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Sacroiliac Joint Dysfunction

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Do you find yourself suffering from excruciating lower back pain? Is this pain affecting your daily activities as well as work? Then, one of the causes of lower back pain may be sacroiliac (SI) joint pain. This article will cover some details related to sacroiliac joint dysfunction and its treatment options.

What is Sacroiliac Joint?

Sacroiliac joint (SI) helps connect the tail bone (sacrum) to the pelvic bones (ilium). It is located in the lower part of the back. The SI joint can absorb shock and helps in stabilizing the body. This joint has very little movement and helps transfer the body weight from the spine to the pelvis.

The sacroiliac joint can suffer from inflammation, wear and tear or injury leading to damage. This damage can affect their normal movement and lead to debilitating, long-term lower back pain.

SI joint dysfunction is one of the most under-diagnosed causes of pain in the lower back region. It has been found about 25% of the cases of lower back pain is due to sacroiliac joint dysfunction. This is because the SI joints are very close to the hip bone and lower back. Thus, it is often mistaken as a herniated disc pain.

Signs and Symptoms of Sacroiliac Joint Dysfunction

It is very difficult to pinpoint lower back pain as sacroiliac joint dysfunction. Some of the symptoms that may indicate SI joint dysfunction includes radiating pain in the hip, buttocks, groin and thigh region. The pain will become severe if one stands, sits, walks or lies down for a long period of time. Other symptoms include:

  • Touching the lower back region may hurt in severe conditions
  • Pain when carrying out daily activities like climbing stairs, etc.
  • Stiffness or burning sensation in the pelvic region
  • Pain when trying to roll over in bed
  • Pain when trying to remove or wearing socks and shoes
  • Asymmetry of the pelvis caused by muscle stiffness

Causes of Sacroiliac Joint Dysfunction

Sacroiliac joints have very little movement. Their main function is to provide stability to the body. However, normal wear and tear or any injury can affect the joints, leading to chronic lower back pain. The main causes of SI joint dysfunctions include:

  • Any anatomical variation like uneven leg length, abnormal gait, scoliosis can lead to SI joint dysfunction. The extra stress and pressure on the joint due to the variation in the normal body structure can lead to degeneration of the joint causing excruciating pain.
  • Injuries to the spine or SI joint like a car accident or slipping and falling on your lower back or hips can lead to inflammation of the sacroiliac joint.
  • Sudden jerking or twisting or lifting of heavy weights can damage the sacroiliac joint.
  • Women often suffer from sacroiliac joint dysfunction during pregnancy. The SI joint stretches to help ease labor. When they do not come back to their original position post-pregnancy, it can lead to painful movement of the joint leading to lower back pain.
  • The cartilage layer over the SI joints can get damaged or worn off with age. This causes the bones to rub over each other, leading to degenerative arthritis. Osteoarthritis is the most common cause of sacroiliac joint dysfunction.

Diagnosis of Sacroiliac Joint Dysfunction

Diagnosis of SI joint dysfunction is very difficult. The damage or inflammation in the SI joints does not show up in X rays, CT scan and MRI’s. Thus, making it extremely difficult to diagnose.However, in order to determine the lower back pain as SI joint dysfunction, the doctor has to conduct a few simple tests during your physical examination. These include Flexion Abduction External Rotation (FABER) test. In this, the patient is asked to lie down on the back and carry out specific movements like flexing, rotating and extending the hips. This will help determine the origin of pain from the SI joints.

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Other tests to determine SI joint dysfunction include:

  • Fortin finger test
  • Pelvic gaping test
  • Pelvic compression test
  • Sacral thrust test
  • Thigh thrust test
  • Gaenslen’s test

SI joint injection test is conducted as a gold standard for diagnosis sacroiliac joint dysfunction.

Treatment for Sacroiliac Joint Dysfunction

There are many ways to treat sacroiliac joint once it is correctly diagnosed. One should not carry out any activity that causes pain of the SI joints. The management of SI joint dysfunction includes:

  • Medications like acetaminophen and non-steroidal anti-inflammatory drugs. If these do not provide relief, the doctor will prescribe corticosteroid medications or injections.
  • Physical therapy that helps in easing the stress on the SI joints, abdominal muscles as well as the back muscles.
  • Radiofrequency ablation and electrical stimulation that helps in relieving the SI joint pain.
  • Sacroiliac belt or brace to help hold the joints together and reduce the pain.
  • Alternative hot and cold compression to reduce the pain and swelling.
  • Surgical options that help in fusing the SI joints, if the other treatments do not work.

Rest is the most important part of treatment for sacroiliac joint. Get enough sleep and avoid standing for long time.

Prognosis of sacroiliac joint dysfunction varies from patient to patient. When correct treatment is given, the patient may be pain-free in a couple of weeks. However, it takes about 2 to 3 months for the sacroiliac joints to heal completely. Thus, take care to avoid any exertion during this period.

Written by: Saptakee sengupta
Date last updated: April 01, 2015