SI Joint Syndrome
The sacroiliac joint is one of the large joints in the body and is formed by the connection of the sacrum and the right and left iliac (pelvic) bones. The sacroiliac joint has small amount of movement and transmits all the forces of the upper body to the lower body. The sacrum is the triangular-shaped bone at the bottom of the spine, below the lumbar spine. The sacroiliac joint acts as a shock-absorbing structure. Sacroiliac joint syndrome or sacroiliac joint pain is one of the common causes of lower back pain.
Causes of sacroiliac joint dysfunction include:
- Traumatic injuries caused when there is a sudden impact to the body
- Biomechanical problems such as twisted pelvis, leg length discrepancies or muscle imbalances
- Hormonal changes during pregnancy
- Inflammatory joint conditions such as arthritis and ankylosing spondylitis
The most common symptom of sacroiliac joint dysfunction is pain. The patient often experiences pain in the lower back, thigh, groin or buttocks that radiates down the leg. The pain is typically worse with standing and walking and is relieved on resting. Other symptoms include limping, fever, psoriasis, eye inflammation and limited range of motion.
Proper diagnosis is essential because the symptoms mimic other common conditions, including sciatica, herniated discs or other lower back pain problems. Sacroiliac joint pain is diagnosed by reviewing the patient's medical history and by performing a physical examination. Other imaging studies such as MRI, CT scan, bone scan and X-rays may be needed to know the extent of joint damage.
Treatment options include adequate rest, use of pain medications, wearing a sacroiliac belt to stabilize the joint and physical therapy. Corticosteroid injections may be given to reduce the pain and inflammation.
Surgery may be considered in patients not responding to conservative line of management.
For severe cases of pain, one or a combination of the above treatments, may be effective.