The sacroiliac (SI) joint plays a crucial role in providing stability and transmitting forces between the spine and the pelvis. It is where the lower portion of the spine (sacrum) joints the posterior portion of the pelvis (ilium). Sacroiliac joint dysfunction is characterized by pain and dysfunction in this joint, often caused by various factors ranging from trauma to degenerative changes. Understanding the causes, symptoms, and treatment options for sacroiliac joint dysfunction is essential for effective management and improved quality of life for affected individuals.
Sacroiliac joint dysfunction can arise from several underlying causes. First, traumatic injuries such as falls, motor vehicle accidents, or direct impact to the pelvic region can disrupt the normal alignment and function of the sacroiliac joint, leading to dysfunction and pain 1. Second, as with other joints in the body, the sacroiliac joint can undergo degenerative changes over time, such as arthritis or osteoarthritis. These changes can result in inflammation, stiffness, and pain in the joint. Third, during pregnancy, hormonal changes, increased joint laxity, and the biomechanical effects of carrying additional weight can contribute to sacroiliac joint dysfunction, leading to pain and discomfort in the lower back and pelvis 1. Finally, inflammatory conditions can affect the sacroiliac joint, causing inflammation, stiffness, and pain, while a change in one’s gait or joint motion, or a dysfunction in the muscles surrounding the sacroiliac joint such as weakness or tightness in the hip or pelvic muscles, can alter joint mechanics and contribute to dysfunction and pain 1.
The symptoms of sacroiliac joint dysfunction can vary widely among individuals. However, these tend to include pain in the lower back, buttocks, and hips. The pain may be dull, achy, or sharp. In addition, pain may radiate from the sacroiliac joint into the groin, thigh, or lower extremities, mimicking symptoms of other conditions such as sciatica. Furthermore, individuals with sacroiliac joint dysfunction may experience stiffness and difficulty with certain movements, as well as leg or pelvic pain and instability 2,3.
Effective management of sacroiliac joint dysfunction often involves a combination of conservative treatments and interventions tailored to individual needs. Specific physical therapy exercises and stretches aimed at improving joint mobility, strengthening surrounding muscles, and correcting muscle imbalances can help alleviate pain and improve function 4. Over-the-counter or prescription medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or corticosteroid injections may be used to reduce inflammation and alleviate pain 5. Manual therapy techniques such as chiropractic manipulation, osteopathic manipulation, or massage therapy may help realign the sacroiliac joint and alleviate pain 5. Furthermore, sacroiliac joint belts or braces can provide external support to the joint, reduce pain, and improve stability, particularly during activities that aggravate symptoms 6,7. In cases where conservative treatments fail to provide relief, minimally invasive procedures such as sacroiliac joint injections or radiofrequency ablation may be considered to provide targeted pain relief by disrupting nerve signals responsible for transmitting pain from the joint 8. Finally, in rare cases of severe and refractory sacroiliac joint dysfunction, surgical interventions such as sacroiliac joint fusion may be recommended to stabilize the joint and alleviate pain 9.
Sacroiliac joint dysfunction can significantly impact quality of life, causing pain, stiffness, and limitations in mobility. However, with prompt diagnosis and appropriate treatment, many individuals can experience significant improvement in symptoms and function. A multidisciplinary approach involving healthcare providers such as physical therapists, pain management specialists, and orthopedic surgeons can help tailor treatment plans to address individual needs and optimize outcomes for all patients.
References
1. Sacroiliac (SI) Joint Pain Diagnosis and Treatment Options | UPMC. Available at: https://www.upmc.com/services/rehab/physical-medicine-rehab/conditions/sacroiliac-joint-pain. (Accessed: 12th February 2024)
2. Sacroiliac Joint Pain – StatPearls – NCBI Bookshelf. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470299/. (Accessed: 12th February 2024)
3. Sacroiliac Joint Dysfunction | Cedars-Sinai. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/sacroiliac-joint-dysfunction.html. (Accessed: 12th February 2024)
4. Exercise for Sacroiliac Joint Pain Relief | Spine-health. Available at: https://www.spine-health.com/wellness/exercise/exercise-sacroiliac-joint-pain-relief. (Accessed: 12th February 2024)
5. Sacroiliac Joint Dysfunction (SI Joint Pain) | Spine-health. Available at: https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/sacroiliac-joint-dysfunction-si-joint-pain. (Accessed: 12th February 2024)
6. Trochanteric Belts: Supportive Braces for Sacroiliac Joint Pain. Available at: https://www.healthcentral.com/condition/sacroiliac-joint-pain/trochanteric-belts-type-spinal-brace. (Accessed: 12th February 2024)
7. Best Braces for SI Joint Problems – The Bracing Experts. Available at: https://www.thebracingexperts.com/help-pages/si-joint-problems-sacro-iliac. (Accessed: 12th February 2024)
8. Aranke, M. et al. Minimally Invasive and Conservative Interventions for the Treatment of Sacroiliac Joint Pain: A Review of Recent Literature. Orthop. Rev. (Pavia). 14, 2022 (2022). doi: 10.52965/001c.34098
9. Surgical Treatment for Sacroiliac Joint Pain | Spine-health. Available at: https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/surgical-treatment-sacroiliac-joint-pain. (Accessed: 12th February 2024)