What are Sacroiliac (SI) joints?
The Sacroiliac joints (SIJ) are formed where the pelvic bones join at the base of spine, or sacrum. The web of interosseous sacroiliac ligaments maintains the stability of the joint and decrease motion/dysfunction. The primary function of the sacroiliac joints is to absorb shock between the upper body and the pelvis and legs.
What art the symptoms of SI joint pain?
This joint can be a source of pain like any other joint, and it may cause hip, low back, or buttock pain. Sacroiliac joint dysfunction may also be associated with radiation of pain into the groin and/or back of the thigh. Symptoms may worsen with sitting, standing, sleeping, walking, or climbing stairs. Often the SI joint is painful sitting or sleeping on the affected side. Some people have difficulty riding in a car or standing, sitting, or walking too long. Pain can be worse with transitional movements (going from sit to stand), standing on one leg or climbing stairs.
What causes SI joint pain?
- Sacroiliitis is defined as inflammation of one or both sacroiliac joints secondary to spondyloarthropathy such as ankylosing spondylitis, osteoarthritis, and trauma, etc.
- Sacroiliac joint dysfunction is usually defined as laxity in the interosseous ligaments secondary to trauma, wear and tear or other causes such as pregnancy/childbirth, etc.
- Other causes such gait issues (biomechanical conditions) such as wearing a walking boot following foot/ankle surgery or non-supportive footwear, can lead to degenerative sacroiliitis.
- Extra mechanical pressure and stress from previous history of lumbar surgery such as fusion and weakness of pelvic and gluteal muscles from deconditioning
- Trauma such as car accident, falls, etc.
How do you diagnose SI joint pain/dysfunction?
- A thorough medical history (location, intensity, description, modifying factors) and physical examination provocative maneuvers with specific focus on lumbar and pelvic region (Sacral Thrust test, FABER test, Gaenslen test, Yeoman’s test).
- Diagnostic imaging X rays, CT scan, MRI (to rule out herniated disc or facet joints referring pain to SI joint region)
- Diagnostic local anesthetic injections under image guidance
How do you treat symptoms associated with SI joint pain?
- Physical therapy, Chiropractic treatments, rest, stretching exercises, ice, heat, etc.
- Pharmacological treatments such as NSAIDs, Tylenol, etc.
- Interventional options such as SI joint injections with steroids, SI joint nerve ablations
- Rare cases of SI joint fusion surgery
How do you prevent SI joint pain/dysfunction?
- Proper lifting techniques
- Maintaining healthy weight
- Good posture during sitting, standing, walking, sleeping
- Exercise regularly
- No smoking