Possible causes of sacroiliac pain include arthritis, traumatic injuries, pregnancy and postpartum, systemic inflammatory conditions, and infections. Other possible contributors are spinal scoliosis, leg length discrepancy, and previous lumbar spine fusion. Sometimes, there's no clear cause for sacroiliac pain. Sacroiliitis can be difficult to diagnose.
It can be confused with other causes of low back pain. It has been linked to a group of diseases that cause inflammatory arthritis of the spine. Treatment may include physical therapy and medications. Arthritis can cause the problem.
A type that affects the spine, called ankylosing spondylitis, can damage the sacroiliac joint. It will also hurt when the cartilage above the sacroiliac joint slowly wears out as you age. Abnormal walking can cause sacroiliac joint dysfunction. You may walk abnormally due to problems such as a leg length discrepancy, a knee, hip, or ankle fusion, or favoring one leg because of pain.
Correcting these problems can resolve sacroiliac joint pain. Sacroiliac joint (SI) disorders are a difficult condition affecting up to 30 percent of patients with chronic low back pain. According to published scientific data, it's common for sacroiliac joint pain to feel like disc pain or lower back pain. For this reason, sacroiliac joint disorders should always be considered in the diagnosis of low back pain.
The sacral joint is located in the pelvis; it connects the iliac bones (pelvis) to the sacrum (the lowest part of the spine above the coccyx). It is an essential component for shock absorption and prevents impact forces from reaching the spine. Joints have limited mobility, but, like any other joint, can be susceptible to arthritic changes over time, especially in patients who have undergone previous lumbar fusions. The sacroiliac joint is a major cause of lower back pain and can affect populations of all age groups.
It can be due to direct trauma, a fall, a car accident, or a birth. Clinical publications have identified the sacroiliac joint as a pain generator in 15-30 percent of patients with chronic low back pain. In addition, the sacroiliac joint causes pain in up to 43 percent of patients with continuous or new-onset low back pain after lumbar arthrodesis. Like any other joint in the body, the sacroiliac joint can degenerate or its supporting ligaments can be injured.
When this happens, people may feel pain in the buttocks, lower back, groin, and even legs. This is especially true when you lift objects, run, walk, or lie down in the affected area. It's important to note that sometimes patients who haven't had any symptomatic relief after lumbar spine surgery may have had other problems at first. Pain in the lower back and buttocks can come from the sacroiliac joint, the hip, the spine, or any combination of these three possible interrelated pain generators.
Pain caused by sacroiliac joint dysfunction can be felt anywhere in the lower back, buttocks, or legs.
Chronic sacroiliac joint pain or dysfunction
can make it difficult to perform common daily tasks and can affect many aspects of a patient's life. Many people have pain that worsens over time; however, more than half of the time, sacroiliac joint pain may be related to a specific event, often an injury. It is difficult to relate a single specific functional difficulty (such as walking, sitting, standing, sleeping on the affected side) to work activity, bowel movements, coughing, sneezing, etc.Ball will consider all the information you provide, including a history of injuries, the location of the pain, and problems with standing or sleeping. As part of your physical exam, he or she will ask you to stand up or move in different directions and will indicate where you are feeling pain, and you may feel tenderness in your sacroiliac joint. A variety of tests performed during the physical exam can help reveal that the sacroiliac joint is the cause of the symptoms. Sometimes, x-rays, computed tomography, or magnetic resonance imaging can be useful in diagnosing problems related to the sacroilician joint.
It's also important to remember that more than one condition (such as a disc problem) can co-exist with sacroiliac joint disorders. The most reliable and accurate method for determining if the sacroiliac joint is the cause of low back pain symptoms is to inject a local anesthetic into the sacroiliac joint. The injection is given with a fluoroscopy guide or CT scan to verify the precise placement of the needle in the sacroiliac joint. If your symptoms decrease by at least 50 percent, it's likely that the sacroiliac joint is the source or a major contributor to low back pain.
If your symptoms don't improve after the sacroiliac joint injection, a sacroiliac joint problem is less likely to be caused by a sacroiliac joint problem. Once it is confirmed that the sacroiliac joint is the cause of the symptoms, treatment can begin. Some patients respond to physical therapy, the use of oral medications, or injection therapy. The anti-inflammatory effect of sacroiliac joint injections is not permanent and does not stabilize the sacroiliac joint.
Intermittent use of the pelvic belt can also ease symptoms. Treatments, such as injections or the use of a belt, are performed repetitively and the improvement of symptoms with these therapies may be temporary. When conservative methods fail, minimally invasive arthroplasty can be performed on an outpatient basis or with a 2- to 3-hour stay in the hospital or surgical center. The only fusion option approved by Medicare because of its excellent clinical results and its longevity of use is the iFuse implant system manufactured by SI-BONE, Inc.
This is a minimally invasive surgical treatment option for the sacroiliac joint that provides sacroiliac joint stabilization and fusion for some causes of sacroiliac joint pain. This is achieved by inserting triangular-shaped titanium implants into the sacroiliac joint to maximize post-surgical stability and weight-bearing capacity. The procedure is performed through a small incision on the buttock and lasts approximately one hour. Sacroiliac joint treatment, which uses the patented triangular design of the iFuse ImplantTM, has produced unparalleled clinical results.
More than thirty published and peer-reviewed articles demonstrate the safety and effectiveness of the iFuse implant system. iFuse is the only sacroiliac joint fusion system with clinical studies showing that the treatment improved pain, patient function and quality of life. Women may be at greater risk of suffering from sacroiliac joint problems due to their wider pelvis and the greater curvature of the lumbar spine, which causes different biomechanics of the sacroiliac joint. Women also have more elastin in the collagen that forms their ligaments.
Elastin is a molecule that allows greater flexibility of ligaments. In addition, pregnancy often results in the stretching of the sacroiliac ligaments. Some women have permanent changes in the ligaments of the sacroiliac joint as a result of pregnancy and vaginal delivery. If you have trouble sleeping comfortably, or you frequently experience sagging legs, pain when lying down or bending down, or tenderness in your buttocks, you may have a sacroiliac joint disorder.
It's not always easy to diagnose sacroiliac joint disorders, but provocative tests and injections are helpful in confirming that the sacroiliac joint is the source of pain. Sometimes, physical findings indicate a sacroiliac joint condition, but chronic changes can also be seen in the lumbar spine. The iFuse implant system (“iFuse”) is designed for sacroiliac joint fusion for conditions such as sacroiliac joint dysfunction, which is the direct result of sacroiliac joint disorders and degenerative sacroiliitis. This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted after delivery for more than 6 months.
You will be told when to stop eating and drinking before surgery. If you take a medicine every day, ask if you still need to take it the morning of surgery. It is essential to inform Dr. Ball if you are taking any blood-thinning medications.
At the hospital, your temperature, pulse, breathing, and blood pressure will be measured. An IV may be started to provide the fluids and medications needed during surgery. Sacroiliac joint fusion is performed in an operating room under general or spinal anesthesia. You will lie face down while the surgeon uses a specially designed system to guide the instruments that prepare the bone and insert the implants.
Both the surgical technique and the iFuse implant system are designed to offer maximum protection to surrounding tissues. The entire procedure is done through a small incision, approximately 2 to 3 inches long, along the side of the buttock. During the procedure, fluoroscopy provides the surgeon with live images to allow the correct placement of the implants. Typically, three implants are used, depending on their size.
The procedure takes about 1 hour. You may feel comfortable enough to go home the same day of surgery or perhaps the next morning. Ball will make this decision based on your post-surgical status. The iFuse ImplantsTM have a unique triangular-shaped design to maintain the position of the implant over time.
Implants allow bone growth and internal growth and promote sacroiliac joint fusion over time. iFuse implants are small titanium rods the size of your little finger. Titanium is a very strong but lightweight material commonly used for medical device implants. At the time of discharge, Dr.
Ball will provide you with post-surgical care instructions based on your health condition. He will also arrange follow-up visits to assess your progress, the condition of the incision, and your state of health. You may experience some buttock swelling after surgery, which can be relieved with ice in the region after surgery. After surgery, you will partially bear the weight for 3 to 4 weeks with the use of crutches or a walker.
Ball will evaluate your progress and decide when you can return to supporting all your weight and resume your daily activities. The strictly necessary cookie must be enabled at all times so that we can save your cookie configuration preferences. If you get up from your chair and feel pain in your lower back, it could be that your sacroiliac joint is malfunctioning. The body releases hormones that cause joints to relax and move more, causing changes in the way joints move.
Stretching the muscles surrounding the sacroiliac joint can help reduce pain by relieving tension in the lower back. Still, just as staying agile and active can help prevent other joint pain, you may be able to slow the progression of sacroiliac joint pain by exercising and choosing a healthy lifestyle. While gout almost always affects the big toe first, all joints, including the sacroiliac joint, can be affected. .
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