor exercises strengthen the inner thighs. Lie on your back with both knees bent. Place a basketball between your knees. Keeping your back slightly arched, squeeze the ball with both knees for 5 seconds. Repeat for 10 sets.
- The bridge pose strengthens your lower back. Lie on your back with your knees bent and your palms flat on the floor. Lift your hips as high as you can. Hold for 5 seconds to strengthen muscles in the lower abdomen, lower back, and hips. Repeat for 10 sets.
- Gait training: Pain can alter your gait, or could be caused by an improper gait. Gait abnormalities can become habitual, so it’s advised to work with a qualified professional who can help you identify gait abnormalities and retrain you in how to walk properly. This can be done during physical therapy.
Until the condition is fully healed, avoid:
- Sitting with knees crossed or sitting with the torso twisted
- Standing with the knees locked
- Standing with your weight shifted to one side (as when carrying a child on a hip)
- Twisting to one side repeatedly
- Sleeping on one side without support between the knees
- Any sport or activity that requires twisting and bending
- Stretching that could aggravate already overstretched muscles and ligaments
If you’re pregnant, sacroiliac joint pain may have resulted from hypermobility; the ligaments of pregnant women naturally become looser, to help with childbirth. You may want to avoid stretching until the postpartum period to give your ligaments a chance to tighten up again.
In addition to strengthening exercises and other forms of physical therapy, ongoing low-impact aerobic exercise such as water aerobics or walking will maintain fitness.
Learn, Learn, Learn
Educate yourself on biomechanics, including the effects of posture and the effects of compensating for an injury. Poor posture can contribute significantly to sacroiliac joint dysfunction. Outside of exercise, focus on maintaining correct posture while standing and especially while sitting. If your job requires sitting for many hours, use a chair with lumbar support.
Looking at your posture in a full-body mirror helps you see just how the forces of an improperly aligned spine affect the tilt of your pelvis; and how correcting your posture results in proper alignment of your whole body, from head to toe.
A physical therapist will educate you about the best way to stand, sit, move, sleep, and perform daily activities to prevent additional strain on the sacroiliac joint.