There are few forms of discomfort worse than back pain. This especially true of pain from the sacroiliac joint. This can be a sharp, stabbing pain that radiates up from the upper buttock out to the hips and down to the back of your thighs.
Sacroiliac pain can also be experienced as a tingling or numbness in the legs. Believe it or not, the SI joint is actually responsible for 15 to 30 percent of all cases of chronic lower back pain.
Where are the Sacroiliac Joints Located?
Here are the basics: The SI joint are located where your sacrum and ilium meet. The sacrum is a triangle-shaped bone at the bottom of the spine The ilium is the uppermost point of your pelvis, and is one of the three bones that form your hip bones. These joints are essentially located in your upper buttock; there is one on each side.
The purpose of the SI joints is to act as a shock absorber to support the weight of your body by distributing it evenly across the pelvis and reduce pressure on the spine. These joints are where your upper body meet your lower body. It is meant to be very stable joint; in anatomic studies it has only minor movement. To add to stability these joints are connected by muscles and ligaments that support the area further reducing its mobility.
What’s the Source of SI Joint Pain?
Ankylosing Spondylitis
This is a type of inflammatory arthritis that generally impacts the vertebrae and joints of the spine.
Anklylosing spondylitis not only affects SI joints, it’s also known to cause painful inflammation in a number of other joints, as well as pain in the eyes and organs of the body.
Pain resulting from AS is typically mild and intermittent, yet is sometimes quite severe and ongoing.
Osteoarthritis
Osteoarthritis is most often associated with aging. It is caused by the wearing down of cartilage in the SI joint, spine, and other joints.
Pregnancy
Sacroiliac pain can also be caused by significant bodily changes such as pregnancy, when hormones are released making the SI joints more elastic. This is necessary so that the pelvis can widen during childbirth.
But this also makes joints less stable. Thus combined with increased weight and the added weight of the baby, the mother will experience severe lower back pain. This often will resolve with child birth, however for some patients this pain does not go away due to instability in the joint.
Abnormal Walking Patterns
People who have developed abnormal walking patterns are often prone to joint dysfunction in the lower back. In many cases this is caused by such irregularities as having one leg shorter than the other, as well as from a change in walking pattern during pregnancy.
Physical Trauma and Injury
Sacroiliac pain can also be caused by any form of physical injury. This could result from car accidents, falls, a wide range of sports injury, as well as any type of severe physical trauma that might not become apparent for day or weeks later following the traumatic event.
Previous Lumbar Spine Surgery/Fusions
After patient’s have had spine surgery, especially lumbar fusions, the normal body mechanics change. Often the hardware that is placed is much stronger than the normal bones. Due to this, the force is transmitted to the area below the fusion. The final stop is the SI joint. This pressure often will cause the joint to undergo additional wear and tear as well as increased instability causing pain.
The Symptoms of Sacroiliac Pain
Although every individual is different, and experiences sacroiliac pain somewhat differently, there are some universal symptoms to watch for:
These include pain in the lower back radiating down the back of the thighs typically stopping at the knee however sometimes it does go down to the feet. Other symptoms are increased pain when standing up from a sitting position (like getting off the toilet or out of a car low to the ground) or pain in the lower back while driving.
Another symptom that might point to sacroiliac joint pain is the feeling like your legs may buckle and not support the weight of your body, as well as stiffness or a burning sensation in the pelvis.
Diagnosing the Problem
Due to the fact that the sacroiliac joint is located deep inside the body, it can be challenging for a doctor to examine. It’s also difficult to detect damage to these joints with imaging tests such as X-rays or CT scans.
There are some physical exam maneuvers which can clue in your physician that the SI joint is an issue.
The most precise method to diagnose this problem often requires a doctor to inject a numbing drug, such as lidocaine. If this injection makes the pain go away in a short amount of time, it’s an indication that you do indeed have an SI joint problem.
Treating Sacroiliac Pain
There are a wide variety of treatments for this form of pain, ranging from self-care and physical therapy, to surgery:
Physical Therapy and Exercise
Low-impact exercise such as yoga is ideal for alleviating lower back pain. Massage is often effective at easing pain, and helps to strengthen and stabilize the joints of the lower back area.
Physical therapy can also be useful, as well as wearing a sacroiliac belt that helps ease the pain by support the SI joint.
Medication
There are a number of anti-inflammatories and muscle relaxers that can be used for short-term pain relief. But these should not be considered long-term options due to the risk of addiction, and because they simply do not fix the problem.
Injections
Simple injections can often provide intermediate to long term relief from SI joint pain. These injections include numbing medicine and anti-inflammatory steroids. Another injection that can make the pain relief last longer is a radiofrequency ablation where the nerves transmitting the pain from the SI joint are destroyed via special needles. There is no incisions for these type of procedures.
SI Fusion with the Corner Loc System
Lastly, a permanent fix for SI joint pain is treatment with the revolutionary Corner Loc system. This minimally invasive procedure introduced cadaver bone graft into the SI joint through a straw like instrument. This graft is then then surrounded with your own stem cells and bone marrow. The graft acts as scaffolding for your own bone to grow around it eliminating SI joint instability. This is better than other SI fusion systems which use rods and screws which is riskier, move invasive, and can lead to more issues.
