At some point in their lives, the majority of adults living in the US will experience low back pain. In 2002 a National Health Interview survey found that almost one third of those surveyed had complained of low back pain within the previous 3 months. Back pain is a big concern and people want answers. What is causing it? How long is it going to last? How can they treat it?
Challenges In Diagnosing Low Back Pain
Back pain is extremely difficult to diagnose because there are so many different causes and conditions that can influence it. MRIs and other diagnostic tools are often useless because, in many cases, there is nothing specific to “see”. Pinpointing conditions with an x-ray, CT or MRI is often not possible, especially when it comes to conditions like degenerative disc disease or muscle spasms. There is also a lack of specificity with the current diagnostic techniques. Even if radiographic abnormalities are detected they are not always connected to, or responsible for, the low back pain that someone is experiencing.
There are other tests like EMG (electromyographic studies) and PET (positron emission tomography) scans that healthcare providers use from time to time to try and discover specific causes of pain. Occasionally these tests are helpful in determining if there is a surgically treatable condition present. More often than not, however, the standard tests for spinal surgery workups fail to detect a definite cause of the pain. Because of this, many patients don’t actually need surgery but still need treatment for low back pain. This need has led surgeons to consider other types of causes for low back pain and SI Joint dysfunction is one cause that is gaining in popularity.
What Is SI Joint Dysfunction?
The sacroiliac joints (SI joints) connect your pelvis to your lower spine. These joints are composed of the bony structures that are located above your tailbone and below your lower vertebrae, as well as the top part of your pelvis, called the ilium. SI joints are found on both sides of your lower back. Dysfunction in this area can sometimes cause pain in your leg or your lower back.
What Causes SI Joint Dysfunction?
SI joint pain happens when the ligaments become either too loose, or too tight. When the movement in the pelvis isn’t equal on both sides it can start to cause pain. This can happen for a variety of reasons some of which include:
Spine surgery (lumbar fusion or laminectomy)
Risk Factors For SI Joint Dysfunction:
Some common risk factors for developing SI joint dysfunction include:
Sustained intense athletic workouts
Differences in leg length
Diagnosing SI Joint Dysfunction
Just like general low back pain, SI joint dysfunction can be difficult to diagnose since it looks like a lot of other back conditions. Healthcare providers must be sure to take a detailed history and test out appropriate physical movements that can indicate the presence of this condition. Some specific diagnostic criteria are:
Pain must be in the SI joint area
Pain must be produced by specific movements
Injecting a local anesthetic into the SI joint should relieve the pain.
What Does SI Joint Pain Feel Like?
SI Joint pain is often described as a sharp, stabbing pain that radiates from your pelvis and hips, down to the thighs and up to your lower back. You might also feel a weakness in your legs. SI joint pain can also be described as a dull, aching pain and it can be felt on one side only, or on both sides. You can see why it can be challenging to diagnose!
Is SI Joint Pain Serious?
Symptoms of SI joint pain can range from merely mild discomfort to drastic and debilitating pain. When the pain becomes severe it can significantly impact people's lives, making daily activities a challenge.
How To Treat SI Joint Pain?
Fortunately most cases of SI joint pain are treatable and are often managed effectively with non-surgical options. Treatments often include:
SI joint injections
Over the counter pain relievers (acetaminophen and NSAIDs)
Who Treats SI Joint Pain?
When it comes to the treatment and management of SI joint pain, the most commonly recommended healthcare provider for the job is a physiatrist. Physiatrists specialize in treating illnesses or injuries that impact range of motion. They are trained in rehabilitation techniques and can often use non-surgical approaches to low back pain.
Does SI Joint Pain Ever Go Away?
Fortunately, like many incidences of lower back pain injuries, in many cases acute SI joint pain resolves by itself within days or weeks. If it persists for more than three months it is then considered to be chronic.
Just like with low back pain, SI joint pain can range from mild incidences to seriously severe cases. It can occur suddenly, and it often resolves on its own within a few weeks. Unfortunately, also just like low back pain, SI joint dysfunction can be difficult to diagnose, making treatment more challenging for those experiencing it. Chronic SI joint pain can be downright debilitating and it can have numerous negative effects on people’s lives. The good news is that there are clear criteria for making a diagnosis as well as a variety of effective treatments that are available to help speed up the recovery process and get people back on their feet again and living their best lives.
If you suspect that you might be suffering from SI joint pain, make an appointment to see your healthcare provider and discuss your concerns. They should be able to do a thorough evaluation and let you know if you meet criteria and then be able to suggest some treatment options.