What is sacroiliac pain?
Sacroiliac pain (aka sacroiliac joint pain) refers to the pain originating in the sacroiliac joints, which connect the sacrum (the lower part of the spine) to the pelvis. Sacroiliac (SI) pain can be felt in the lower back, buttocks, groin, legs, lower extremities, as well as the abdomenal region.
SI pain is characterized by discomfort or pain in the lower back or buttocks that is caused by irritation or inflammation of the sacroiliac joint. The pain may be dull and aching, or it may be sharp and shooting. It may be worse with certain activities, such as standing, walking, or climbing stairs, and it may be relieved by sitting or lying down.
Both SI pain and sacroiliac joint dysfunction can be treated with physical therapy, medications, and/or injections to reduce inflammation and manage pain. In some cases, surgery may be necessary to correct the misalignment of the joint and ease SI joint pain. It is important to see a healthcare provider for an accurate diagnosis and appropriate treatment plan.
What is sacroiliac joint dysfunction?
Sacroiliac joint dysfunction and sacroiliac joint pain are often used interchangeably, but they actually do not mean the same thing. As stated earlier, sacroiliac pain refers to the pain that starts from the sacroiliac joints, whereas sacroiliac joint dysfunction refers to abnormal motion of the sacroiliac joints. Although sacroiliac pain can be a main symptom of SI joint dysfunction, sacroiliac joint dysfunction does not always result in sacroiliac pain, and not all sacroiliac pain is caused by sacroiliac joint dysfunction.
Sacroiliac joint dysfunction refers to a misalignment or dysfunction of the sacroiliac joint. The sacroiliac joint is located in the pelvis and connects the sacrum (the triangular bone at the base of the spine) to the ilium (one of the two large bones in the pelvis). It is a strong, weight-bearing joint that plays a critical role in providing stability to the spine and pelvis. This can cause pain and discomfort, as well as difficulty with mobility and balance. The joint may feel stiff and may be painful to move. Dysfunction of the sacroiliac joint can also cause referred pain, which is pain that is felt in other areas of the body, such as the legs or feet.
There are several potential causes of SI joint dysfunction, including injury or trauma, pregnancy, osteoarthritis, and poor posture. It is important to see a healthcare provider for an accurate diagnosis and appropriate treatment plan for SI joint dysfunction. Treatment may include physical therapy, medications, and/or injections to reduce inflammation and manage pain. In some cases, surgery may be necessary to correct the misalignment of the joint.
What causes sacroiliac pain?
Surrounded by strong ligaments, sacroiliac joints provide stability to the pelvis, and act as shock absorbers to the spine. The joints have only limited mobility. Too much movement (hypermobility) or too little movement (hypomobility) of the sacroiliac joints can cause sacroiliac pain.
Sacroiliac joint dysfunction is a major risk factor for sacroiliac pain. Other risk factors for sacroiliac pain include traumatic injury, pregnancy, spinal fusion, hip arthritis, and scoliosis.
There are several potential causes of sacroiliac (SI) pain, which is pain or discomfort in the lower back or buttocks that is caused by irritation or inflammation of the sacroiliac joint. Some common causes of SI pain include:
- Trauma or injury: A fall, car accident, or other trauma can cause damage to the sacroiliac joint and result in SI pain.
- Pregnancy: The hormone relaxin, which is released during pregnancy, can cause the ligaments in the pelvis to loosen, leading to instability in the sacroiliac joint and resulting in SI pain.
- Osteoarthritis: This is a type of degenerative joint disease that can affect the sacroiliac joint and cause pain.
- Spondylolisthesis: This is a condition in which one vertebra slips forward over another vertebra, causing strain on the sacroiliac joint and resulting in SI pain.
- Poor posture: Slouching or standing in a poor posture can put excess strain on the sacroiliac joint and cause pain.
- Overuse: Engaging in activities that place repetitive stress on the sacroiliac joint, such as running or lifting heavy objects, can lead to SI pain.
It is important to see a healthcare provider for an accurate diagnosis and appropriate treatment plan for SI pain. Treatment may include physical therapy, medications, and/or injections to reduce inflammation and manage pain. In some cases, surgery may be necessary to correct the underlying cause of the pain.
Treatments for sacroiliac pain
SI joint pain relief might include:
- Cold, heat and rest: Ice or cold packs can be used to reduce inflammation, while rest reduces irritation. When inflammation and acute pain have subsided, a return to normal activities may be possible and a heat wrap or hot bath may further help the sacroiliac joint pain relief and healing.
- Physical therapy and exercise: Physical therapy can strengthen the muscles around the sacroiliac joint, which increases the range of motion, and low-impact aerobic exercise can help increase the flow of blood to the area, which stimulates healing.
- Pain medications: Acetaminophen and anti-inflammatory drugs (such as ibuprofen or naproxen) can reduce the swelling that contributes to sacrum pain.
- Support or brace: A pelvic belt can be used to stabilize a joint that is too loose until the inflammation and pain subside.
- Joint injections: Numbing injections into the sacroiliac joint are used diagnostically to help identify the cause of the pain but are also useful in providing immediate pain relief. Typically, an anesthetic is injected along with an anti-inflammatory medication.
Spinal fusion and sacroiliac pain
Spinal fusion is a surgical procedure that involves fusing together two or more vertebrae in the spine. The goal of spinal fusion is to stabilize the spine and reduce pain, which may be caused by various conditions such as degenerative disc disease, scoliosis, or a spinal injury.
In some cases, spinal fusion may be recommended for the treatment of SI pain.
During spinal fusion surgery, the surgeon removes the damaged or diseased tissue between the vertebrae and replaces it with bone grafts or bone graft substitutes. The grafts may come from the patient's own bone (an autograft), from a bone bank (an allograft), or from a synthetic material. The vertebrae are then held in place with screws, rods, or plates until they fuse together.
In some cases, spinal fusion such as lumbosacral fusion, a surgical procedure that fuses the lower part of the lumbar spine and the sacrum together, can lead to sacroiliac joint dysfunction and result in sacroiliac pain. However, spinal fusion and sacroiliac pain do not go hand in hand. Although sacroiliac joints can be a potential source of lower back pain after lumbar or lumbosacral fusion, studies have shown that not all patients suffer from sacroiliac pain after spinal fusion procedures.