Sacroiliac Joint Pain Relief
After years of back pain, some people finally go to their physician. They’re not sure where the pain is coming from—but they are sure that they’re ready for a fix. Often the cause is the sacroiliac joint, says Dr. John W. Aldridge of Hampton Roads Orthopaedics and Sports Medicine in Newport News.
The sacroiliac (SI) joint is where the pelvis attaches to the sacrum, the large triangle-shaped bone at the base of the spine. Problems with the SI joint can cause pain in the sides of the lower back and pain that radiates down the legs, Aldridge says. SI joint pain also can mimic a pinched nerve.
“Patients come in and say ‘It’s my hip’ and point to 10 different places,” Aldridge says. “A lot of these people are unable to walk.”
Up to 25 percent of all lower back pain can be attributed to the SI joint, according to clinical literature. Those at risk include people who have had spinal fusion surgery. That surgery causes stress on the next joint down, the SI joint, he says. About 30 percent of people who have had spinal fusion surgery develop SI joint problems, he says.
Other common culprits include trauma such as a wreck or fall as well as severe scoliosis. Sometimes women develop SI joint issues when the bones that opened up during pregnancy don’t return to the previous position post pregnancy, he says.
Once a physician determines the culprit is the SI joint, treatment begins with non-steroid anti-inflammatory drugs (NASIDs) such as ibuprofen, he says. If the main problem is inflammation, the NASIDs can alleviate symptoms. Steroid injections also can provide relief, he says.
Another measure is a stabilization belt, similar to a belt worn by a weight lifter, to squeeze the pelvis tighter, providing stabilization and support, Aldridge says. But the belt can be uncomfortable, obviously isn’t stylish and helps only when the patient is wearing it.
Physical therapy is another option. PT can help stretch out the muscles and joints around the SI joint and strengthen core muscles to provide better support and relieve pressure, Aldridge says. Most people go to physical therapy two to three days a week for a month or two, he says.
If these nonsurgical options don’t provide relief, SI joint fusion surgery can help by stabilizing the pelvis to the spine, Aldridge says. The surgery, which was in development for seven or eight years, began to be used widely in 2014, he says. Aldridge has done more than 100 since April 2014, he says. Most of his patients have been in their 60s and 70s. The youngest was late 30s. The surgery takes only 20 to 30 minutes and most people go home the same day, he says.
Although fusion surgery higher in the spine can cause SI joint problems, SI joint fusion surgery does not cause trouble for the next lower joint—the hip, he notes.
“The hip is very mobile,” he says. “SI joint fusion doesn’t affect the hips at all.”
Results can be life changing.
“It’s amazing to see how many people come in who have been told there is nothing else that can be done for them,” he says. “They’re using walkers, not going out of the house because they can’t do it physically. After surgery, some people are able to get rid of their walker and get back to walking around their neighborhood and seeing their friends. They’re more functional, less likely to be depressed and have a better outlook on life.”