Studies have estimated that up to 84 percent of adults have lower back pain at some point in their lives. One common cause of this pain is sacroiliac joint (SI joint) dysfunction. Find out what this condition is, what symptoms you might experience if you have it, and what to do about it.
What is SI Joint Dysfunction?
The SI joint connects the hip bones to the sacrum–the triangular bone between the lumbar spine and the tailbone. The joint serves as a shock-absorber between the upper body and the pelvis and legs. It’s kept stable by a network of surrounding muscles and ligaments. But when the SI joint suffers injury or other trauma, you might experience painful symptoms.
The exact cause of SI Joint Dysfunction isn’t clear. However, it’s generally tied to some type of destabilization of the joint. Traumatic destabilization is the most common cause. This can occur from something like a fall or car accident. Micro-destabilization can also occur, which often happens to women during childbirth. Additional causes include repeated squatting while bearing heavy weight or overstretching.
Symptoms of SI Joint Dysfunction
Common symptoms of SI joint dysfunction are:
- Persistent lower back pain across either the entire lower back or one side of the back
- Radiating leg pain, typically the back of the leg to the knee
- Leg pain that radiates beyond the knee
Leg pain from SI joint dysfunction can be particularly difficult to differentiate from lumbar disc herniation (sciatica) pain. This is especially true if the pain travels beyond the knee–a common sciatica symptom. To ensure that you’re addressing the right problem, it’s important to consult a spine professional that will take the proper steps to diagnose and treat your condition.
The University of Maryland Spine Network offers advanced spine care at their practices across the state. Home to the region’s leading spine surgeons, many of our board-certified experts can provide recommendations on what kind of treatment is right for you.
Diagnostic Methods
The first step in diagnosing SI joint dysfunction is generally physical examination. During this exam, a physician may press on certain muscles, the hip bones, and the SI joint itself. They may also ask you to lift your legs in different ways. Different pain responses or certain muscle movements in these areas gives your physician an idea of what might be causing your lower back pain.
The gold standard for diagnosing the condition is a trial set of two long-lasting local anesthetic injections into the SI joint itself. If you experience a significant amount of pain relief from these injections, even for a short period of time, it indicates that SI joint dysfunction is the cause. Typically, the physician will then run a second trial of injections to confirm the diagnosis.
Generally, MRI, CAT scan, and x-ray won’t help diagnose SI joint dysfunction.
Treatment for SI Joint Dysfunction
SI joint dysfunction pain can generally be managed with over-the-counter pain medications. A supportive brace may be recommended. Physical therapy will help you strengthen the surrounding muscles and the SI joint itself. You can access first-class physical therapy through the University of Maryland Rehabilitation Network, which offers first-class physical rehabilitation services across the state.
If these conservative treatment methods don’t improve your condition, then you may be a candidate for surgery. During surgery, the surgeon makes a small incision and places hollow threaded titanium alloy dowels filled with bone putty around the SI joint to stabilize it. This allows the surrounding muscles that have been attempting to stabilize the joint to relax, decreasing pain.
Patients typically go home the same day of the procedure and most achieve 75-85 percent recovery within about a week.
Can SI Joint Dysfunction Be Prevented?
While some causes of SI joint dysfunction are unavoidable—such as a genetic predisposition—others can be prevented. Avoid trauma to the SI joint area by taking steps to prevent falls and not lifting too much weight.
Be your own health care advocate. When talking to your doctor about your back pain, ensure SI joint dysfunction is being considered. If you come into the doctor’s office with back pain and leg pain, SI joint dysfunction needs to be included as a potential cause.
