Is SI Joint Dysfunction Causing Lower Back Pain?
Primary care physicians are often the first to see patients with lower back pain; however, if sacroiliac (SI) joint dysfunction is suspected it is important to be evaluated by a specialist as soon as possible since early and expert intervention can keep the condition from getting worse.
The Spine Team at Florida Orthopaedic Associates provides comprehensive, integrated care for patients with SI joint dysfunction and many other conditions of the spine.
In this month’s blog, Dr. Stephane Lavoie, orthopaedic spine surgeon, reviews SI joint pain from symptoms and diagnosis to treatment.
What is the sacroiliac joint?
The SI joint is the joint formed by the sacrum (five fused vertebrae near the base of the spine) and the pelvis (ilium). It is a strong, stable joint that connects the spine and upper body to the lower body. It is an essential component for shock absorption to prevent impact forces from reaching the spine.
SI joint pain symptoms
SI joint pain is often caused by excessive motion in the joint.
Like any other joint in the body, the SI joint can be injured and/or become degenerative. When this happens, people can feel pain in their buttocks and sometimes in their low back and legs. This is especially true while lifting, running, walking, or even sleeping on the involved side.
According to scientific data, it’s common for pain from the SI joint to feel like disc pain or low back pain.
Do you experience one or more of the symptoms listed below?
- Low back pain
- The sensation of low extremity: pain, numbness, tingling, weakness
- Pelvis/buttock pain
- Hip/groin pain
- Feeling of leg instability (buckling, giving way)
- Disturbed sleep patterns
- Disturbed sitting patterns (unable to sit for long periods, sitting on one side)
- Pain going from sitting to standing
How do you diagnose sacroiliac joint pain?
A variety of tests performed during a physical examination may help reveal the SI joint as the cause of your symptoms. Sometimes, X-rays, CT scans, or MRIs may be helpful in the diagnosis of SI joint-related problems.
The most relied upon method to accurately determine whether the SI joint is the cause of your low back pain symptoms is to inject the SI joint with a local anesthetic. The injection will be delivered under either X-ray or CT guidance to verify the accurate placement of the needle in the SI joint.
If your symptoms are decreased by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to your low back pain. If the level of pain does not change after SI joint injection, it is less likely that the SI joint is the cause of your low back pain.
Treatment options for SI Joint pain
Once the SI joint is confirmed as the cause of your symptoms, treatment can begin. Some patients respond to physical therapy, use of oral medications, or injection therapy. These treatments are often performed repetitively, and frequently symptom improvement using these therapies is temporary.
At this point, you and your surgeon may consider other options, including minimally invasive surgery.
Sacroiliac joint fusion surgery
SI joint fusion surgery attaches the sacrum to the pelvic bone so that they grow together into one bone. A fusion will reduce freedom of movement in the spine by making the fused bones immobile, but that immobility serves the purpose of reducing pain.
How SI joint fusion works:
- During surgery, a bone graft is added to the SI joint.
- Your body grows new bony tissue over the bone graft between the two segments of the SI joint, fusing them together.
- When the fused bones heal, the fusion prevents movement at the joint.