Learn More About Sacroiliac Joint Dysfunction

The sacroiliac joint (SI joint), which connects the leg and hip, is the largest in the human body. It is also a common cause of lower back pain, with as many as 20% of cases pointing back to the sacroiliac joint. It is important to get an accurate diagnosis from a qualified pain doctor if you have lower back pain, as other treatments for back pain are not effective against sacroiliac joint dysfunction.

What Is Sacroiliac Joint Dysfunction?

When the sacroiliac joint is stressed or inflamed, lower back pain can result. A number of inflammatory, infectious or traumatic conditions can cause pain in the sacroiliac area. Because of the many different possible causes of pain, it is important to get an assessment from your doctor.

Symptoms of Sacroiliac Joint Dysfunction

Sacroiliac joint pain can sometimes be difficult to distinguish from other lower back pain. However, certain symptoms could point to pain being caused by sacroiliac joint dysfunction instead of other causes. Common symptoms include:

  • Pain that is temporarily improved by standing or walking.
  • Pain that becomes worse with bending or when going from a sitting to a standing position.
  • Tenderness over the sacroiliac joint when the area is palpated.
  • Pain below the lumbar 5 area on the skin.

Additionally, sacroiliac joint pain is more likely to be felt on one side; other types of low back pain typically involve both sides of the back or are situated in the middle of the back. Sacroiliac joint dysfunction may also include pain that radiates into the groin, buttocks or upper thigh. In some rare cases, pain will radiate into the back of the thigh and down into the leg below the knee.

Sacroiliac Joint Dysfunction Causes

The causes of sacroiliac joint dysfunction are most often related to situations that put extreme amounts of stress on the sacroiliac joint. These can include ligament injury, cysts and muscle pain. Causes of sacroiliac joint dysfunction are typically divided to issues that affect the inside of the joint (intra-articular) and those that affect the outside of the joint (extra-articular).

Intra-articular causes include:

  • Cystic diseases.
  • Trauma to the joint.
  • Arthritis.
  • Infection.
  • Spondyloarthropathy, a family of chronic joint diseases.

Extra-articular causes include:

  • Ligament injuries.
  • Fractures or other trauma.
  • Pregnancy.
  • Cystic disease.
  • Myofascial pain.
  • Enthesopathy, a disorder involving the attachment of ligaments and tendons to the bone.

Extra-articular causes are more likely to result in one-sided pain. Additionally, these are more likely to occur in younger people, be associated with a physical trauma, and be associated with greater tenderness to palpation.

About half of all people who are diagnosed with sacroiliac joint dysfunction report a history of trauma. The leading causes include car accidents, falls, and pregnancy. People are also at higher risk for sacroiliac joint pain if they have increased stress on the joint due to obesity, legs of different lengths, spinal deformities, or previous spinal injuries.

How Sacroiliac Joint Dysfunction Is Diagnosed

Sacroiliac joint dysfunction can sometimes be difficult to distinguish from problems that include pinched nerves, or pain that originates in the spine or hip. A combination of medical history and a physical exam are the first steps in identifying sacroiliac joint dysfunction. This may be followed by a diagnostic block of the sacroiliac joint. If temporary relief is experienced, it is a strong indication of sacroiliac joint dysfunction. Diagnostic imaging tools like CT scans, x-rays and MRIs are not frequently used to diagnose sacroiliac joint dysfunction unless an undiagnosed trauma is suspected.

Treatment Options for Sacroiliac Joint Dysfunction

The first goal of treatment for sacroiliac joint dysfunction is to uncover and treat the underlying cause. For instance, if a discrepancy in leg lengths is the cause, physical therapy and shoe lifts can help. If there is no treatment that can prevent sacroiliac joint pain, the condition is treated directly.

The most conservative treatments for sacroiliac joint dysfunction include physical therapy and pain management through muscle relaxers and OTC or prescription pain medication. Other treatment options include:

  • Neurolysis and Ablation. These procedures disrupt the nerve to keep it from relaying pain signals to the brain. The goal is to eliminate pain without affected mobility or reaction to normal stimuli.
  • Sacroiliac Joint Block. This injection is the first line of treatment for sacroiliac joint syndrome. Your doctor will insert a small needle into the lower portion of the sacroiliac joint and inject a local anesthetic. In many cases, the pain relief will be dramatic and instant.
  • Sacroiliac Fusion Fusion and Stabilization. In instances where neurolysis provides only short-lived relief, it may be necessary to permanently fuse the joint. This procedure is used to treat dislocations, fractures and pain that are the result of instability or degeneration in the joint. Modern techniques mean that this can be a minimally invasive procedure.

Request a Consultation

If you are experiencing lower back pain, it is important to discover the cause. Once we've diagnosed the source our your pain, we can craft a treatment regimen. Dr. Michael T. Harris has spent years in pain management practices helping individuals discover the sources of their pain and helping them manage it. Are you experiencing persistent lower back pain? Get in touch for a consultation today.