Sacroiliac Joint Pain

Causes

Causes for sacroiliac joint dysfunction include:
1. Traumatic injury. A sudden impact, such as a motor vehicle accident or a fall, can damage your sacroiliac joints.
2. Arthritis. Wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac joints, as can ankylosing spondylitis (a type of inflammatory arthritis that affects the spine).
3. Pregnancy. The sacroiliac joints must loosen and stretch to accommodate childbirth. The added weight and altered gait during pregnancy can cause additional stress on these joints and can lead to abnormal wear.
4. Infection. In rare cases, the sacroiliac joint can become infected.
5. After spine fusion surgery
6. Walking patterns
Walking abnormally can cause SI joint dysfunction. You may walk abnormally because of issues like having one leg shorter than the other or favoring one leg because of pain. Correcting these problems may resolve your SI joint pain.

Clinical Presentation

Each person experiences symptoms of SI joint disorders somewhat differently. Common symptoms include:
1. pain in the lower back
2. pain in the buttocks, hips, and pelvis
3. pain in the groin
4. pain limited to just one of the SI joints
5. increased pain when standing up from a sitting position
6. stiffness or a burning sensation in the pelvis
7. numbness
8. weakness
9. pain radiating down into the thighs and upper legs
10. feeling like your legs may buckle and not support your body

Sacroiliitis pain can be aggravated by:
1. Prolonged standing
2. Bearing more weight on one leg than the other
3. Stair climbing
4. Running
5. Taking large strides

Investigation

SI joint problems can be difficult to diagnose. The joints are located deep in your body, making it difficult for your doctor to examine or test their motion. Often, damage to the joints doesn’t show up on imaging tests such as X-rays, MRIs, or CT scans. And the symptoms are very similar to conditions like sciatica, bulging discs, and arthritis of the hip. Your doctor may take the following steps in order to diagnose SI joint problems: 1. An examination during which they ask you to move and stretch in specific ways. This can help them pinpoint the source of your pain.
2. Imaging tests, such as X-rays, MRIs, and CT scans.

Treatment

1. Medications like NSAIDS & OPIOIDS
2. Physiotherapy
3. Interventional Pain Procedures:
• Dextroze Ozone Prolotherapy Injections are a non-surgical alternative for SI pain. Prolotherapy is an injection treatment that stimulates the repair of connective tissues such as tendons and ligaments. It causes a mild inflammatory response which initiates an immune response.
• Platelet-Rich Plasma Prolotherapy for Low Back Pain Caused by Sacroiliac Joint Laxity. A relatively new treatment modality, PRP prolotherapy demonstrates effectiveness in case studies of patients with sacroiliac joint ligament laxity and painful dysfunction.
• Intraarticular steroid Injection under fluoroscopic and ultrasound guidance is given to relieve pain in inflammatory sacroiliac joint pain like in ankylosing spondylitis.
• A radiofrequency ablation (RFA) of the sacroiliac joint (SI joint) is a procedure that uses radio waves to heat and destroys nerves. These nerves carry pain signals from the injured sacroiliac joint to the brain.
• Sacroiliac Cooled RF System uses revolutionary cooling technology for sacroiliac joint denervation. The Cooled RF System enables the placement of large volume, spherical lesions that are optimized in size and position to compensate for the variable nerve course, compared to a flat lesion created with conventional RF.