Sacroiliac Joint Disorders
Condition: Lower Back Pain and the Sacroiliac Joint
Where is the sacroiliac joint?
The sacroiliac joint connects the last segment of the spine, the sacrum, to the pelvis. The integrity of the sacroiliac joint depends on strong ligaments that encase and cover the joint. These ligaments compress and stabilize the joint.
How does the sacroiliac joint cause lower back pain?
The ligaments that encase the sacroiliac joint may be disrupted due to injury or degenerate due to age, allowing the joint to have excessive motion. This excessive motion may inflame and disrupt the joint and surrounding nerves.
Your physician may also refer to sacroiliac joint pain by other terms like sacroiliitis, SI joint degeneration, SI joint inflammation, SI joint syndrome, SI joint disruption and SI joint strain.
How do the symptoms of sacroiliac joint pain present?
The most common symptom of sacroiliac joint disorders is pain in the lower back, buttock and legs. This can present as sciatica like symptoms (leg pain, burning, numbness, and tingling) that mimic lumbar disc or radicular low back pain, pain that radiates down into the legs.
Causes of sacroiliac joint disorders
Causes of sacroiliac joint disorders can be split into five categories:
- Traumatic (lifting, fall, accident)
- Biomechanical (leg length discrepancy, prior lumbar fusion)
- Hormonal (pregnancy / childbirth)
- Inflammatory joint disease (sacroiliitis)
- Degeneration (age related wear and tear)
Diagnosing sacroiliac joint pain
In order to diagnose the sacroiliac joint as the pain generator, your physician will typically start with a history and a physical examination. During the physical examination, your physician may try to determine if the sacroiliac joint is the cause of pain through movement of the joint. If this joint movement recreates the pain, the SI joint may be the cause of the pain.
Your physician may also use X-rays, CT-scan or MRI to help diagnose the sacroiliac joint. It is also important to remember that more than one condition (like a disc problem) can co-exist with sacroiliac joint disorders.
Finally, your physician may request sacroiliac joint injections as a diagnostic test. Sacroiliac joint injections involve injecting a numbing medication into the sacroiliac joint. If the injection alleviates your symptoms, then your sacroiliac joint may be the likely source of your pain.
Treatment Options for Sacroiliac Joint Disorders
Treatments can vary depending on the severity of your symptoms and how much they limit your everyday activities. Below are some of the treatment options you may want to discuss with your doctor, depending on your symptoms.
Nonsurgical Treatment for Sacroiliac Joint Disorders
As a first line of treatment, your doctor may prescribe any one or more of the following:
- Medications like non-steroidal anti-inflammatory drugs may help relieve pain and reduce inflammation.
- Physical therapy can help provide strengthening and pelvic stabilization exercises to reduce the movement in the SI joint.
- SI belt wraps around the hips to help squeeze the sacroiliac joints together. This supports and stabilizes the pelvis and sacroiliac joints.
- SI joint injections can reduce inflammation and relieve the pain.
Surgical Treatment of Sacroiliac Joint Disorders
If symptoms persist due to instability, your physician may recommend stabilizing your joint with sacroiliac joint fusion.
Sacroiliac Joint Fusion with the iFuse Implant System®
The iFuse Implant System is a minimally invasive option for patients suffering from sacroiliac joint disorders, including SI joint disruptions and degenerative sacroiliitis.
The iFuse procedure takes about an hour and involves three small titanium implants inserted surgically across the sacroiliac joint. The entire procedure is done through a small incision, with no soft tissue stripping and minimal tendon irritation. Patients may leave the hospital the next day after surgery and can usually resume daily living activities within six weeks, depending on how well they are healing and based on physician’s orders.
The iFuse procedure offers several benefits compared to traditional sacroiliac joint surgery:
- Minimal incision size
- Immediate post-operative stabilization
- Minimal soft tissue stripping
- Potential of a quicker recovery
iFuse Implant System Indications and Risk Statement
The iFuse System is intended for sacroiliac joint fusion for conditions including sacroiliac joint disruptions and degenerative sacroiliitis. As with all surgical procedures and permanent implants, there are risks and considerations associated with surgery and use of the iFuse Implant. You should discuss these risks and considerations with your physician before deciding if this treatment option is right for you.
If you are suffering from a sacroiliac joint disorder, Dr. Keenen at Pacific Spine Specialists can help. Request an appointment today.