SI Joint | Lower Back Pain - Midwest Orthopedic Specialty Hospital

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Published on August 14, 2019

Woman with SI Joint Lower Back Pain

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. 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, SIJ 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 pain, the trouble with SIJ 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 SIJ symptoms, you should contact your doctor.

  • Radiating, sharp pain that moves from your pelvis through your buttocks or thighs
  • Numbness and tingling in the lower back, pelvis or legs
  • Stiffness or immobility in your lower back
  • Hips and pelvis or groin pain
  • Leg 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 cases complicates the task of SIJ diagnosis. As a category, “lower back pain” is vague. Physicians need to explore 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 maladies that present similarly to SIJ dysfunction.
Once your doctor has a better understanding of the source of your pain, a diagnosis and treatment plan can be identified. 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 be used to 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 conducted in the exam room, 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, or if the patient experiences no difference in pain level, the physician may be able to determine if the SI joint is the culprit and source of pain.

SI Joint Treatment

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, physical therapy will be recommended.

A physical therapy regimen typically consists of weekly appointments that span the duration of four to six weeks, depending on progress. Through a series of exercises, SI joint dysfunction patients are taught how to manipulate the joint and strengthen surrounding ligaments and muscles to lessen inflammation, improve mobility 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 procedures such as cortisone injections may also be an option. Beyond that, your doctor may consider fusion surgery. There are different types of fusion surgeries available, but essentially the goal is to stabilize the joint with either a medical device or 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 now treated round the world. 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 specialist today.