Sacroiliac Joint

At the base of the spine, just under the lumbar spine, is located the sacrum, which is a wedge-shaped bone formed by five vertebrae fusing together. The sacroiliac joints, or SI joints, are located on either side of this wedge-shaped sacrum and the left and right iliac bones, therefore the term 'sacroiliac joint'. The iliac bones are the large hip bones that make up the pelvis. Thus, the sacroiliac joints join the spine and the pelvis.

Strong ligaments hold the ileum and the sacrum together, and therefore there is hardly any movement in the sacroiliac joints. Most of the movement in the pelvic area occurs either in the region of the lumbar spine or the hips.

It seems that motion is not a particularly important role of the sacroiliac joints, and with increasing age, they often get totally ankylosed, which means that they become completely rigid. It is thought that the main role of the sacroiliac joints is to act as a shock absorber and enable just enough flexibility and movement in order to reduce the stress on the spine and pelvis.

Sacroiliac Joint Dysfunction

One of the common causes of pain in the lower back is pain in the sacroiliac joints, which is referred to as sacroiliac joint dysfunction. Medical science still does not understand fully the reason the sacroiliac joints become painful, and the resultant lower back pain. Although the condition can be bothersome, but it is usually not dangerous and seldom requires surgical intervention. Generally, those affected with this problem can use fairly simple methods to deal with the problem and alleviate the pain.

Causes of Sacroiliac Joint Dysfunction

The sacroiliac joints, along with the rest of the lower spine area, bear the weight of the whole body when we stand erect, which can put them under a lot of stress. This can result in the cartilage of the sacroiliac joints wearing off, leading to arthritis.

Similar to other joints like the shoulder, hip, and knee, the sacroiliac joints are synovial joints, due to which they are also affected by the various types of arthritis that affect the other joints, like rheumatoid arthritis, psoriatic arthritis, and gout. They can also be affected by a condition known as septic arthritis which occurs when bacteria settle in the joints by traveling there via the blood, which can be one of the most troubling types of sacroiliac joint pain as it could require surgical intervention in order to drain out the sepsis.

Pregnancy is another fairly common cause of sacroiliac joint dysfunction. A hormone known as relaxin is secreted in pregnant women, when the time of delivery approaches, preparing the body for the birth of the child. However, since this causes the ligaments that hold the sacroiliac joints together to relax, it often increases the stress in the area along with abnormal amounts of wear. Plus, the increased weight along with the alteration in the gait during pregnancy also adds to the stress on the sacroiliac joints.

Another common cause of pain in the sacroiliac joints is injury, which can occur due to some sport, which involves jarring effects on the lower limbs and the hip joints, or an motor vehicle accident.

Sacroiliac joint pain can also be caused when one leg is shorter than the other, which results in stress in the hip area due to abnormal alignment. Abnormal gait or alignment can also be caused due to pain in the foot, ankle, knee, or hip. People who have severe lower extremity pain often develop sacroiliac joint dysfunction. However, in most of these cases, treating the underlying condition usually results in improving the sacroiliac joint dysfunction.

What is the Treatment for Sacroiliac Joint Dysfunction?

One of the most accurate techniques of diagnosing sacroiliac joint dysfunction is by injecting the sacroiliac joint directly with an anesthetic substance such as novacaine or lidocaine, along with cortisone, which is a steroid. The cortisone and anesthetic help in diagnosing that the pain is actually originates in the sacroiliac joints when the pain and the inflammation subside. The relief from the pain can last from a single day to a longer period. Another effective method of relieving the pain is oral anti-inflammatory drugs, which can be taken over a longer period, according the advice of the doctor.

Physical therapy is also another method used for treating sacroiliac joint dysfunction. There are various stabilizing and stretching exercises that can be done, which can be learned from a physical therapist, which can help in reducing the pain. A sacroiliac belt, which is a device that can be wrapped around the hips, enables the stabilization of the sacroiliac joints, which is also used for relieving the pain.

In case other treatments do not work, and the pain hampers daily activities, surgery could be resorted to. This involves fusing the sacroiliac joints, by removing the cartilage, and the bones fixed together with the help of screws and plates, until they become fused. This makes the sacroiliac joints completely rigid, thus eliminating the pain.