Sacroiliac Joint Dysfunction
The sacroiliac joint is one of the large joints in the body and is formed by the connection of the sacrum and the right and left iliac (pelvic) bones. The sacroiliac joints have small amount of movement and transmits all the forces of the upper body to the lower body. The sacrum is the triangular-shaped bone at the bottom of the spine, below the lumbar spine. The sacroiliac joint acts as a shock-absorbing structure. Sacroiliac joint dysfunction or Sacroiliac joint pain is one of the common causes of the low back pain.
Causes of sacroiliac joint dysfunction include:
- Traumatic injuries caused when there is a sudden impact
- Biomechanical problems such as twisted pelvis, leg length discrepancies or muscle imbalances
- Hormonal changes during pregnancy
- Inflammatory joint conditions such as arthritis and ankylosing spondylitis
The most common symptom of sacroiliac joint dysfunction is pain. Patient often experiences pain in the lower back, thigh, groin or buttocks that radiates down the leg. The pain is typically worse with standing and walking and is relieved on resting. Other symptoms include limping, fever, psoriasis, eye inflammation, and limited range of motion.
Proper diagnosis is essential because the symptoms mimic other common conditions, including sciatica, herniated disks or other low back pain problems. Sacroiliac joint pain is diagnosed by taking medical history and performing physical examination. Other imaging studies such as MRI, CT scan, bone scan, and X-rays may be needed to know the extent of joint damage.
Treatment options include adequate rest, use of pain medications, wearing a sacroiliac belt to stabilize the joint, and physical therapy.
Diagnostic Sacroiliac joint Injection: An SIJ injection can serve to diagnose the source of pain, as well as treat the pain. Injecting the SIJ with a local anaesthetic, can help a clinician determine whether the source of the pain originates in the joint or from outside the joint. This is given as a single injection under fluoroscopic guidance. A steroid may be added before the needle is removed in order to reduce inflammation, which may he causing the pain. Although it may take several days to reduce the inflammation, the pain-relieving effects of injecting cortisone can last for weeks or even months.
Sacroiliac Joint RF Denervation: This is done in recurrent cases of sacroiliac joint dysfunction
Surgery may be considered in patients not responding to conservative line of management.
For severe cases of pain one or a combination of the above treatments may be effective.