Sacroiliac (SI) joint pain, or SI pain, is characterized by discomfort or pain in the sacroiliac joints. The sacroiliac joints are located in the lower back, connecting the sacrum (the triangular bone at the base of the spine) to the ilium bones of the pelvis.
Sacroiliac joint pain is often associated with pain in the sacroiliac joints. These are located in the lower lumbar region and connect the base of the spine (the sacrum) to the ilium bones of the pelvis. They transfer forces between the upper and lower body when walking or running.
When there is swelling or instability in the sacroiliac joints, it can lead to SI pain. Early recognition of symptoms can help with accurate diagnosis.
Some characteristic symptoms of Sacroiliac joint pain include the following:
- Lower back pain
- Hip pain
- Groin pain
- Pain while sitting or standing for extended periods
- Pain during certain movements
Causes for sacroiliac joint pain can include:
- Inflammation: Inflammatory conditions in the spine could affect the sacroiliac joints leading to SI pain.
- Injury or trauma: Physical trauma in the sacroiliac joint leads to the development of SI joint pain.
- Pregnancy and childbirth: As the body changes during pregnancy, the hormonal changes loosen the sacroiliac joints, causing SI joint pain.
- Infection: When the SI joint becomes infected by conditions such as septic arthritis, it could cause pain.
To identify the root cause of your back pain, your doctor will perform the following steps:
- Examine your medical history
- X-rays, MRIs, and CT Scans
- Measurement of the electrical activity of muscles and nerve cells (electromyography)
If your healthcare provider determines your case is related to sacroiliac joint pain, they will help you determine the best treatment plan.
Some of the treatments to treat sacroiliac joint pain (SI) includes:
Conservative therapies are non-invasive procedures, often using the patient’s body to reestablish its structure. This can include massage therapy, acupuncture, or chiropractic care.
These treatments could help release tension trapped within the sacroiliac joints, decreasing pain and restoring mobility.
Some tips that could help your sacroiliac joints release pressure include performing low-impact
exercises like swimming or cycling, having a healthy diet to manage your weight, and maintaining good posture by using ergonomic chairs.
Non-opioid medications offered by your healthcare specialist can help reduce spinal swelling and nerve pressure. Some of the most effective non-opioid medications to treat sacroiliac joint pain include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These work by inhibiting the production of certain chemicals in the body that cause swelling.
- Muscle relaxants: They target the nervous system and block the transmission of pain signals.
Injections offer longer-lasting relief for patients dealing with SI pain, focusing on the nerves that send pain signals into the brain. Unlike other minimally invasive interventions, injections offer long-term relief for patients with almost no recovery time.
The injections are administered using digital imaging to precisely place the needle into the nerves causing discomfort. Some injection options that help alleviate the discomfort caused by SI pain include the following:
- Corticosteroids have anti-inflammatory properties and are administered through a small incision. They are usually prescribed for short-term use.
- Nerve block Injections block the transmission of pain signals from the nerves to the brain.
Spinal cord stimulation is a type of neuromodulation treatment that uses electrical impulses to modify the nerve activity in the spine. As the nerve signals become blocked by this stimulation, the pain won’t be felt even though the symptom source remains.
On the other hand, peripheral nerve stimulation uses electrical stimulation to target peripheral nerves around the spinal cord.
Minimally invasive interventions aim to restore the functionality of the spine, reducing complication risks and recovery time. The best minimally invasive interventions for SI pain include the following:
- SI joint fusion uses screws or rods to stabilize the joint and promote bone healing. It aims to reduce pain and improve the functionality in sacroiliac joints that may have become damaged.
- Radiofrequency ablation uses the heat from radio waves to reduce nerve irritation. A needle is placed using imaging guidance near the nerves during the procedure. Once this is done, radiofrequency generates heat that interrupts the transmission of pain signals.