The sacroiliac joint is the joint where the spine joins the pelvis, pain and inflammation in this area is classified as sacroiliac joint pain; however the cause of the pain can be from any of a number of conditions.
Infection of the joint from injury can lead to the condition, and osteoarthritis, more common in older adults, can cause sacroiliac joint pain. Trauma from injury (automobile accidents and falls), which can cause stress fractures, and impact related sports injuries are a common cause for athletes who suffer from sacroiliac joint pain.
Pregnancy can cause the condition as the pelvic girdle expands to allow for childbirth, this is usually temporary and stops after recovering from labor. Ankylosing spondylitis often leads to sacroiliac joint pain. Ankylosing spondylitis is a type of arthritis that affects the joints and bones specifically at the base of the spine at the sacroiliac joint which causes the joint to become swollen, inflamed, and painful. Often the joint is fused together from the effects of the condition after a long period of time.
What symptoms are associated with sacroiliac joint pain?
Mild-to-severe pain felt in the lower back, buttocks, hip, groin, or the back of the thigh, pain radiating down one leg (on the side most affected), pain felt deep within the pelvis, stiffness and decreased mobility in the lower spine region. This pain is often increased with activities such as bending, twisting, kneeling, walking, or bearing weight.
How is sacroiliac joint pain diagnosed?
The Colorado pain management doctor will discuss your medical history with you, any injuries that could be indicative of sacroiliac joint pain will be considered. Arthritis is another indicator of the condition.
Xray imaging, CT scans, and MRI are often used to determine if the pain is due to arthritis or as the result of an injury. Often an injury years ago that you didn’t think much of when you were young may come back to haunt you as you get older.
Injections of pain relieving medications can be used diagnostically to determine if the felt pain is indeed within the sacroiliac joint and help to determine further course of action.
What treatments are available for sacroiliac joint pain?
OTC (over the counter) pain medication such as aspirin or acetaminophen and (NSAIDs), nonsteroidal anti-inflammatory drugs like ibuprofen (Motrin), and naproxen sodium (Aleve) can often be used to reduce pain and inflammation. Prescription muscle relaxers such as flexeril and skelaxin and opioid analgesics like hydrocodone (Vicodin), and oxycodone (Percocet) are often used to treat pain and inflammation of sacroiliac joint pain.
The most effective treatment for SI joint pain for most people however are nerve block injections. Injections of local anesthetics and corticosteroid medications into the sacroiliac joint to numb the nerves and prevent the pain signals from reaching the brain are very effective in relieving pain.
These injections are performed as an outpatient procedure; they typically take about thirty minutes. The patient is placed on an exam table and the area to be injected is cleansed with antiseptic solution then the skin is numbed with a topical anesthetic. With the aid of fluoroscope guidance (a type of x-ray machine) the needle is inserted and then a contrast dye is injected to ensure the medications will contact the nerve, and then the medications are injected.
Many people find instant relief from the local anesthetic but it usually takes a couple days for the steroid to take effect. These injections can provide relief for several days to several weeks. Risks are minimal and include very slight bruising and bleeding at the injection site. These injections are usually very effective for pain relief. In more severe cases RA may be needed.