SI Joint Pain

SI joint pain refers to pain originating from the sacroiliac joint, which is located where the sacrum (the triangular bone at the base of the spine) meets the ilium (the large pelvic bone).

This condition can be caused by various factors, and its diagnosis and treatment require careful evaluation by a healthcare professional. Here’s an overview of the causes, diagnosis, and treatment of SI joint pain:

Causes

1. Inflammation: Inflammation of the SI joint can lead to pain. Inflammatory conditions such as ankylosing spondylitis, psoriatic arthritis, and other forms of arthritis can affect the SI joint.

2. Trauma: Injuries or trauma to the SI joint area, such as falls, accidents, or sports-related impacts, can lead to pain and dysfunction.

3. Pregnancy: The hormonal changes and increased mobility during pregnancy can lead to SI joint pain due to changes in the ligaments and increased pressure on the joint.

4. Degenerative changes: Wear and tear over time can cause degenerative changes in the SI joint, leading to pain. This is more common in older adults.

5. Ligament laxity: Some individuals have naturally looser ligaments, making the SI joint more prone to instability and pain.

6. Leg length discrepancy: When one leg is shorter than the other, it can cause biomechanical imbalances that affect the SI joint.

Diagnosis

Diagnosing SI joint pain can be challenging because the symptoms may overlap with other conditions, such as lower back pain. A healthcare professional will typically use a combination of methods for accurate diagnosis:

1. Medical history: The doctor will ask about your symptoms, medical history, and any recent injuries or activities that might have triggered the pain.

2. Physical examination: The doctor will examine your spine, pelvis, and hips for tenderness, range of motion, and signs of misalignment.

3. Provocative tests: Specific maneuvers can help reproduce the pain and pinpoint the SI joint as the source. One example is the FABER test (Flexion, ABduction, and External Rotation), where the patient lies on their back and the affected leg is bent at the hip and knee, then moved outward and across the opposite leg.

4. Imaging: X-rays, MRI, or CT scans may be ordered to visualize the SI joint and surrounding structures, looking for signs of inflammation, degeneration, or structural abnormalities.

Treatment

The treatment of SI joint pain depends on the underlying cause and severity of the condition. Common treatment options include:

1. Rest and activity modification: Avoiding activities that aggravate the pain and giving the joint time to heal.

2. Physical therapy: A physical therapist can design exercises to improve joint stability, strengthen supporting muscles, and restore proper movement patterns.

3. Medications: Over-the-counter pain relievers (e.g., NSAIDs), muscle relaxants, or corticosteroid injections can help manage pain and inflammation.

4. Joint injections: Local anesthetic and corticosteroid injections into the SI joint can provide temporary relief and reduce inflammation.

5. Radiofrequency ablation: This procedure involves using heat to disrupt the nerve signals transmitting pain from the SI joint.

6. Surgery: In cases of severe pain that doesn’t respond to conservative treatments, surgical options such as SI joint fusion may be considered.

It’s important to consult a healthcare professional for proper evaluation and treatment if you suspect you have SI joint pain. Customized treatment plans can help alleviate pain, improve mobility, and enhance the quality of life.