A Secret Culprit of Chronic Pain: The Sacroiliac Joint

SI Joint Injuries and Pain

The Sacroiliac Joint is located where the pelvis meet the lowest part of the spine, or more specifically, where the iliac bones meet the sacrum. The SI joint provides stability between the torso and legs and acts as a shock absorber for the spine. Its location makes the SI joint a common culprit of lower back and leg pain; however, it very often flies under the radar when being identified as such.

Like many joints in the body, problems with the SI joint may arise suddenly or over time, often by traumatic injury or degeneration. Conditions such as uneven leg lengths, a twisted pelvis, or inflammatory joint disease are likely to contribute to a chronic onset of symptoms. In women, there can even be resulting hormonal changes during pregnancy, providing further evidence for how interconnected the body systems are. 

The SI joint injury or degeneration is known to cause low back pain, gluteal pain, buckling or instability of one or both legs, difficulty sleeping through the night, and instability to sit for long periods of time. Could this be the cause of your pain?

Diagnosing SI Joint Problems

Providers often find SI joint dysfunction problems difficult to diagnose based upon the invasive and cumbersome nature of determining the pain’s origin. Physicians commonly conduct a variety of tests during a physical exam, which are supported by medical imaging, to determine the source of lower leg pain. This imaging is most often in the form of MRI, X-Ray, or ultrasound. However, the most accurate way to diagnose the SI joint as the source of pain is by injecting the joint with a local anesthetic and observing a change in symptoms. If symptoms improve by at least 50%, then doctors can say with confidence that the SI joint is a major contributor to pain.

What Treatment Options Exist?

Once diagnosed, there are a variety of options for treatment. Many patients respond well to physical therapy, oral medication, or injection therapy. While some of these treatments may provide immediate relief, they require many follow-up visits and results are often temporary. If patients don’t respond well to non-invasive treatments, or want a more permanent solution, SI fusion is another option for pain relief. SI fusion is a surgical procedure where the pelvis and the spine are fused together to limit movement and better distribute weight around the joint. While this procedure reduces pain by preventing micromotion, and therefore discomfort, at the SI joint, this is a very invasive surgery with considerably higher risk than alternate methods of treatment. Here at Ospina Medical, our goal is to provide patients with as many minimally invasive options as possible in order to avoid invasive surgery for SI joints pain  such as this. 

Written By: Andy Garcia

Edited By: Camden Rowe