Lower Back Pain? It Could Be Your SI Joint

Your lower back is screaming with pain. You’re past the point of ignoring it. Did you realize the problem could be caused by a joint that—strangely enough—barely moves?

The sacroiliac joint, or SI joint (SIJ), connects your lower spine to your pelvis and supports the weight of your upper body. Strong ligaments located inside the joint transfer your body’s weight and movement from your spine down to your legs. When your SIJ moves too much or not enough, the result can be painful. If the joint cartilage deteriorates, sacroiliac joint pain can be intense and last for months or even years. The condition is more common than many realize. According to Johns Hopkins University, “The sacroiliac joint accounts for approximately 16 to 30 percent of cases of chronic mechanical low back pain.”

Beyond the chronic pain, the trouble with SI joint dysfunction is that it’s difficult to diagnose. The condition is somewhat controversial as well. Until fairly recently, medical researchers were not in agreement as to whether or not the joint moves at all. It appears we are still learning about this mighty, yet mostly fixed joint.

That does not prevent orthopedic specialists and physical therapists from treating the condition and offering relief. If you are experiencing any combination of the following SI joint symptoms, you should contact your doctor.

  • Radiating, sharp thigh or buttock pain that starts in your pelvis
  • Muscle tightness, numbness, and tingling in the lower back, pelvis, or legs
  • Stiffness or immobility in your lower back
  • Hip, groin, or pelvic pain
  • Leg pain, weakness, or buckling

It’s also extremely important to note that if you experience any of the above symptoms along with incontinence, your condition could be a medical emergency; you should visit your doctor as soon as possible.

The Hardship in Diagnosing SI Joint Conditions

“Apart from the common cold, lower back pain is the most common reason for visits to the primary care doctor,” reports the National Institutes of Health. The prevalence of lower back pain in patients complicates the task of SIJ diagnosis. As a category, “lower back pain” is vague. Physicians must identify possible cases by process of elimination, yet many conditions share the same symptoms and even causes. Lumbar spine disc herniation, ankylosing spondylitis, and sciatica are examples of separate disorders that present similarly to SIJ dysfunction.

Once your doctor has a better understanding of the source of your pain signals, they can outline a diagnosis and treatment plan. Imaging diagnostics such as X-Ray, CT scans, and MRIs are not effective at pinpointing SI joint dysfunction because the joint is deep within the body. However, imaging might help your doctor rule out other conditions through the process of elimination.

If your doctor can replicate your specific pain experience through movement or small exercises during a physical examination, it may be a simple yet important indicator of SI joint dysfunction.

A less common diagnostic tool is a nerve block. In this case, doctors inject an anesthetic into the joint area at the pain site. If a change in symptoms occurs following the joint injection, or if the patient experiences no difference in pain level, the physician may be able to identify the SI joint as the source of pain.

SI Joint Treatment Options

Because inflammation in the SI joint is at the root of the pain source, doctors typically begin treatment with a recommendation for anti-inflammatory medication. If symptoms persist, your doctor will recommend physical therapy.

A physical therapy regimen typically consists of weekly appointments that span four to six weeks, depending on progress. Through exercise-based therapy, SI joint dysfunction patients learn how to manipulate the joint and strengthen surrounding ligaments and muscles to lessen inflammation, improve range of motion and ultimately, provide pain relief. A physical therapist will also offer strategies for sleep positions and how to manage the condition while at work.

Minimally invasive non-surgical treatments such as steroid injections directly into the painful joint may also be an option. Beyond that, your health care provider may consider fusion surgery a medical necessity. Different types of fusion surgeries are available, but the primary goal is to stabilize the joint with a medical device or a bone graft. Surgery should always be the last option in treatment analysis.

MOSH is a leader in the treatment of SI joint dysfunction. A few years ago, MOSH doctors conducted clinical trials that resulted in big advancements in how the condition is treated around the world today. The story was even featured on the nightly news and, more significantly, in the internationally distributed medical journal from Oxford, Neurosurgery. If you suffer from low back pain and suspect you have SI joint dysfunction, contact a MOSH orthopedic specialist today.