Understanding Sacroiliac Joint Dysfunction

Symptoms and diagnosis for Sacroiliac Joint Dysfunction
Neuro

By Neurosurgery Singapore

Sacroiliac joint dysfunction info 2

What is Sacroiliac joint dysfunction?

Sacroiliac joint dysfunction, also known as sacroiliitis, is a painful lower spine condition. It’s a common cause of lower back pain. Inflammation of a sacroiliac joint causes the condition.

There are two sacroiliac joints — one on each side of the spine. The joints connect the bone at the bottom of your vertebrae with the top part of the pelvis. Sacroiliitis can affect one or both joints.

Pain from the condition can occur in the lower back and the buttocks. Sometimes sacroiliitis can send pain down one or both legs.

What are some symptoms of Sacroiliac joint dysfunction?

Sacroiliac (SI) joint dysfunction or inflammation can mimic pain similar to degenerative hip disease, hip bursitislumbar disc herniation, or pinched nerves. Symptoms experienced with sacroiliac joint dysfunction commonly include:

  • Lower back pain that feels dull, aching, and can range from mild to severe. Lower back pain is typically felt only on one side, but in some cases may be felt on both sides.
  • Pain that spreads to the hips, buttocks, and/or groin. One of the most common areas to feel SI joint pain is in the buttocks and upper back or side of the thigh. Pain is typically felt only on one side, but may be felt on both sides.
  • Sciatic-like pain in the buttocks and/or backs of the thighs that feels hot, sharp, and stabbing and may include numbness and tingling. Sacroiliac joint dysfunction may cause sciatica-like symptoms that rarely extend below the knee.
  • Stiffness and reduced range-of-motion in the lower back, hips, pelvis, and groin, which may cause difficulty with movements such as walking up stairs or bending at the waist.
  • Worsened pain when putting added pressure on the sacroiliac joint, such as climbing stairs, running or jogging, and lying or putting weight on one side.
  • Instability in the pelvis and/or lower back, which may cause the pelvis to feel like it will buckle or give way when standing, walking, or moving from standing to sitting.

“Sacroiliitis could be a dull or sharp pain. It starts at your SI joint, but it can move to your buttocks, thighs, groin, or upper back.”

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What types of diagnosis?

Our Spine Specialist will likely begin by requesting a complete medical history and conducting a thorough physical examination to determine where you’re feeling the pain.  

SI joint problems and low back problems can have similar symptoms, like a herniated disc, you may need several tests to rule those out. These include:

  • Physical exam tests that put pressure on the SI joints to see if they cause pain.
  • X-rays of your pelvis to look for arthritis in the SI joints.
  • X-rays of your lumbar spine (low back) to rule out arthritis in your back.
  • An MRI of your pelvis to check for inflammation of the SI joint or sacral insufficiency fractures that aren’t easily seen on X-rays.

If you have severe pain at the back of the hip and buttocks along with a fever, it could mean you have an infection in the SI joint. 

Possible treatment methods?

The treatment of for sacroiliac joint dysfunction (SI joint pain) typically focus on alleviating pain and restoring normal motion in the joint. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment. Most cases of SI joint pain are effectively managed using non-surgical treatments.

Treatments for sacroiliac joint pain typically include:

  • Brief rest period. A rest period of 1 to 2 days may be advised. Resting for longer than a couple days is not recommended, as doing so may worsen stiffness and cause increased pain and generalized deconditioning.
  • Applying ice or heat. Ice applied to the low back and pelvis can reduce inflammation and alleviate pain and discomfort. Heat applied around the joint may help relieve pain by reducing muscle tension or spasms.
  • Pain medication. Over-the-counter pain relievers and anti-inflammatory medications may be recommended for mild to moderate pain relief. Prescription medications such as muscle relaxants or narcotic painkillers may be used during episodes of severe, acute pain. These medications must be used with caution, as they are highly addictive and can cause severe side effects.
  • Supports or braces. When the SI joint is too loose (hypermobile), a pelvic brace can be wrapped around the waist and pulled snugly to stabilize the area. A pelvic brace is about the size of a wide belt and can be helpful when the joint is inflamed and painful.
  • Sacroiliac joint injections. A local anesthetic (such as lidocaine or bupivacaine) is injected with an anti-inflammatory medication (such as a corticosteroid) to reduce inflammation and help alleviate pain. The pain relief from a joint injection can help minimize pain when starting a physical therapy program and returning to normal activity levels.
 

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