THIS POST IS PART OF THE ULTIMATE GUIDE TO BACK PAIN RELIEF
Your spine provides many functions to your body. It keeps your back straight and stable, it connects to your neck to prop up your head and it also is connected to your pelvis, to help carry your upper body while you’re standing, walking or running.
There are two joints that connect your pelvis or hips to your spine. These joints are called your sacroiliac joints. They sit in your lower back and support the top half of your body when you walk, run or stand up. Sacroiliac (SI) joint dysfunction occurs in your lower back, hips and thighs when one or both of your SI joints become inflamed.
OrthoIndy non-operative spine physician, Dr. Nicholas Jasper, discusses what causes SI joint dysfunction, common symptoms and various treatment options.
Anatomy
Your SI joint connects the left and right iliac bones (the bones on each side of your hip) to your sacrum, which is why it’s called your sacroiliac joint. Your sacrum is the bone between your lumbar (lower) spine and your tailbone.
Your SI joint doesn’t move much. “This is the largest joint in the spine and is central to our gait pattern,” Dr. Jasper said. “It helps transfer loads from the trunk to the lower extremities. There are multiple ligamentous structures in our pelvis that help keep the SI joint in place.”
SI joint dysfunction is the universal term for pain in your SI joint. It is also known as:
- Sacroiliitis
- SI joint pain
- SI joint strain
- SI joint disease
What triggers SI joint pain?
Dr. Jasper discusses several causes of SI joint dysfunction. The most common cause is the ligaments and cartilage loosening or tightening because of increased pressure or activity in the joint.
Other causes include:
- Issues in your gait (uneven movement from leg length discrepancy)
- Pregnancy or recent childbirth
- Previous \surgery on the lower back
- Activities putting repeated stress on your joint
- Rheumatoid arthritis
- Osteoarthritis
If your problem is coming from your gait, it could be for several reasons. If you have pain in your knee, hip, ankle or foot, it could be contributing to your SI joint dysfunction. If this problem is addressed and treated, your SI joint dysfunction will likely be resolved.
What aggravates SI joint pain?
People who put a lot of strain on their lower back, whether intentionally or not, are most at risk to develop SI joint dysfunction. For example, Dr. Jasper highlights elite rowers as athletes prone to develop this condition because the rowing movement causes the SI joint to work constantly.
Other groups of people commonly affected are:
- Individuals with L5-S1 fusions
- Individuals diagnosed with rheumatologic disorders
- Pregnant women
- High-level athletes
What does sacroiliac pain feel like?
Symptoms for SI joint dysfunction can be felt in your lower back, hips and legs. Since there is an SI joint on each side of your lower back that connects to your pelvis, symptoms sometimes only affect one side of your body.
Symptoms include:
- Dull, aching pain in your lower back
- Pain spreading to hip, buttocks and groin
- Sciatic-like pain that is hot and stabbing in the back of thighs and buttocks
- Stiffness in your lower back, hips and groin
- Pain worsened by running, climbing stairs or laying on one side
- Instability in your pelvis and lower back
- Pain when you stand from a sitting position
Diagnosis
To determine whether you have SI joint dysfunction, your physician will ask you for a complete medical history, have you describe your symptoms and conduct a physical examination. An X-ray or MRI may be necessary to confirm the diagnosis and determine if there are other problems.
What is the treatment for sacroiliac joint dysfunction?
You may be wondering, “can sacroiliac joint pain be cured?” Treatment for SI joint dysfunction is non-operative with very few exceptions. The most important thing to do is stop the activity causing your pain. If the pain is coming from pregnancy or recent childbirth, give your body the necessary rest it needs to recover.
Rest for a few days to give your SI joint a break. If you rest longer than that, it could cause stiffness in the joint. If your pain persists, your physician will most likely recommend the following methods to reduce your pain and allow you to walk normally again.
- Ice or heat application to the injured area
- Over the counter pain medication
- Physical adjustments by a chiropractor
- Brace for the lower back
- Steroid injections
- Physical therapy
Dr. Jasper says the average recovery time for a patient is four to six weeks, but that may vary depending on the patient’s overall health.
Learn more about treatment options for neck and back pain at OrthoIndy.
Is SI joint dysfunction permanent?
Normally, patients see relief with the non-operative treatments above. However, if patients get unsustained (less than three months) but great relief from SI joint injections, they may be a candidate for a procedure called SI joint ablation, according to Dr. Jasper.
“The SI joint has small sensory nerve fibers that transmit pain signals,” Dr. Jasper said. “In patients with unsustained but great relief with SI joint injections, those small sensory nerves can be burned, or ablated, to help provide longer relief of greater than six months.”
The effects of this procedure take four to six weeks to settle in.
To schedule an appointment with Dr. Jasper, please call 317.802.2483 or request an appointment at OrthoIndy/request.
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