SI Joint Pain and Treatment Options

By Mudit Sharma, MD

Virginia Spine Specialists

. http://www.virginiaspinespecialists.com/

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SI Joint Pain and Treatment Options

The sacroiliac joint (also known as the SI joint) is a strong weight bearing joint in the pelvis. There are two in total, one on each side of the pelvis. They connect the base of the spine (sacrum) to the iliac bones on either side of the pelvis. This is not a very mobile joint and its primary purpose is to absorb the stress on the lower back and spine by acting as a shock absorber.

SI joint pain is a challenging condition that affects 15-25% of patients with lower back pain. Common symptoms of pain in the SI joint include low back pain, pelvis/buttock pain, lower extremity pain, hip/groin pain, and problems sitting, sleeping, or walking.

Causes of SI joint pain include pregnancy, trauma resulting from injury or accident, arthritic conditions, and prior lower back surgery. SI joint degeneration may occur in up to 75% of the time in patients undergoing lumbar fusion at five years after surgery.

SI joint pain must be considered as a possibility in patients who continue to suffer from back, hip, groin, or leg pain even after back or hip/knee surgery. It is typically diagnosed with a physical exam and an injection in the joint to look for relief in symptoms.

Treatment of SI joint pain typically starts with conservative measures such as physical therapy, chiropractic manipulation, specific exercise programs, and sacroiliac belts. Additionally, oral medications may be used as well as therapeutic injections that may provide some patients with a temporary relief of pain.

Surgical intervention may be considered after non-surgical interventions have failed to provide a significant amount of patient symptom relief. Sacroiliac joint fusion provides stabilization of the joint and eliminates motion in the joint, typically providing long-term pain relief for patients.

There is exciting new technology for SI fusion. One procedure called, “Si Join” consists of three allograft (bone) implants placed at opposing angles to increase SI joint stability. The procedure is performed through three small incisions in the lower back, resulting in lower surgical trauma, reduced blood loss, shorter surgery times, faster recovery, and lower risk of injury to nerves.
SI joint pain is important to recognize because there are now very effective treatments available for this condition.