Sacroiliac Joint Pain

Sacroiliac joint pain is characterized by discomfort around the lower back, which may radiate to the hip and thigh. The sacroiliac (SI) joint is located between the sacrum and the ilium bones, connecting the pelvis to the lower spine. When these joints at the spinal base fail to function properly, it can lead to pain in the lower back and leg. This pain can mimic symptoms of sciatica and may be challenging to diagnose. Nevertheless, treatment options, including pain management and physical therapy, are available to manage the condition.

Symptoms

Sacroiliac joint pain symptoms may consist of the following:

• Pain in the lower back and buttock that extends to the groin and leg
• Pain when standing for long periods, climbing stairs, or rolling over in bed
• Lower back discomfort, especially below the dimples in the lower back

Causes

Most sacroiliac joint pain cases result from factors such as:

• Joint stiffness and poor posture.
• Asymmetrical activities like crossing legs or altered leg mechanics, which may lead to a significant leg length discrepancy. Usually, a slight difference is common and typically normal.
• Muscular imbalances.

Additional contributing factors include:

• Systemic inflammatory diseases
• Trauma
• Pregnancy
• Infection

Diagnosis

We often diagnose sacroiliac joint pain using a combination of these methods:

• Medical history review: Your clinician will inquire about your symptoms, medical history, and possible causes.
• Physical examination: This involves using particular techniques to elicit symptoms. Examples are Gaenslen’s test or the FABER (Flexion, ABduction, and External Rotation) test.
• Imaging tests: These include MRIs to view soft tissues and identify inflammation, CT scans to obtain detailed bone images, and X-rays to look for structural alterations.
• Diagnostic injections: To find out whether the SI joint is the cause of the discomfort, local anesthetics are used. The diagnosis is confirmed by the relief experienced after an injection.

Treatment

SI joint pain symptoms can be effectively relieved with physiotherapy (pelvic stabilization exercises), pain medication, and ice packs. Another treatment option is braces that stabilize the SI joint.

Your clinician might recommend an injectable therapy to ease discomfort and minimize swelling. These could include spinal joint injection therapy, soft tissue injections, nerve block injections, or epidural injections. Without requiring open surgery, injection treatment can considerably help address the symptoms of your back pain because it is far less invasive than surgery.