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Understanding Sacroiliac Joint Pain: Causes, Symptoms, and Treatment Options

SIJ pain location

Introduction: Sacroiliac joint pain, though often overlooked, can significantly impact one's quality of life. Understanding this condition, its causes, symptoms, and treatment options is crucial for those experiencing discomfort in the lower back, buttocks, or hips. In this blog, we delve into the intricacies of sacroiliac joint pain, shedding light on its diagnosis and management strategies.

What is Sacroiliac Joint Pain? The sacroiliac joint (SI joint) connects the sacrum (the triangular bone at the bottom of the spine) to the ilium (the large pelvic bone). This joint plays a pivotal role in supporting the upper body's weight and facilitating movement. Sacroiliac joint pain, also known as sacroiliitis or SI joint dysfunction, occurs when there is inflammation or dysfunction in this joint.

Manifestation of Sacroiliac Joint Pain: Symptoms of sacroiliac joint pain can vary but commonly include:

Causes of Sacroiliac Joint Pain: Several factors can contribute to sacroiliac joint pain, including:

Treatment Options for Sacroiliac Joint Pain:

  1. Conservative Measures:
    • Physical therapy: Strengthening and stretching exercises can improve SI joint stability.
    • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants can alleviate pain and inflammation.
    • Heat or ice therapy: Applied to the affected area can provide relief from discomfort.
    • Assistive devices: Such as braces or supports to stabilize the SI joint.
  2. Diagnostic Injections:
    • Sacroiliac joint injections: A diagnostic tool wherein a local anesthetic and steroid are injected into the SI joint to determine if it's the source of pain. This procedure helps confirm the diagnosis and can provide temporary pain relief.
  3. Sacroiliac Joint Arthrodesis:
    • For long-term pain relief, sacroiliac joint arthrodesis may be recommended.
    • During this procedure, the SI joint is fused to eliminate movement and reduce pain.
    • Candidates for this procedure typically have severe, debilitating SI joint pain that hasn't responded to conservative treatments.

Success Rates and Considerations: Studies have shown promising outcomes for sacroiliac joint arthrodesis. For example, a study by Rudolf et al. (2017) [1] reported significant improvements in pain and function post-surgery, with a high rate of patient satisfaction. However, success rates may vary depending on factors such as patient selection, surgical technique, and postoperative care.

Conclusion: Sacroiliac joint pain can be a challenging condition to manage, but with proper diagnosis and treatment, individuals can experience relief and regain their quality of life. From conservative measures to advanced procedures like sacroiliac joint arthrodesis, there are options available to address this often-underrecognized source of lower back and hip discomfort.

 

Ask your APM physician if the SI Joint treatment is right for you.

 

Reference:

  1. Rudolf L, Capobianco R. Five-year clinical and radiographic outcomes after minimally invasive sacroiliac joint fusion using triangular implants. Open Orthop J. 2017;11:144–55.
Author
Still me R James Warren, MD MS Me

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