What is Sacroiliac Joint Pain?

Sacroiliac Joint Pain Explained by Las Vegas, Summerlin, and Henderson Nevada’s Top Pain Doctors

The sacroiliac joint is located at the bottom of the spine, beneath the lumbar spine and above the coccyx. Its purpose is to connect the sacrum (the triangular shaped bone found at the bottom of the spine)  (iliac crest). The sacroiliac joint is small and does not have a significant range of motion. However, it is reinforced by strong ligaments and operates as a buffer by transmitting all of the energy of the upper body, hips, and legs.

As people get older, the sacroiliac joint begins to fuse, which commonly causes the cartilage of the joint to deteriorate and develop arthritis in that area. Patients report that sacroiliac joint pain is usually felt in the lower back, hips, buttocks, and sometimes the groin. The pain seems to be worse when on the feet or walking and better if lying down. On occasion, the pain can radiate to the side of the legs, which is a condition called bursitis. This type of pain can at times be quite severe, traveling throughout the hips and legs.

What Causes Sacroiliac Joint Pain?

Sacroiliac JointThe most common cause of sacroiliac joint pain is degenerative arthritis. As with other weight-bearing joints in the body, there is a layer of cartilage covering the bone that functions as a shock absorber during movement. As a person ages, the cartilage becomes thin and damaged, allowing the bones to rub against one another. When this happens, degenerative arthritis occurs. In addition to degenerative arthritis, other conditions that cause inflammation to the sacroiliac joint can cause pain. Ailments such as psoriasis, gout, and ankylosing spondylitis can negatively affect the sacroiliac joint.

Sacroiliac joint pain is often an outcome of severe trauma, like an injury resulting from a motor vehicle accident. Any change to a person’s movement or walking pattern can increase the amount of stress on the joint, which results in pain and inflammation.

Lower back pain has also been linked with the sacroiliac joint. Studies have shown that when tissues in the pelvic region become stressed and inflamed due to irregularities within the pelvic ring, lower back pain can develop. Reports show that about 13% of people diagnosed with chronic lower back pain have had the cause originate from the sacroiliac joint.

Pregnancy is another cause of sacroiliac joint pain. During pregnancy, a woman’s body releases hormones that allow the ligaments to relax in preparation for childbirth. Relaxed ligaments surrounding the sacroiliac joint result in an increased range of motion, which may in turn cause additional damage to that area. In addition, the weight put on the body during pregnancy can add abnormal amounts of stress and pressure to the sacroiliac joint.

Treatments for Sacroiliac Joint Pain

Sacroiliac-Joint-PainDiagnosing sacroiliac joint pain can be difficult, as the symptoms can be frequently mistaken for other common health conditions. A physician will normally begin with a review of the patient’s medical history, a clinical analysis of the symptoms or injury, and a thorough examination of the pelvis and spine. Imaging tests, such as X-rays, MRIs, or CT scans may also be used to help diagnosis the severity of the condition.

There are numerous types of treatment that can help people suffering from sacroiliac joint pain. The most common type of treatment is sacroiliac joint injections. This is when a needle filled with a mixture of an anesthetic and a steroid is injected directly into the sacroiliac joint. As the medicine distributes itself into the area, the patient is able to experience pain relief. Depending on the patient and the severity of the pain, sacroiliac joint injections can offer relief for one or two days or up to a few months at a time.

Medications are often prescribed to treat sacroiliac joint pain and have shown very good results. Non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and steroid medications often supply the most pain relief. Other treatment techniques frequently used are physical therapy, chiropractic therapy, and acupuncture.

If a patient does not experience pain relief from these common types of treatment, there are interventional options such as medial branch blocks, radiofrequency ablation, and spinal cord stimulation that can help.

Conclusion

Sacroiliac Joint ModelThe sacroiliac joint is located near the base of the spine and assists in connecting the spine to the pelvis. Since that area helps to manage the weight of the body, over time damage and inflammation can develop in the joint. Once this happens, due to arthritis, pregnancy, or injury, a patient can begin to experience chronic pain when standing or walking. Though difficult to diagnose, treatments such as non-steroidal anti-inflammatory drugs (NSAIDs), sacroiliac joint injections, and chiropractic therapy have proven to be successful. For patients with more severe cases, interventional treatments like spinal cord stimulation can provide pain relief.

At Nevada Pain our goal is to relieve your sacroiliac joint pain and improve function to increase your quality of life.
Give us a call today at 702-912-4100.

References

  1. Dreyfuss P, Michaelsen M, Pauza K, et al. The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine. 1996;21:2594–2602.
  2. DonTigny RL. Anterior dysfunction of the sacroiliac joint as a major factor in the etiology of idiopathic low back pain syndrome. Phys Ther. 1990;70:250–265.
  3. Fortin JD, Dwyer AP, West S, Pier J. Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: Asymptomatic volunteers. Spine. 1994;19(13):1475-82.
  4. Laslett M, Young SB, Aprill CN, McDonald B. Diagnosing painful sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother. 2003;49:89-97.
  5. Levangie P. The Vertebral Column. Joint Structure and Function a Comprehensive
  6. Analysis. Philadelphia: FA Davis Co. 2005;173-6.
  7. Maigne JY, Aivaliklis A, Pfefer F. Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine 1996;21:1889-92.
  8. Schwarzer AC, Aprill CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine 1995;20:31-7.
  9. Szadek KM. Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. .
  10. J Pain. 2009;10(4):354-68