The sacroiliac joint (SI joint) is located in the pelvis; it links the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone). It is an essential component for energy transfer between the legs and the torso.
Do you have SI joint pain?
The SI joint can be a significant cause of lower back pain. Clinical publications have identified the SI joint as a pain generator in 15-30 percent of chronic lower back pain patients.In addition, the SI joint is a pain generator in up to 43% of patients with continued or new onset lower back pain after a lumbar fusion.
Like any other joint in the body, the SI joint can be injured and/or undergo degeneration. When this happens, people can feel pain in their buttock and sometimes in the lower back, hips and legs. This is especially true while lifting, running, walking or even lying on the involved side.
It’s common for pain from the SI joint to feel like disc or lower back pain, or sometimes hip or groin pain. For this reason, SI joint disorders should always be considered in lower back, hip, and pelvic pain diagnosis.
Symptoms can include:
- Lower back pain
- Sensation of low extremity: pain, numbness, tingling, weakness
- Pelvis/buttock pain
- Hip/groin pain
- Feeling of leg instability (buckling, giving way)
- Disturbed sleep patterns due to pain
- Disturbed sitting patterns (unable to sit for long periods, sitting on one side)
- Pain going from sitting to standing
Making a diagnosis
A variety of tests performed during physical examination may help reveal the SI joint as the cause of your symptoms. Sometimes, X-rays, CT-scan or MRI may be helpful in the diagnosis of SI joint-related problems because they can rule out other common sources of pain—such as your lumbar spine or hip joints. It is also important to remember that other conditions (like a disc problem) can co-exist with SI joint disorders.
The most relied upon method to accurately determine whether the SI joint is the cause of your lower back pain symptoms is to inject the SI joint with a local anesthetic. This diagnostic injection will be performed under either X-ray or CT guidance to verify accurate placement of the needle in the SI joint. If your symptoms decrease by at least 50 percent, it can be concluded that the SI joint is either the source of or a major contributor to your lower back, hip, or pelvic pain. If the level of pain does not change after SI joint injection, it is less likely that the SI joint is the cause of your pain.
Once the SI joint is confirmed as the cause of your symptoms, treatment can begin. Some patients respond well to physical therapy, use of oral medications, or injection therapy. These treatments are often performed repetitively, and frequently symptom improvement using these therapies is temporary. If non-surgical treatment options have been tried and do not provide long-term relief, your surgeon may consider other options, including a minimally invasive fusion implant system.
Dr. Kuhns is trained in the latest minimally invasive surgical (MIS) techniques, including use of an iFuse Implant System® . The system is intended for sacroiliac joint fusion for some causes of SI joint pain. SI joint treatment using the patented triangular design of the implant has been clinically evaluated more than any other SI joint fusion procedure. More than 100, peer-reviewed publications demonstrate the safety, durable effectiveness, and biomechanical and economic benefits. The implant is the only SI joint fusion device with clinical studies, including two randomized controlled trials, demonstrating that treatment improved pain, patient function, and quality of life. As with any minimally invasive surgical procedures, there are potential risks associated with the Implant System It may not be appropriate for all patients and all patients may not benefit.
Austin Spine welcomes patients from the greater Austin area, south and central Texas and beyond! We are here to help properly diagnose and treat the source of your pain. We look forward to caring for you.