You have two sacroiliac (SI) joints located in your pelvis where the sacrum (the triangular bone at the base of the spine) connects with the iliac bones (the large, wing-shaped bones of the pelvis). SI joint pain, or sacroiliac joint dysfunction, originates in one or both sacroiliac joints. Typically, the pain starts in the actual SI joints, but it can travel through the lower back, buttocks, hips and sometimes radiate down the legs, mimicking sciatica.
At Summit Orthopedics, we offer comprehensive SI joint pain management with expert diagnosis and tailored treatment plans developed in partnership with you. If you’re in the Minneapolis/St. Paul area and are experiencing SI joint pain, trust the experts at Summit Orthopedics to help.
Sacroiliac Joint Pain Symptoms
SI joint pain can manifest in various ways, often affecting the lower back and surrounding areas. Common symptoms include:
- A feeling of instability in the pelvis
- Pain in the buttocks, hips and/or upper thighs
- Pain in the lower back, often on one side
- Pain is aggravated by prolonged sitting or standing
- Pain is relieved by lying down
- Pain that radiates down the leg
- Pain that worsens with activities such as standing on one leg, climbing stairs, getting in and out of a car or turning in bed
- Stiffness in the lower back, particularly in the morning
Diagnosing Sacroiliac Joint Pain
Identifying the cause of SI joint dysfunction helps your provider create an effective treatment plan. Your provider will review your medical history, do a physical exam and likely recommend diagnostic tests.
- Medical history. Past health, injuries, symptom onset, lifestyle and other factors provide important clues for diagnosis and treatment.
- Physical exam. Your provider will want to perform a series of specific tests on your SI joints. These tests may include pressing on the joint, range of motion assessments and using specific movements to find the source of your pain.
- Diagnostic imaging. X-rays, MRI and CT scans allow your provider to see what is happening with your SI joints. X-rays may be used to look for signs of arthritis or structural issues, although they are often less helpful for soft tissue problems. A CT scan can provide more detailed images of the bony structures of the SI joint, and MRI can help identify other structural abnormalities in and around the SI joint.
Nonsurgical Treatment for Sacroiliac Joint Pain
Most people with SI joint pain can find relief without surgery. Nonsurgical options include:
Injections
Therapeutic injections, such as corticosteroids, can help reduce swelling and irritation and improve mobility and function in the lower back, hips and legs.
Medications
Medications play a significant role in managing the pain and inflammation associated with the SI joints. Some of the medications used to treat SI joint pain include:
- Corticosteroids (Oral). Oral corticosteroids like prednisone may be prescribed short-term for severe inflammation.
- Disease-modifying antirheumatic drugs (DMARDs). If the SI joint pain is due to an inflammatory condition like ankylosing spondylitis, DMARDs may be prescribed.
- Opioid pain relievers. These are generally not the first-line treatment for SI joint pain and are typically reserved for severe, acute pain when other medications haven’t provided relief.
- Over-the-counter (OTC) pain relievers. Acetaminophen, ibuprofen and other OTC drugs are commonly used for SI Joint pain.
- Prescription medications: A wide variety of prescription drugs, including nonsteroid anti-inflammatory drugs are available to relieve inflammation and SI joint pain.
Physical Therapy
Physical therapy is essential for addressing SI joint pain. Tailored exercise programs improve strength and relieve pain.
Radiofrequency Ablation
This minimally invasive procedure uses radiofrequency energy to destroy the nerves transmitting pain signals from the SI joint to the brain.
Self-care
Self-care strategies can be done at home to manage SI joint pain. Some of the techniques often recommended include:
- Gentle movement. Carefully controlled, low-impact exercises and stretches can help to restore a more normal range of motion in the SI joint and surrounding tissues.
- Heat or ice. Warm compresses and showers can relax muscles and increase blood flow. Ice can reduce inflammation and numb pain. Your provider will help you choose the best approach.
- Massage. Gentle massage may relieve muscle tension, improve circulation and reduce pain.
Surgical Treatment for Sacroiliac Joint Pain
If other treatments haven’t helped and your pain significantly limits daily activities, your spine specialist may recommend SI joint fusion surgery.
This minimally invasive procedure is performed to stabilize the SI and relieve pain. A small incision is made above the joint, and metal implants are placed to stabilize the joint and fuse the bones together. In some cases, bone grafts are placed within the SI joint to encourage new bone to grow over the graft. Once it’s healed, the fusion reduces joint movement and pain.
Personalized Care for SI Joint Pain
Summit Orthopedics has nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics spine expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
