Sacroiliac joint dysfunction is a medical condition that leads to sacroiliac (SI) joint pain. While the exact cause of SI joint pain has not been determined, there are a variety of treatments available to alleviate joint pain. Fortunately for most patients, SI joint pain can be managed through nonsurgical treatments and rarely requires SI joint surgery. Sacroiliac joint dysfunction can be managed through simple techniques and treatments.
What parts of the spine are affected by SI joint pain?
The sacrum is a triangular bone in the pelvis that begins just after the end of the lumbar spine. The sacrum gets its shape from several vertebrae merging together during fetal development. The SI joint lies between the sacrum and iliac bone, which is where the sacroiliac joint gets its name. These joints make a dimple-like imprint on your lower back just above the waistline. The SI joints are one of the larger joints within the body. SI joints move very rarely. The normal movements of the SI joints include tilting, sliding, and rotating, which only occurs for a couple of millimeters.
The SI joints are held in place by multiple strong ligaments. If these ligaments are damaged, the stability of the pelvis may become jeopardized. This can happen if the pelvis is injured from a fracture. Fortunately, these ligaments are quite sturdy and are not commonly torn completely after an injury. Because of these ligaments, the SI joints barely move in adults.
In pregnant women about to give birth, a special hormone is released that relaxes these joints, allowing the pelvis to stretch more easily while giving birth. Several pregnancies may increase the possibility of arthritis in the SI joints. With age, it is common that the SI joints become completely stiff and offer no movement, which is not problematic as regular mobility does not seem to be affected by these joints. It is thought that the SI joints act more as shock absorbers to reduce the stress on bones during a fall or other activity that might jar the body.
What causes sacroiliac joint dysfunction?
There are many reasons why you might experience SI joint pain.
- Multiple pregnancies may cause SI joint arthritis later in life.
- One leg being longer than the other.
- Conditions such as gout, psoriasis, and rheumatoid arthritis.
- Patients may suffer from SI joint pain after a car accident, injury, or other traumatic event, such as s fall that lands on one side of your hip or buttocks.
What are the symptoms of sacroiliac joint dysfunction?
Sacroiliac joint pain symptoms include pain in your lower back and buttocks. This pain may affect both sides of the back and buttocks or just one side. Similar to a herniated disc or other spinal conditions, pain from the SI joints may radiate down the leg and into the foot, often confusing patients into thinking that they may be suffering from another spinal condition. Pain in the groin and spasms within the muscles of the buttocks are also common sacroiliac joint dysfunction symptoms. SI joint pain can cause sitting to be painful.
How is SI joint pain diagnosed?
There are several ways to diagnose SI joint pain:
- A physical exam and analysis of your medical history. Notify your doctor about any activities or positions that seem to worsen or alleviate your SI joint pain.
- Lab tests may be performed to determine if you may be suffering from an infection or arthritis.
- A spinal x-ray, to determine if another condition may be contributing to your SI joint pain. If further imaging is required, Dr Paley will order an MRI of the spine.
What nonsurgical SI joint pain treatments are available?
- Anti-inflammatory medications to help reduce inflammation and discomfort in the joint.
- Pain medications
- Limiting activities, while allowing the SI joint to rest
- A specifically designed sacroiliac joint belt, to help immobilize your pelvis
- Physical therapy, to help support and strengthen the surrounding structures
- Corticosteroid injections
What SI joint pain surgery is available?
If noninvasive SI joint pain treatments do not alleviate your symptoms, sacroiliac joint dysfunction surgery may help to relieve your symptoms. SI joint pain surgery involves the fusion of the SI joint that causes pain. SI joint fusion can be achieved by removing the cartilage from both ends of the bones that form the SI joints. These 2 bones will be securely placed together with plates and screws known as instrumentation until these 2 bones fuse into 1 bone. SI joint fusion surgery can reduce the movement of the bones and help to ease SI joint pain. SI joint surgery is often the last resort and reserved only for patients who experience severe sacroiliac joint dysfunction symptoms.
What should I expect after a nonsurgical SI joint pain treatment?
Physical therapy is often suggested after undergoing a nonsurgical SI joint pain treatment. With multiple sessions a week, physical therapy may last up to 4-6 weeks. If you are suffering from moderate-to-severe SI joint pain, additional sessions may be required. Physical therapy for SI joint pain can help promote more mobility in the lower back and pelvis, which can improve the pain associated with sacroiliac joint dysfunction. If you are suffering from limited mobility due to SI joint pain, physical therapy can help you achieve a wider range of motion with specifically designed exercises. Your physical therapist can tailor an exercise regimen that can help improve endurance, strength, and flexibility.
What should I expect after SI joint pain surgery?
Following SI joint surgery, you will need a minimum of 6 weeks of rest before beginning physical therapy sessions. Physical therapy may last for 6-8 weeks or longer for a patient recovering more slowly from sacroiliac joint dysfunction surgery. Complete recovery from SI joint surgery may take up to 6 months or more. Your initial physical therapy sessions will revolve around managing any pain or inflammation after SI joint pain surgery. As you heal, your sessions will begin to incorporate additional exercises to build strength. At the end of your physical therapy, your physical therapist will teach you proper movements to avoid future pain and techniques to practice if SI joint pain symptoms ever return.