Are You Experiencing
SI Joint Pain?

SI joint pain is a complicated condition. Sacroiliac joint dysfunction can be related to lower back pain. How can you tell what is the source of your pain? Understanding the true cause of your joint pain is necessary in finding pain relief.




What is the SI Joint?

SI joint


The sacroiliac (SI) joint is formed by the Sacrum and the Ilium of the pelvis. The joint is a strong irregular joint, surrounded by supporting ligaments. Although considered a joint, compared to other joints of the body, minimal movement occurs between the bony surfaces. The SI joint functions in helping to transfer weight from the trunk and upper body to the lower body via the pelvis.



Causes of SI Joint Symptoms

True SI joint pain most frequently occurs following trauma. A fall with landing on the buttocks can result in a sprain of the SI joint. Auto accidents are another source of potential sacroiliac joint dysfunction. Commonly if the knees are driven in to the dash board of the car, the femur (thigh bone) can move backwards causing trauma to the pelvis. This trauma to the pelvis can potentially disrupt the SI joint.

Another common cause for sacroiliac joint pain is pregnancy. As hormonal changes allow for the ligaments of the pelvis relax in order to accommodate the growing baby, the SI joint can become unstable creating pain.

Because of the association of the SI joint with the lumbar spine, a full low back screening must be performed to rule out a potential low back component. The joint formed by fifth lumbar and first sacral vertebrae is a common source of SI region and buttocks pain. Low back conditions such as facet joint pain and degenerative disc disease to mimic sacroiliac joint pain. It is much more common for pain in the region of the SI joint to actually be caused by the lumbar spine then the SI joint itself. Pain in the SI region alone is not a good predictor of sacroiliac joint dysfunction. Thus it is very important that if you are experiencing pain related to the SI region to seek advice from a spine specialist.



Symptoms of Typical SI Joint Dysfunction

Pain originating from the SI joint will be located in the posterior pelvis and buttocks region. Symptoms are most often only on one side. In cases of instability, such as during pregnancy, symptoms can include a feeling of the SI joint moving or being ‘out of place’. Other common aggravator of sacroiliac joint pain is walking and standing. The SI joint is compressed in weight bearing. Joint pain is often aggravated by this compression.


Diagnosis and Treatment

SI joint pain and dysfunction is complicated to diagnose. Unfortunately there are not clear tests that can be done to directly implicate the SI joint. Pelvic alignment and other SI related tests have not been shown to be good predictors of true SI joint related pain. Often x-ray and MRI testing can reveal a normal SI joint, even if the SI joint is the cause. Rather, diagnosis is often a means of ruling out other potential causes of pain. The gold standard for determining if the SI joint is the cause of pain is to inject a pain relieving medication into the joint to see if doing so eliminates the pain.

If you are experiencing sacroiliac joint pain, there are things you can do. As with any joint condition that causes pain, reducing inflammation is the first step in treatment. Use of ice therapy is the safest means of decreasing inflammation. Apply ice to the painful region 10 to 15 minutes, three times a day.


SI belt

Of course, anti-inflammatory medication can also be helpful (consult your doctor regarding medications). When significant pain is present and oral medications are not helpful, cortisone injections are warranted. Finally, resting from painful activities is also a key in allowing the joint to heal.

For instances when SI instability is the cause of the pain (such as in pregnancy) the use of an SI belt can help to stabilize the joint and minimize the pain.


Physical therapy can also be a great treatment option for sacroiliac joint dysfunction. Specific joint mobilizations and muscle energy techniques can be useful in obtaining proper SI alignment.


Summary

• Sacroiliac joint pain is difficult to diagnose and can be caused by the SI joint itself or the lower back.

• True SI joint pain is usually caused by trauma or related to pregnancy.

• SI treatment can include medication, injections, ice, and the use of an SI belt.


True SI joint pain can be difficult to diagnose and treat. Seek help from qualified medical professionals. Be patient if clear answers are not immediately available. Relief from SI joint pain is possible.




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