Lower back pain is a common complaint among people, especially the older ones. There can be quite many health problems that can induce lower back pain along with other discomforts. Joint injuries and age-related wear and tear are two of the key problems that cause joint pains in people. If it is a sharp pain that spreads to the back, buttocks, hips, and thighs, and interrupts sitting and standing, you might be having a sacroiliac joint pain or SI pain, as it is known commonly. Though there can be other conditions causing some of the same symptoms, in this article, we are discussing sacroiliac joint pain, its causes, symptoms, and treatments.
Persistent Back Pain Troubles You? Your SI Joint Might Be To Blame!
The sacroiliac joint or the SI joint in the lower back connects the spine to the hips. It is termed sacroiliac joint, as it attached the sacrum and iliac bones. The two bones are located at the left and right sides of your spine. They are positioned in a way to support your upper body movements like lifting or other activities. You might have a sacroiliac joint pain out of an injury or damage to the joint that meets sacroiliac bones. Depending on various factors, you might experience mild to severe lower back pain as a result. This pain when left untreated can slowly affect your hips, buttocks, and groin.
What can Cause Dysfunction in the Sacroiliac Joint?
Aging is a vital factor that can instigate wear and tear of joints and muscles. Most kinds of joint pain are a result of wear and tear which can even lead to reduced mobility. When aging effects hit the sacroiliac joints, it leads to damage in the protective layer of the cartilage, making the sacroiliac bones rub each other. This can even cause degenerative arthritis in some people.
To your surprise, pregnancy can also be a major cause of developing sacroiliac joint dysfunction. During pregnancy, when the muscles and joints prepare for childbirth, changes, and movements that cause extra stress on the sacroiliac joints induce joint pain. Changes like loosening or lightening of the ligaments due to an injury, surgery, aging, or a fall can also cause pain and inflammation in the sacroiliac joint. Other conditions like arthritis, spondylitis, and overuse of the joint also can result in SI joint pain.
What are the Symptoms of SI Joint Pain?
The sacroiliac joint is the base of your spine that supports your upper body in movements. Any kind of damage in the SI joint can lead to pain in the lower body. The primary symptom that you may experience is a pain in the lower back and buttocks. Gradually, it might come down to the hip, groin, and thigh. You may also feel numbness or tingle in the leg. The symptoms might get worse with body movements like standing, sitting, lying down, standing, walking, and climbing stairs. Your symptoms may vary according to the underlying cause of the pain, and it varies in people. However, one may experience lower back pain, pain in the hips, buttocks, groin, and pelvis along with other discomforts, muscle weakness, pain while standing, pain that spreads to the legs and thighs, and burning and rigidity in the pelvis. In most cases, pain starts on one side and gradually spreads to other parts of the body.
How SI Joint Pain affects your Mobility and Function?
As the debilitating pain interferes with your mobility and freedom to move, it can hit your mental health hard. There are reports of depression and mood swings as a secondary side effect of SI joint pain. To avoid depression, what you can do is to engage yourself in activities that you like other than prolonged sitting, lying, or standing. Avoid doing activities that can intensify the symptoms in you. You may also avoid contact sports and other sports activities that might also worsen the symptoms.
To improve your functional independence, you can try various following tips:
- While sitting, keep your back straight, support your feet and elbows right, keep the knee joints and hip close to 90 degrees.
- Avoid heavy lifting. If you have to, lift by bending the knees and keeping the back straight.
- Enhance muscle and joint strength with the help of regular exercise as suggested by your doctor.
If the condition is tormenting, visit your doctor immediately, and share your mental health issues as well.
How is the Diagnosis Done?
As with any other condition, the doctor will first check for the symptoms. While examining the symptoms, the doctor may also test your mobility, reflexes, and pain levels by applying pressure to the joints. For detailed images of the joints and surrounding bones, you may need to undergo imaging tests like MRI scans, CT, or an X-ray. If the doctor finds it difficult to confirm a diagnosis with the help of imaging tests, the doctor may administer a corticosteroid injection to numb the sacroiliac area. If you experience pain even after the injection, the source of pain might not be the SI joints.
What are the Non-surgical Treatment Options?
Whether non-surgical or surgical, the main focus of treatments is to alleviate the symptoms and to improve mobility. Medications like analgesics are the first-line non-surgical options recommended to reduce the joint pain. If you experience inflammation along with pain, you may be even recommended to take non-steroidal anti-inflammatory drugs and steroid injections for quick relief from inflammation. Sometimes, the doctor may even suggest applying ice packs to the inflamed area. Heat packs can also be used if the doctor suggests.
Other than medications, you can also improve your mobility and joint strength with the help of physiotherapy. Yoga and other low-impact exercises can also help reduce symptoms. You can also use a sacroiliac belt to aid the mobility of the hip and pelvic area. These belts are designed to promote healing while allowing you to do your daily activities. Though it is a rare choice, radiofrequency denervation is used to treat sacroiliac joint pain, by destroying the nerve tissue that causes pain using radiofrequency energy. The procedure called an electrical stimulation is about planting a stimulator inside the sacrum to relieve the pain. Although these procedures are used to treat SI joint pain, your doctor decides the best option according to the symptoms and severity.
What are the Surgical Treatment Options?
Surgery is the last resort when all other treatment options fail to fetch results. If medications, physical therapy, and injections fail to knock the pain out, a sacroiliac joint fusion surgery may be suggested. Here are the common surgical treatment options for SI joint pain:
SI joint fusion surgery is done to join the sacrum and ilium bones together. There are minimally invasive and open surgery options for the joint fusion procedure.
Minimally invasive surgery: Minimally invasive joint fusion is the preferred option, for it is convenient and less time-consuming. During this procedure, you might need fewer cuts and sutures through which the implants are placed. Through the holes made in the sacrum and ilium, the doctor will place implants to fix the joint. It may take around an hour to complete a minimally invasive joint fusion surgery. However, you may not need to stay in the hospital for so long. For the first four to six weeks, you might need to rely on crutches to walk. You will be able to return to your chores within 6 months.
Open surgery: As you know a typical open surgery would require long and deep cuts to perform the surgery. The open joint fusion procedure might require a cut of 7 to 8 inches. Through these cuts, your surgeon will open the tissues and muscles to get the SI joint exposed. Bone from the pelvis is used for a bone graft, which is put into the joint after removing the cartilage tissue. To hold the joint in place until it heals, a few screws will be placed. The duration of the procedure can last to three hours or above, according to the severity of the condition. Compared to the minimally invasive procedure, open surgery may need you to stay in the hospital for a few days.
Your doctor suggests the surgical option for you after analyzing your condition and the cause. What studies suggest is that there are chances you have less pain after a few years of a minimally invasive procedure than the other. The implants placed in open surgery are said to induce pain in the future.
People usually tend to avoid lower back pain as it is very familiar, especially among women. However, if you have persistent lower back pain along with other discomforts, it might be a problem in the SI joint. Consult an Orthopaedician if you have been suffering from the symptoms since long back.
