Sacroiliac Joint Dysfunction Treatment, Symptoms, Tests & Pain Relief

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An illustration of the sacroiliac (SI) joints.Source: MedicineNet

SI Joint Dysfunction Symptom


Joint Pain

Symptoms and signs associated with joint pain can include

  • joint redness,
  • joint swelling,
  • joint tenderness,
  • joint warmth,
  • limping,
  • locking of the joint,
  • loss of range of motion of the joint,
  • stiffness, and
  • weakness.

A doctor explains causes of sacroiliac (SI) joint pain to a patient.

A doctor explains causes of sacroiliac (SI) joint pain to a patient.Source: iStock

What are the causes of sacroiliac joint dysfunction?

As with most other joints in the body, the SI joints have a cartilage layer covering the bone. The cartilage allows for some movement and acts as a shock absorber between the bones. When this cartilage is damaged or worn away, the bones begin to rub on each other, and degenerative arthritis (osteoarthritis) occurs. This is the most common cause of SI joint dysfunction. Degenerative arthritis occurs commonly in the SI joints, just like other weight-bearing joints of the body.

Another common cause of SI joint dysfunction is pregnancy. During pregnancy, hormones are released in the woman’s body that allow ligaments to relax. This prepares the body for childbirth. Relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear. The additional weight and walking pattern (altered gait) associated with pregnancy also places additional stress on the SI joints.

Any condition that alters the normal walking pattern places increased stress on the SI joints and is a risk factor for SI joint dysfunction. This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle, or foot. Patients with severe pain in the lower extremity often develop problems with either the lower back (lumbar spine) or SI joints. Usually, if the underlying problem is treated, the associated lumbar spine or SI joint dysfunction will also improve.

There are many disorders that affect the joints of the body that can also cause inflammation in the SI joints. These include gout, rheumatoid arthritis, psoriatic arthritis, reactive arthritis, and ankylosing spondylitis. These are all various forms of arthritis that can affect all joints. Ankylosing spondylitis is an inflammatory arthritis that always affects the SI joints. It can lead to stiffness and severe pain in the SI joints, due to inflammation in the sacroiliac joints (sacroiliitis). As the disease process continues, the SI joints can fuse together and have no range of motion. Once this occurs, there is no further pain associated with the SI joints. Rarely, bacterial infection can involve the sacroiliac joints.

A doctor discusses sacroiliac (SI) joint pain with a patient.

A doctor discusses sacroiliac (SI) joint pain with a patient.Source: iStock



SLIDESHOW


Lower Back Pain: Symptoms, Stretches, Exercise for Pain Relief
See Slideshow

A technician prepares a patient for a CT scan.

A technician prepares a patient for a CT scan.Source: Getty Images

A patient receives a cortisone shot for her sacroiliac (SI) joint pain.

A patient receives a cortisone shot for her sacroiliac (SI) joint pain.Source: iStock



QUESTION


Nearly everyone has low back pain at some time during their life.
See Answer

A physical therapist works with a patient on stretching exercises to help with sacroiliac (SI) joint pain.

A physical therapist works with a patient on stretching exercises to help with sacroiliac (SI) joint pain.Source: iStock

What is the treatment for sacroiliac joint dysfunction?

As stated above, injections into the SI joint can provide both diagnosis and treatment. The duration of pain relief from injection can last from one day to much more long term. The injections can be repeated each month up to three each year. Oral anti-inflammatory medications (NSAIDs, ibuprofen [Motrin], naproxen [Naprosyn]) are often effective in pain relief as well. These can be taken long term if the patient does not have any other medical problems that prevent them from taking these medications. Oral steroids (prednisone) are used as well for short periods of time occasionally to treat the inflammation.

Physical therapy can be very helpful. Pain in the SI joint is often related to either too much motion or not enough motion in the joint. A physical therapist can teach various stretching or stabilizing exercises that can help reduce the pain. A sacroiliac belt is a device that wraps around the hips to help stabilize the SI joints, which can also help the SI joint pain. Other options to stabilize the SI joints include yoga, manual therapy, and Pilates.

If other treatments fail and pain continues to interfere with normal activities, surgery might be an option. Surgery for SI dysfunction typically involves a fusion of the SI joints. In this surgery, the cartilage covering the surfaces of the SI joints is removed and the bones are held together with plates and screws until they grow together (fuse). This eliminates all motion at the SI joints and typically relieves the pain. This should be considered only if other less invasive treatments have not been successful.

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A doctor explains spinal X-ray results to a patient.

A doctor explains spinal X-ray results to a patient.Source: iStock

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Medically Reviewed on 4/2/2021

References

Szadek, K.M., P. van der Wurff, M.W. van Tulder, W.W. Zuurmond, and R.S. Perez. “Diagnostic Validity of Criteria for Sacroiliac Joint Pain: A Systematic Review.” J Pain. 10.4 Apr. 2009: 354-68.

Tuite, M.J. “Sacroiliac Joint Imaging.” Semin Musculoskelet Radiol. 12.1 Mar. 2008: 72-82.





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