Sacroiliac Joint Pain

SACROILIAC JOINT PAIN: Experiencing a twinge in your lower back when you stand up? Your lower back pain might not be what you think it is. Often, the culprit is the sacroiliac (SI) joint, located on either side of your spine. This unsung hero plays a crucial role in transferring weight between your upper body and legs, but it can become inflamed and cause discomfort.

What is the SI joint and what does it do?

The sacroiliac joint, or SI joint for short, is a hidden hero in your lower back. There are two SI joints, located on either side of your spine. These unsung heroes act as a bridge, carrying your upper body weight and transferring it to your legs when you stand, walk, or twist.

What does sacroiliac joint pain feel like?

SI joint pain can manifest in a few ways:

• Dull or sharp ache: The pain often starts at the SI joint but can radiate to your buttocks, thighs, groin, or even your upper back.
• Triggered by standing: Getting out of a chair might be the culprit, and the pain might be worse in the morning, improving as the day progresses.
• One-sided pain: SI joint pain often affects just one side of your lower back.

This type of pain is surprisingly common, affecting 15-30% of people with lower back pain.

Causes of SI Joint Pain

There are various reasons why your SI joint might be unhappy:

• Injury: Sports injuries, falls, or repetitive activities like jogging can inflame the SI joint.
• Uneven leg length: If one leg is longer than the other, it can cause abnormal strain on the SI joint.
• Ligament damage: Damaged ligaments supporting the SI joint can lead to pain and abnormal movement.
• Arthritis: Ankylosing spondylitis, a type of arthritis affecting the spine, can damage the SI joint.
• Age-related wear and tear: Over time, the cartilage cushioning the SI joint can wear down, causing pain.
• Pregnancy: Pregnancy hormones loosen joints, which can lead to SI joint pain due to altered movement patterns.

Treatment Options for SI Joint Pain Relief

There’s a range of treatment options available to combat SI joint pain. The first step is to identify and avoid activities that aggravate the joint. Your doctor might also prescribe pain medication for initial relief.

Here are some additional strategies to explore:

• Physical therapy: Exercises can strengthen your core, improve flexibility, and correct any pain-avoidance habits you might have developed. Physical therapists may also use techniques like ultrasound, heat/cold therapy, massage, and stretching to promote healing.
• Injections: Cortisone injections can reduce inflammation, while numbing injections around the SI joint can offer temporary pain relief. Prolotherapy, an injection of saline and numbing medication, might be used to tighten loose ligaments.
• Chiropractic treatment: Chiropractic adjustments can help improve joint and muscle mobility, potentially relieving pain.
• Nerve treatment: In rare cases, your doctor may use a needle to permanently disrupt the nerve pathway carrying pain signals from the SI joint to your brain. Nerve freezing is another option, though less commonly used.

• When is Surgery Considered?

If conservative treatments fail to manage the pain, surgery might be an option. SI joint fusion is a procedure where a surgeon uses implants and pins to permanently join the bones around the SI joint.