Back Pain

Sacroiliac joint dysfunction refers to pain that is experienced in the sacroiliac joint.  The joint sits next to the spine, connecting the sacrum (the triangular bone at the bottom of the spine) to the iliac bones of the pelvis.  The joint connects the spine to the pelvis and supports a great deal of weight.  Dysfunction in the joint is suspected in causing pain in the lower back and legs.



What is Sacroiliac Joint Dysfunction?

Sacroiliac joint dysfunction refers to pain that is experienced in the sacroiliac joint.  The joint sits next to the spine, connecting the sacrum (the triangular bone at the bottom of the spine) to the iliac bones of the pelvis.  The joint connects the spine to the pelvis and supports a great deal of weight.  Dysfunction in the joint is suspected in causing pain in the lower back and legs.   


What causes Sacroiliac Joint Dysfunction?

There are various causes of sacroiliac joint dysfunction.   Any condition that causes the cartilage in the joint to wear away can cause a problem in the joint and resulting pain.  For example, osteoarthritis, which causes cartilage in the joint to wear away so that the bones begin to rub together is one cause of sacroiliac joint problems.  Conditions that alter normal gait (such as pain in the knee, hip, ankle or foot, or even pregnancy) can place stress on the sacroiliac joint causing wear of the cartilage and pain.  Other conditions that affect joints (such as rheumatoid arthritis and gout, among others) can also affect the sacroiliac joint.  In most cases, pain is caused by too much or too little mobility in the joint.


What are the symptoms of Sacroiliac Joint Dysfunction?

Sacroiliac joint dysfunction typically causes pain in the lower back, thighs, groin, and the back of the hips.  The pain is usually worse with movement (such as walking) or while standing and appears to improve upon lying down.  If there is arthritis in the joint, stiffness and burning may also be felt in the pelvis.  The pain of sacroiliac joint dysfunction, however, is often similar to symptoms of other back problems (such as sciatica and disc herniation) and may be hard to diagnose.


How is Sacroiliac Joint Dysfunction diagnosed?

A medical professional will perform a physical examination and will take a full medical history.  Questions will be asked related to the pain, such as when it started, what improves the pain or makes it worse, what activities the individual engages in, and other questions that may help with diagnosis.   Manual movements will be performed to see if the source of pain can be pinpointed.  Diagnosing sacroiliac joint dysfunction is difficult because there are no non-invasive tests that can determine when dysfunction is specific to the sacroiliac joint.  The symptoms are similar to other conditions, such as radiculopathy and disc herniation.  An x-ray, CT scan, MRI or bone scan may be used to get a clearer picture of the joint and surrounding bones.  Another test, called an arthrogram or sacroiliac joint injection may be used to determine if there is dysfunction in the joint.  A needle is injected into the joint using guided x-ray and an anesthetic and steroid are injected into the joint.  If the patient experiences pain relief, then it can be assumed that the pain was caused by the sacroiliac joint.


When should I seek care for Sacroiliac Joint Dysfunction?

If you experience pain in the lower back, pelvis or legs that does not resolve itself with a few days of rest or a limitation of activity, it is best to seek medical advice.  It is often difficult to diagnose dysfunction in the sacroiliac joint, but with proper treatment additional deterioration of the cartilage in the joint may be avoided.


What will the treatment for Sacroiliac Joint Dysfunction consist of?

Treatment for sacroiliac joint dysfunction may include physical therapy, targeted exercises, water therapy and sacroiliac joint injections (which are sometimes used to diagnose the condition but also provide pain relief and reduce inflammation).  Anti-inflammatory medications may help ease pain.  Physical therapy is focused on stretching and stabilizing exercises since the cause of pain is usually related to too much or too little movement in the joint.  A sacroiliac belt can be worn around the hips to help stabilize the joint.  As a last resort, surgery may be performed to fuse the bones of the sacroiliac joint together.


Which muscle groups/joints are commonly affected by Sacroiliac Joint Dysfunction?

The sacroiliac joint is located at the bottom of the spine where the spine meets the pelvis. Pain from the condition may be felt in the lower back, groin, thighs or the back of the hips.


What type of results should I expect from the treatment of Sacroiliac Joint Dysfunction?

Most non-surgical treatments will be fairly successful in eliminating or diminishing pain, although some may have to be repeated occasionally (such as sacroiliac joint injections).  When surgery is indicated, the cartilage of the sacroiliac joint is removed and the bones of the joint are fused together.  Surgery is often successful in this situation.

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