What is sacroiliac joint pain, and what are the causes?
The sacroiliac (SI) joints connect the lower part of the spine to your hip. The SI joints distribute your weight across the pelvis. This absorbs shock and reduces the pressure on your spine.
Sacroiliac joint pain, or sacroiliitis, is an inflammation of one or both of the SI joints. Lower back pain caused by sacroiliac joints occurs in 40% of patients although sacroiliitis can be difficult to diagnose because the symptoms are similar to other causes of lower back pain.
A common cause of sacroiliitis is sacroiliac joint dysfunction, a condition resulting from abnormal motion in the sacroiliac joint.
Typical causes of sacroiliac joint pain:
- Years of stress on the SI joint can lead to osteoarthritis and affect the SI joint, spine, and other joints throughout the body.
- Ankylosing spondylitis affects the vertebrae and joints of the spine and in severe cases can cause new bone growth that fuses the joints in the spine.
- Gout, or gouty arthritis, can cause pain in all joints if your body has high levels of uric acid.
- A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints.
- Relaxin, a hormone released during pregnancy, makes the SI joints more elastic and less stable.
What are the symptoms, and how do they progress?
Sacroiliac joint pain may occur in your buttocks or lower back and can extend down one or both legs. Prolonged standing or stair climbing can also make it worse. You may also experience
- increased pain when standing up from a sitting position
- stiffness or a burning sensation in the pelvis
- numbness or weakness
- feeling like your legs may buckle and not support your body
During a physical exam, your doctor might try to pinpoint the cause of your pain by pressing places on your hips and buttocks and moving your legs into different positions to gently stress your sacroiliac joints. Imaging tests such as X-rays and magnetic resonance imaging (MRI) can also provide detail. Because lower back pain can have many causes, your doctor may also suggest targeted numbing injections to help with diagnosis.
What are some home remedy solutions?
Alternating hot and cold packs can help reduce inflammation in your sacroiliac joints as can modifying or avoiding the activities that worsen your pain. Proper posture is also important. Many over-the-counter medications are available to help with pain management, but you should always consult a doctor about any potential side effects.
Treating Sacroiliac joint pain at NWA Interventional Pain
Our pain clinic can prescribe muscle relaxers and pain medicines to help with inflammation and stiffness. We can also help you explore physical therapy options to learn range-of-motion and stretching exercises to maintain joint flexibility as well as strengthening exercises to make your muscles more stable.
For patients with chronic pain, we can provide sacroiliac joint injections. Using x-ray guidance, we inject a small amount of cortisone and numbing medicine into the SI joint. The steroid injection can relieve pain for several months at a time, and we can repeat it if the pain returns.
What sort of problems can occur after pain treatment?
Injections do not work for everyone, so you should maintain an open dialogue with the pain control clinic about the progress of your treatment. If your symptoms become more severe, you develop a fever of over 101, or you notice redness or drainage at the injection site, you should call your pain doctor or go to the nearest ER.