SI Joint Pain
What is Sacroiliac Joint Pain?
The sacroiliac (SI) joint is located where the sacrum (tail end of the spine) meets the left and right iliac bones of the legs, and serves to connect the spine to the pelvis. The bones are held together by muscle, tendons, and ligaments to form the SI joint, which is housed in a protective layer of cartilage. Gradual use of this joint, which occurs with nearly every movement of the body, can wear down the cartilage and produce symptoms of pain.
What are the causes of Sacroiliac Joint Pain?
The sacrum and iliac bones form the support structure of the torso, serving to hold the entire weight of the body by the two SI joints. Due to this, there is a large amount of physical stress place upon the bones of the SI joint, which normally have a very limited range of motion (less then 2mm of movement).
This stress can cause irritation of the joint by degradation of cartilage, producing inflammation which can be very painful to the patient. Cartilage degradation through use is called arthritis, and is the most common cause of pain in the SI joints and other weight-bearing joints of the body.
A common, gender-specific, cause of SI joint pain is pregnancy. While pregnant, the body releases an excess of hormones into the blood to force ligaments to relax in preparation for child delivery. Relaxation of the ligaments inside a SI joint will increase the available range of motion for that joint, allowing for greater movement and an accelerated rate of wear and tear on the joint. Increased weight and body size may also produce an awkward gait, which can cause excess stress on the joints.
There are a number of inflammatory conditions which can also directly impact the SI joints, which include rheumatoid arthritis, gout, psoriasis, and ankylosing spondylitis (which directly affects the SI joints leading to stiffness and severe pain).
What are the symptoms of Sacroiliac Joint Pain?
The symptom experienced most commonly by patients is pain in the back or the hips or in the lumbar region of the spine. Pain may also manifest in the groin. For many patients, the exact area causing symptomatic pain can be difficult to determine and may produce more severe symptoms during periods of standing or movement.
Published studies have actually shown that anywhere from 12-25% of low back pain actually comes from a problem in the SI joint. So it should always be evaluated as a potential source of pain.
How is Sacroiliac Joint Pain diagnosed?
The first step in diagnosing sacroiliac joint pain is to rule out any other conditions that may be producing similar symptoms for the patient. This is achieved through a complete examination of the symptoms present and of the events leading up to the presence of symptoms.
Patients may have their hips and legs placed in specific diagnostic positions, where if pain is felt it can be determined that the SI joints are the likely cause instead of a separate secondary condition. The next step in diagnosis is the usage of imaging techniques to examine the SI joints for damage, including spots of arthritic inflammation and area of the joint which have become malformed and may be directly causing pain.
The most reliable method of diagnosis is to administer a SI joint injection to the patient, where the assumed area of pain will be numbed. If symptoms of pain cease, it is likely that the root cause of pain was the numbed area.
What are the treatment options for Sacroiliac Joint Pain?
For patients who have a confirmation of a pain source in the SI joint, the aforementioned injection can provide a large amount of relief. Other methods of treatment include anti-inflammatory medications and physical therapy to instruct the patient on exercises to help reduce pain.
Another type of injection that can help tremendously is a lateral branch block. This stops the transmission of pain signals to the joint and can provide months of pain relief. If this injection’s pain relief wears off, a radiofrequency ablation may help tremendously. Studies have shown this may provide over 6 months of continuous pain relief.
The top pain clinics in Denver are Colorado Pain. The providers include Board Certified pain management doctors in Denver along with chiropractors, acupuncture providers, physical rehab and spinal decompression therapy.
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