Overview of Sacroiliac Joint Pain Treatment

Sacroiliac (SI) Joint Pain

There are two sacroiliac (SI) joints in the human body. These joints are located at the very low back region, at the left and right side where the pelvic bone meets the sacrum (lower portion of the spine). SI joint pain can occur with movement, and it is often related to degenerative arthritis.

How does movement occur in the sacroiliac joints?sacroiliac joint

The SI joints contain cartilage much like the knee or hip joints. These joints tend to be irregular and jagged in shape. These joints contain articular cartilage and only move around 3 mm in any one direction. These joints can experience pain even with minor movement when arthritis is present.

What causes SI joint pain?

The cartilage of the sacroiliac joints is prone to arthritis, just like other body joints. A person develops pain either due to trauma (auto accident or fall), or from degenerative arthritis. Other causes of SI joint pain include infection, trauma, or a fracture.

How common is sacroiliac joint pain?

The prevalence of sacroiliac joint pain is around 13% of the general population. However, some studies report low back pain having a prevalence rate of around 22-30%.

What symptoms are associated with sacroiliac joint pain?

The most common symptoms of SI joint pain are:

  • Very low back discomfort – The pain is often described as a dull ache on one side of the low back, but both sides may be affected. SI joint pain often radiates into the thigh.
  • Buttock pain – The pain is often felt one or both buttocks, described as stabbing, sharp, aching, and shooting down one or both legs.
  • Pain with stair climbing – Because this activity requires twisting of the pelvis, stair climbing often produces pain.
  • Pain with sitting or lying on one side – The pain may occur after lying on your side, or with sitting for long periods.

How does the pain management doctor in Chicago diagnose SI joint pain?

The doctor will first inquire about your symptoms, take a detailed medical history, and conduct a physical examination. The exam involves provocative maneuvers of the SI joints, as well as tests of muscle strength and joint flexibility. Diagnostic tests include x-rays to assess for joint and bony deformities, as well as magnetic resonance imaging (MRI) scans to assess for spine and soft tissue problems.

How is sacroiliac joint pain treated?

Treatment is aimed at improving function and relieving pain. Options include:

  • Medications – Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for inflammation Sacroiliac Joint Injectionsand pain, including ibuprofen and ketoprofen. Short-term narcotics will help with severe pain.
  • Physical therapy – Pain relief modalities used include electrical stimulation, ultrasound, massage, and heat therapy. The therapist also uses strengthening and stretching exercises
  • Corticosteroid injections – The Chicago pain management doctor can inject the SI joints with a long-acting corticosteroid agent, which decreases inflammation. This procedure often requires use of x-ray guidance for correct needle placement. In a recent medical report, SI injections offered an 89% efficacy rate.
  • Lateral branch block – This injection involves placing an anesthetic, with or without a corticosteroid, around the area near the nerves of the SI joint. Radiofrequency ablation is often used to destroy a portion of the nerve root for long-term pain relief. A small probe is inserted so the heat can be projected onto the nerves. A large clinical study found that most participants enjoyed a 50% reduction in pain after radiofrequency ablation.

Premier Pain & Spine offers top treatment for sacroiliac and back pain at several pain clinics in Chicago, Wilmette, Glenview, Schaumburg, Downers Grove and surrounding areas. Most insurance is accepted by the Board Certified Chicago pain management doctors. Call us today!

Resources

Bernard TN Jr, Kirkaldy-Willis WH (1997). Recognizing specific characteristics of nonspecific low back pain. Clin Orthop Relat Res, 217:266-80.

Nagda JV, Davis CW, Bajwa ZH, & Simopoulos TT (2011). Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain. Pain Physician, 14(4), 371-376.

Sahin O, Harman A, Akgun, RC, & Tuncay IC (2014). An intraarticular sacroiliac steroid injection under the guidance of computed tomography for relieving sacroiliac joint pain: A clinical outcome study with two years of follow-up. Archives of Rheumatology, 27(3). DOI: 10.5606/tjr.2012.028

Schwarzer AC, Aprill CN, Bogduk N (1995). The sacroiliac joint in chronic low back pain. Spine, 20(1):31-7.

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