Sacroiliac Joint Pain

Although the sacroiliac joint, also referred to as SI joint, is small, it is incredibly strong, connecting the sacrum and the crest of the iliac in order to support the hips and spine. Tough fibrous ligaments hold this joint together. The joint forms the main shock absorber between the legs and the torso. Hence, during normal activities, it is subjected to forces of compression and twisting.

Background of Sacroiliac Joint Pain
For decades, it was thought that the pain occurring in the sacroiliac joint region was due to leg and low back pain. The difficulty in proving that the sacroiliac joint was involved in the pain caused in the area was the reason why many in the medical profession were skeptical. In addition, in the last 20-30 years, medical practitioners concentrated more on back pain caused due to discogenic reasons, like disc herniation. As a matter of fact, even today, the dysfunction of the sacroiliac joint is difficult to diagnose since no non-invasive technique has been found yet which has the ability to isolate this hard to access joint, apart from anesthetic injections applied directly into the joint.

What is SI Joint Pain?
Often, when people experience this pain, they describe it as being focused in the hip and the lower part of the back. Sometimes they even say that it radiates out higher up in the lower back and toward the buttocks. Sometimes it can even spread to the front, in the groin region, or down into the legs. Some men even experience pain in the testicles.

What Causes Sacroiliac Joint Pain?
While the medical profession is still not certain what brings about the pain, it is believed that changes in the normal joint movements may be perpetrating it. Hence, the pain in the joint may be caused by either:

Excessive movement, also described as instability or hypermobility
Or
Diminished movement, also referred to as fixation or hypomobility

Sacroiliac joint pain could also be caused due to inflammation of the joint or injury. The pain is akin to sciatica and other back pains, hence the difficulty in diagnosing it. Sacroiliac joint treatments often are used as tools for diagnosing the condition.

How is Sacroiliac Joint Pain Diagnosed?

Generally, the process of exclusion is employed to diagnose dysfunction of the sacroiliac joint. For instance, if after an examination it is determined that a lumbar spinal condition is not responsible for the pain, it is then diagnosed that SI joint syndrome is the cause of the pain. Although some tests are done to aid the diagnosis, but the results are ambiguous, as it has been seen that any back condition may be responsible for the pain. Usually, an anesthetic injection is administered directly into the sacroiliac joint, using fluoroscopy. If it is found that the pain diminishes, then it becomes obvious that the SI joint is responsible. Although, there can be ambiguity involved in this procedure too, as the anesthetic could affect a nerve that is not connected to the sacroiliac joint, and relieve the pain in the area. This is the main problem about diagnosing this condition. However, most experienced medical practitioners can diagnose it accurately via the process of exclusion.

What are the Treatments for SI Joint Pain?

There are a number of methods of treatment, which are used in a progressive way, in order to bring about relief for sacroiliac joint pain:

Physical Therapy: This is often the first thing that is prescribed to patients. Stretches and exercises are used to tone and strengthen the ligaments of the sacroiliac joint.

Chiropractic Treatment: This is a treatment method wherein the spinal structure is manipulated in order to provide relief in the joint. It is usually a complementary program of back care treatment.

Massage Treatment: Massage is used as a method of relaxing the ligaments and muscles of the lower back region.

Prescription or OTC Painkillers: Your physician may prescribe Non-steroidal Anti-Inflammatory Drugs, also known as NSAIDS, like ibuprofen and aspirin, or a pain medication like acetaminophen. The sacroiliac joint may also be injected with steroid injections, which usually provides relief for a short time. Antibiotics may also be prescribed if it is found that there is infection in the joint.

Surgical Intervention: If it is an advanced case of sacroiliac joint pain, surgery may also be resorted to.