What is the prognosis for si joint pain?

Sacroiliac joint pain, like most mechanical lower back pain, has a good prognosis. Patients should avoid bed rest and continue to mobilize. Stabilizing and stretching exercises are beneficial. Pregnancy-induced sacroiliac joint dysfunction is usually self-limiting and resolves within 12 months after delivery.

Sacroiliac joint (SI) pain is felt in the lower back and buttocks. The pain is caused by damage or injury to the joint between the spine and the hip. Sacroiliac pain may look like other conditions, such as a herniated disc or a hip problem. Accurate diagnosis is important in determining the source of pain.

Physical therapy, stretching exercises, pain relievers, and joint injections are first used to control symptoms. Surgery may be recommended to fuse the joint and stop painful movement. Sacroiliac joint pain ranges from mild to debilitating, depending on what caused it. Severe pain can come on without warning, but the good news is that the affected joint often heals on its own in about a week.

It can also last longer than three months, in which case it is considered chronic. The pain may be present all the time or may worsen with certain poses or activities. The sacroiliac joints are located on either side of the spine, between the two pelvic bones, which are attached to the sacrum. Sacroiliac joint syndrome is a difficult condition to diagnose and is often overlooked by doctors and physical therapists.

Specifically, each sacroiliac joint connects an ilium bone to the sacrum, which consists of five vertebrae that fuse at the base of the spine. Sacroiliac joint pain is a difficult diagnosis to diagnose and is best treated by an interprofessional team that includes a physical therapist, a pain specialist, a specialized nurse, a primary care provider, and an orthopedic surgeon. It is often included under the general term “dysfunction”, but this syndrome must be differentiated from other sacroiliac joint disorders. Positive responses to at least three physical provocation tests suggest sacroiliac joint dysfunction, and local anesthetic blockages of the sacroiliac joint may also be useful in confirming that the sacroiliac joint is the source of pain.

To differentiate sacroiliac joint dysfunction from other diagnoses that occur with low back pain, it is necessary to perform a complete medical history and physical examination of the spine, pelvic girdle and hips, as well as a review of other systems to rule out warning signs, such as a history of trauma, unexplained weight loss, fever, changes in the bowels and bladder, cancer and nighttime pain. Usually, sacroiliac joints have a very small range of motion, which provides stability when, for example, a person is walking. Radiofrequency ablation is only considered if temporary pain relief is achieved after injection into the sacroiliac joint. The prevalence of sacroiliac joint dysfunction (SI) is approximately 25% in adult patients with chronic low back pain.

Sacroiliitis is specific to an inflammatory process present in the sacroiliac joint and the pain detected is the direct result of these inflammatory processes, while sacroiliac joint dysfunction is a condition caused by abnormal movement or a slight malposition of the sacroiliac joint.

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