About Sacroiliac Joint Degeneration
The sacroiliac joint commonly known as the SI joint is the joint between your spine and pelvis. The SI joint can become injured or develop “wear and tear” arthritis called degeneration; this may be more common after lumbar fusion surgery. When this happens people may feel pain in their low back, buttock and hip. The pain is most commonly located in the area of your back jean pocket. This pain may be brought on or worsened by lifting, walking, running or even sleeping on the involved side.
SI joint pain may mimic degenerative disk disease (DDD) or arthritis in the facet joints (facet arthropathy). People with back, buttock and hip pain require a history and physical exam to determine if SI joint may be the cause of the pain. X-rays, CT scan and MRI may be helpful in diagnosing SI joint disorders. After a tentative diagnosis has been madeconfirmation is done with a diagnostic SI joint injection.
Diagnostic injection is done in a procedure room with an x-ray machine. Under x-ray guidance a needle is placed into the SI joint and pain medication (lidocaine) and steroid are injected. If your symptoms are decreased by at least 75%, then the SI joint may be either the source, or major contributor to your pain.
Conservative Treatment for SI Joint Pain
Initial treatment is physical therapy, chiropractic manipulation and anti-inflammatories. Pelvic belt may provide some pain relief. If conservative treatments fail then surgery may be considered.
SI Joint Fusion Surgery
Traditional surgery required large incision, significant tissue damage and long recovery time. Today there is a minimally invasive option. The procedure involves the percutaneous placement of 3 small titanium implants across the SI joint through a small incision. These implants stabilize and fuse the joint. The procedure takes about one hour. The patient may be discharged home the same day or after a short hospital stay.
DID YOU KNOW?
The Sacroiliac (SI) joint may be a pain generator in 15-30% of patients with chronic lower back pain and even higher (up to 43%) for patients with continued or new onset low back pain after a previous lumbar fusion.*
*Rashbaum – Clin Spine Surg 2016
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