Sacroiliac Joint Pain

The sacroiliac (SI) joints are located between the sacrum, a bone at the end of the spine, and the iliac bones that make up the pelvis. The SI joints move only a few degrees and are held together by ligaments. When standing up, the SI joints are supporting the upper body. Pain of the SI joint will emanate from the lower back, to the right or left of the spine, high on the buttocks.

  1. Diagnosis

    • Sacroiliac pain can be difficult to diagnose. The pain and inflammation can spread to the spine and around the hip. In addition to a physical examination by the doctor, x-rays, bone scan, CT (computed tomography) or MRI (magnetic resonance imaging) may be used in the process of diagnosis. Though these examining techniques will not exclusively pinpoint the SI joint as the source of pain, the results can determine if an area other than the SI joint might be the source of the discomfort or an additional contributing source to the discomfort.

    Possible Causes of Pain

    • Sacroiliac joint pain may be called dysfunction, syndrome, strain or inflammation. Wear on the joint, just like with a knee or hip, can cause osteoarthritis, which will result in inflammation. Pregnancy can affect the joint with added weight as well as the expanded movement during childbirth. An injury, such as a fall to one knee on a hard surface, may push the SI joint beyond its limits strain the ligaments. The pain from the SI joint can be quite powerful, affecting how you walk, sit or lie.

    Physical Treatments

    • Physical therapy is the common recommended treatment for SI joint problems. An SI belt, which wraps around the hips just below the waist, may help to stabilize motion of the joint as you perform daily tasks. Massage of the back to relieve muscle tension that may help reduce SI joint pain. The application of heat to relax muscles followed by ice to reduce inflammation may also help sacroiliac joint pain.

      You may find that taking shorter strides helps. Sleeping on the opposite side of the pain with both knees bent or only the knee of the ailing side bent and with a pillow beneath it may help.

    Medical Treatments

    • A pain management specialist can inject a steroid (cortisone) along with an anesthetic into the SI joint. This injection will not only relieve the pain, but by doing so, can affirm that the pain was indeed coming from the SI joint. For some, the duration of pain relief from the injection is limited to as little as a few hours. Repeat injections, up to three per year, can be performed over the course of months if the pain returns. Treatment for SI joint pain may include long-term use of an anti-inflammatory like Naproxen (the ingredient in Aleve), plus muscle relaxers and pain killers.

    Long-Term Prognosis

    • Your doctor will advise you of the best form of treatment for your sacroiliac joint pain. Pain management may be the best answer, and that can include learning what you can or cannot do to avoid pain. Overall, you may find that you will need to make changes in how you perform tasks, including how you get out of bed, to reduce the discomfort to a bearable level.

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