Sacroiliac Joint Dysfunction
Sacroiliac (SI)joint dysfunction is a common cause of low back pain and refers to abnormal movement in the sacroiliac joint located between the sacrum and the pelvis. This can cause pain in the lower back, buttocks and hips and legs. It is often challenging to diagnose and can result from either too much or too little motion in the joint.
The prevalence of sacroiliac (SI) joint dysfunction is approximately 25% in adult patients with chronic low back pain. Pain can be unilateral or bilateral but usually not midline. Women are more likely to present with SI joint dysfunction than men. The SI joint in women is more mobile compared with the SI joint in men, resulting in larger stress load, and pelvic ligament strain. SI joint dysfunction is common in pregnant and postpartum patients.
Causes
Sacroiliac Joint Dysfunction can be caused by various factors including
- Arthritis - conditions like osteoarthritis can lead to dysfunction
- Pregnancy - hormonal changes and weight gain can stress the joints
- Injury - such as sudden impact or falls
- Mechanical issues - mechanical faults or imbalances in the pelvis
- Inflammatory Diseases - like Crohn’s Disease or ulcerative Colitis
Common Symptoms
- Pain in the lower back, often on one side
- Discomfort in the buttocks or hips
- Pain that worsens with prolonged sitting or standing
- Stiffness, especially in the morning
- Pain radiating down the legs
Aggravating Factors
- Prolonged sitting or standing
- Climbing stairs
- Running
Diagnosis
Diagnosis involves a physical examination and may include imaging tests to help confirm the sacroiliac joint dysfunction. These tests may include X-rays or CT scans. A complete history and physical examination are critical in differentiating other diagnoses that may have similar signs and symptoms.
Treatment Options
Conservative treatment consists of a multimodal program combining patient education, pelvic girdle stabilization with focused stretching, and manipulative therapy. These programs can be performed by physical therapists. Pelvic belts may be beneficial in affected postpartum patients. Patients with symptoms that do not improve with conservative management may benefit from interventional treatment options including intra-articular corticosteroid injections, cooled radiofrequency ablation, or SI joint fusion.
- Physical Therapy: Strengthening exercises and stretching can alleviate pain.
- Medications: Over-the-counter pain relievers may help manage discomfort.
- Injections: Corticosteroid injections can reduce inflammation and pain.
Understanding sacroiliac joint dysfunction is crucial for effective management and treatment.