SI Joint and Lower Back Pain
About the Sacroiliac (SI) Joint
The sacroiliac joints are strong joints (or articulations) between the bottom-most triangular bone of your spine, called the sacrum, and the ilium sections of the pelvis (the sections of the pelvis you put your hands on when you “put your hands on your hips”).
The Function of the Sacroiliac Joint
The function of the sacroiliac joint is both shock absorption (depending on the joint’s possible amount of movement) and torque conversion, to transfer movement in your lower body up to your spine.
POTENTIAL SACROILIAC JOINT ISSUES
Why Sacroiliac (SI) Joint Dysfunction May Occur
Your sacroiliac joints act a lot like the suspension system in a car – they absorb your body’s daily dose of steps, jolts and bumps, and provide you with stability. However, inflammation, normal wear and tear, or even a single incident or accident can damage your SI joint, affecting their slight normal movement and creating chronic and often debilitating low back pain.
Common Causes of Sacroiliac (SI) Joint Problems
- Injuries (a fall, car accident, or even a simple misstep)
- Pregnancy (the ligaments that allow the SI joint to stretch to allow for delivery may remain loose, post-pregnancy)
- Anatomic variation (such as uneven leg length or scoliosis)
- Prior lumbar surgery (fusion of the lumbar spine changes its natural movement and ability to absorb shock)
- Inflammatory joint disease (sacroiliitis)
The Difference Between Sacroiliac Joint Dysfunction and Inflammation
- Sacroiliac joint dysfunction refers to pain in the sacroiliac joint region due to abnormal movement in the sacroiliac joint – either too much movement, or too little. This abnormal joint movement typically results in inflammation of the sacroiliac joint.
- Sacroiliac joint inflammation, called sacroiliitis, describes inflammation in the sacroiliac joint. Sacroiliac joint inflammation may or may not be caused by sacroiliac joint dysfunction.
Why Sacroiliac Joint Dysfunction or Inflammation May Cause Pain
When the strong ligaments of the sacroiliac joint become damaged, they may move excessively or insufficiently, causing inflammation and disrupting the joint and its surrounding nerves. When this happens, you may feel pain in your low back, buttocks and/or legs, especially while walking, running, lifting or even sitting or lying down.
Common Symptoms of Sacroiliac Joint Dysfunction or Inflammation
- Pain in your low back, buttocks and/or legs
- Pain or discomfort performing common daily activities that require your pelvis to pivot, like getting in and out of bed, walking up or down stairs or even turning in a chair
- Difficulty sitting or lying down – especially if you experience an ache on one side of your body so painful it requires shifting your weight to the other side to gain relief
SACROILIAC JOINT DYSFUNCTION DIAGNOSIS
Diagnosing Sacroiliac Joint Dysfunction or Inflammation
Dr. Guy Fogel will ask about symptoms, medical history, and level of physical activity, and may conduct additional tests depending on the information provided. These diagnostic tests may include provocative maneuvers designed to gauge the scope and degree of sacroiliac joint pain. Your physician may also take x-rays of the pelvis and low back, a CT scan or an MRI scan. Additionally, the physician may also conduct tests based on joint injections or nerve blocks – drugs that temporarily block nerve signals from parts of the affected area to determine if pain originates in the SI joint.
The Challenge of Diagnosing Sacroiliac Joint Dysfunction and/or Inflammation
Because many of the symptoms of sacroiliac joint dysfunction and/or inflammation mimic symptoms of low back pain, such as pain in your low back and legs, it may not initially be correctly diagnosed. A trained and experienced physician, such as Dr. Fogel, is your best resource for correctly identifying the root cause(s) of low back pain and discomfort.
Connection between low back pain and sacroiliac (SI) joint dysfunction or inflammation
It has been reported that up to 30% of all chronic low back pain is due to SI joint dysfunction.1,2 However, patients with SI joint dysfunction may not be correctly diagnosed, leading to unnecessary treatment such as lumbar spine surgery. Additionally, the sacroiliac joint is the most likely source of low back pain after lumbar fusion.3
SACROILIAC JOINT DYSFUNCTION TREATMENT
Nonsurgical Treatment for Sacroiliac Joint Dysfunction and/or Inflammation
iFuse Implant System (Minimally Invasive Sacroiliac Joint Surgery)
The iFuse Implant System is a minimally invasive surgical procedure for patients who have had unsuccessful non-surgical procedures for sacroiliac joint pain. Over 25,000 procedures have been performed in the last few years. Click here to learn more.
Treatment options for sacroiliac joint dysfunction and/or inflammation should be individualized to each patient. The most common conservative (nonsurgical) treatment methods include:
- Short-term rest – refraining from intense physical activity, twisting, turning or bending
- Medications – potentially including pain medicines, anti-inflammatory drugs, steroid injections, antibiotics, or radio wave nerve treatment
- Physical therapy – exercises to stretch and strengthen muscles of the lower back and/or the motion of the sacroiliac joint
- Preventive therapy – regular exercise, weight loss, and proper techniques for lifting
Surgical Treatment for Sacroiliac (SI) Joint Dysfunction and/or Inflammation
Patients who have not responded sufficiently to conservative treatment therapies for SI joint dysfunction and/or inflammation may be a candidate for surgical intervention. The surgical procedure leads to a fusion across the sacroiliac joint.