SI Joint Pain: Where Does It Come From?


According to a report by the C.D.C., almost one in four adults living in the United States is affected by joint pain. While it makes sense that daily life can cause added stress on our bodies, joint pain is not something you necessarily have to deal with forever.

Indeed, you can live a life without this pain, but you must first identify it. There are different types of joint pain, and if you are living with SI joint pain, it’s time to learn all about it.

Experiencing lower back pain can be debilitating, but it doesn’t have to be permanent.

Read on to learn everything you need to know about SI joint pain.

What Is the SI Joint?

There are two sacroiliac joints (SI joints) in your lower back. They are found between the sacrum and iliac bones, connecting your spine to your hips.

SI joints are extremely important in absorbing the impact of walking, running, and lifting. They are there to stabilize your lower back and are surrounded and supported by strong muscles and ligaments.

SI Joint Pain Symptoms

SI joint pain generally starts as lower back pain, and then will gradually move to pain in the buttocks, lower hip, groin area, or upper thigh.

Often, the pain will occur on only one side, but it may occur on both sides. Tingling, numbness, or weakness in the leg is common.

SI joint pain can quickly affect one’s quality of life because the pain can get worse when sitting, walking, standing, lying down, and climbing stairs.

Transitioning from standing to sitting down and vice versa can cause extreme pain. Sleep can get disrupted if sleeping on the affected side causes more pain, or if lying down in general increases pain.

SI Joint Pain Causes

SI joint pain is often caused when the ligament becomes too loose or too tight. This can happen after a fall, car accident, pregnancy, childbirth, and after hip or spine surgery.

If the movement in the pelvis is uneven, SI joint pain can quickly start. For example, if one leg is weaker than the other, or if there is arthritis in the legs or knees, you will walk unevenly. This can also occur when wearing a walking boot after a foot or ankle injury.

Autoimmune diseases, such as axial spondyloarthritis, can cause degenerative sacroiliitis.

How to Get a Diagnosis

There are a few different ways that you can get a diagnosis regarding SI joint pain. Generally, it is a combination of medical history, physical exams, and radiology testing.

First, your doctor will collect all relevant information, including if you have had a recent injury, have trouble sleeping, and where the pain is located.

Most likely, the next step will be conducting a physical exam, often involving you moving around in certain positions and pointing to where you feel the pain coming from. Your doctor may feel for tenderness over the joints and manipulate the area to see how you react.

If they can’t get an accurate determination of whether your pain is truly coming from the SI joints, they may then send you to get images done in radiology, either an X-ray, CT, or MRI. You may also get these images done if they think something else is causing your spine and hip pain along with the SI joints.

Lastly, you may get an SI joint injection to determine the source of your pain. With this, X-ray fluoroscopy is conducted to get accurate imaging of the SI joints. Then, a needle is carefully placed to inject the SI joint with corticosteroid medication and local anesthetic.

Your pain level would be recorded before the injection, and then again 20-30 minutes after. It is then monitored for the next week, and if the pain is reduced by at least 75%, it will be confirmed that the SI joints are causing your pain. If not, other avenues must be explored.

Treatments Available

Depending on your level of pain and the length of time you’ve had it, you can choose between non-surgical treatments, joint injections, nerve ablations, and surgical treatments.

Non-surgical treatments help many patients, but may not always be enough. These include getting a chiropractic adjustment, doing targeted stretches, and participating in physical therapy. You may also need anti-inflammatory medication or topical salves and creams to help aid the pain.

The joint injections discussed above can be a treatment method along with a diagnostic method. While they are a temporary treatment, if they help to reduce your pain, you can get them done up to three times a year.

Nerve ablations work as “blocks” that help to stop the pain radiating from your joints. This is a minimally invasive procedure that uses electric currents to destroy nerve fibers that carry the pain signals from the SI joints. 

If none of the above helps to reduce your pain, surgery may be required.

SI joint fusion surgery is minimally invasive. Your doctor will cut a small incision and place bone graft material and titanium implants to promote bone growth and stabilize the joints. This procedure usually lasts about an hour, and the patient can go home the same day.

Prevention Methods

There are some things you can incorporate into your daily life to help prevent causing this kind of pain. Avoid smoking cigarettes at all costs.

When lifting weights, always use proper technique. Make sure you have proper posture when sitting, standing, and walking.

Regularly exercise, get good nutrition, and manage your stress. The healthier your lifestyle, the less chance you have of developing SI joint pain.

Become an Expert to Overcome SI Joint Pain

Learning about SI joint pain may not be the most fun you’ve ever had, but it is crucial. The more you know, the more you can do to help get yourself treatment.

If you think the SI joints are causing your pain, it may be time to schedule an appointment with your doctor. You want to get your diagnosis sooner rather than later so you can reduce your pain as quickly as possible.

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