Sacroiliac Joint Dysfunction
The sacroiliac joints are the joints between the sacrum (triangular part of the lower spine, just below the lumbar spine, above the tailbone) and the ilium (hip bone), and are responsible for connecting the lower spine to the hips. There are two sacroiliac joints, which are held together by strong ligaments. Since these joints are responsible for holding the weight of an erect individual, they incur a large amount of stress, and are therefore prone to injury by way of wearing of the cartilage of these joints and arthritis. Too much movement (hypermobility) or too little movement (hypomobility) can contribute to the development and progression of sacroiliac joint dysfunction. Hypermobility usually results in lower back and/or hip pain, which sometimes also radiates to the groin area. On the other hand, hypomobility results in pain on one side of the lower back or buttocks, and may radiate into the leg. The pain is usually aggravated by bending or standing up after sitting for a long period of time, and usually feels better after lying down.
There are several causes of sacroiliac joint dysfunction, including: gout, rheumatoid arthritis, psoriasis, and osteoarthritis. Of these, osteoarthritis is the most common. This results from the wearing away of the cartilage that surrounds the bones. Fundamentally, anything that affects the normal gait (walking) of an individual can lead to increased stress on the sacroiliac joints. Trauma, leg length discrepancy, or pain in the lower extremities, can lead to an abnormal gait and therefore cause stress on the sacroiliac joints. Additionally, pregnancy can lead to sacroiliac joint dysfunction because of the relaxation of ligaments as part of the childbirth process. Moreover, the extra weight and abnormal walking pattern that stem from pregnancy can also contribute to sacroiliac joint dysfunction. Overall, it is more prevalent in middle-aged and young women.
Diagnosis, Treatment, and Prevention
Because its symptoms are similar to other causes of back pain, and because the sacroiliac joints are so close to the lumbar spine and the hip bones, sacroiliac joint dysfunction is difficult to diagnose. However, if other causes are ruled out, anesthetic injections to the sacroiliac joints are usually used as the gold standard test for diagnosis. If the pain subsides after the injection, it means that the sacroiliac joints are indeed the source of the pain. Oral anti-inflammatories or steroids, physical therapies including stretching or stabilization exercises, ice, heat, rest, supportive braces, injection therapies (to administer a steroid or a numbing solution or both), or surgery to fuse the sacroiliac joint, are all options available for those who suffer from sacroiliac joint dysfunction. Surgery is the last option after all other methods have been exhausted.
The sacroiliac joints are the primary source of pain in 13% to 18% of all patients with low back pain. It is important to remember that sacroiliac joint dysfunction cannot be prevented in all circumstances. For many people, sacroiliac joint dysfunction is a part of the aging process. Maintaining a healthy body weight and decreasing the stress on the sacroiliac joints can reduce the chances of sacroiliac joint dysfunction. The patient’s health care provider will decide which treatment is appropriate for them and will offer ways in which they can help manage their condition without exacerbating the symptoms.
Sources:
http://www.medicinenet.com/sacroiliac_joint_pain/article.htm
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000610.htm
https://www.spineuniverse.com/conditions/sacroiliac-joint-pain
We offer ultrasound guided diagnostic injections with local anaesthetic and therapeutic injections with cortisone, dextrose (prolotherapy), and/or Botulinum toxin injections, chiropractic, physiotherapy, acupuncture, active exercises, medication, psychotherapy, biofeedback, lumbar supports, TENS/MET devices, and orthotics for patients suffering from sacroiliac joint dysfunction.