What Is SI (Sacroiliac) Joint Pain?

What IS Sacroiliac joint pain?

Do you have severe pain that rises from your hips and pelvic area up the lower
back region and down your thighs?
What about a tingly or numb feeling that makes it seem as though your legs are
going to buckle beneath you?

If you answered yes to one or more of these questions, the pain you’re feeling could be a problem with one of your Sacroiliac (SI) Joints.

We have one on each side of the body – although you likely only have pain on one side. This condition afflicts between 15 -30% of people and can lead to chronic pain in the lower back.

Across the US, a staggering 80% of adults suffer from lower back pain at some point in their lifetime.

And lower back pain is identified as one of the most significant reasons for job disabilities and lowered productivity.

Plus, as with all types of chronic pain. Si joint pain can negatively impact your mental and physical health because it’s tough being in pain all the time, especially when nobody can “see” your pain.

But don’t worry. We can fix it.

What Are Sacroiliac Joints?

Sacrum joints

The area where the ilium and sacrum bones connect is the location of the SI joints.

The ilium is one of the three bones that constitute the hip bone and the uppermost region of the pelvis. It’s the largest of these three bones – and it’s the one that is the most synonymous with the “hip bone” to anyone that hasn’t studied anatomy and physiology in depth.

The sacrum is a bone-shaped triangle at the lower end of the spine, directly above the tailbone (coccyx).

The SI joints play an essential role in weight distribution across the pelvic region.

In addition, they decrease pressure on the spine and function as a suspension to absorb any shock; Like the shock absorbers on your car do when you drive down a bumpy road.

The bones are jagged in structure, which helps keep them in alignment, and there are spaces filled with fluid that serve as a lubricant.

These spaces also contain nerve endings that transmit pain signals to the brain, so if your SI joints become misaligned, it leads to severe pain.

The SI joint bones are linked with sturdy ligaments and muscles that provide stability and limited movement.

But although their movement is minimal, it’s imperative for us to remain upright and childbirth in women.

What Are The Symptoms Of SI Joint Pain?

Symptoms of SI joint pain

The symptoms of SI joint pain tend to vary from person to person, with the most common ones being:

  • Lower back pain
  • An increase in pain when getting up from a seated position
  • Weakness and numbness in the pelvic area
  • Experiencing pain in the pelvic region, hips, and buttocks
  • Burning sensation or unusual stiffness in the pelvic area
  • Pain arising from the groin region
  • Pain spreading from the lower back to the thighs and upper legs
  • “Wobbly legs” that seem to give and are not able to support your body weight

What Are The Causes of SI Joint Pain?

Causes of SI pain

Sacroiliitis, also termed sacroiliac joint dysfunction occurs when both or one SI
joint is inflamed. SI joint dysfunction covers a wide variety of conditions like:

  • Gout: Also termed “gouty arthritis,” is caused by a rise in uric acid levels. Its main symptoms are crippling joint pain. It generally affects the big toe initially, although later, other joints and the SI joint can be affected.

  • Ankylosing spondylitis: is a chronic condition of inflammatory arthritis that affects the joints and vertebrae. Ankylosing spondylitis leads to intense pain and, at an advanced stage, can lead to bone growth responsible for the fusion of spinal joints. While Ankylosing Spondylitis mainly occurs in SI joints, it may lead to other joint inflammation as well. In a few cases, doctors report it affecting the eyes and organs of patients as well. Ankylosing Spondylitis manifests as intermittent bouts of mild pain and later chronic severe pain in the early stages. Although not exclusively, it is relatively more common in younger men.

  • Osteoarthritis: Older adults are more susceptible to osteoarthritis with the spine and SI joints (among other joints) having their cartilages worn out with the wear and tear associated with this condition.

  • Injury: Another cause of SI Joint Pain can be blunt force trauma to the SI joint due to an accident, sports injury, or a fall.

  • Pregnancy: Specifically, during the first trimester of pregnancy, your body releases large amounts of relaxin. This hormone increases the elasticity of the SI joints. It aids in widening the pelvis during childbirth. However, it can also lead to joint instability. The main cause of this instability is the combination of pregnancy weight gain and the baby’s weight inside the womb, which puts additional pressure on the “relaxed” SI Joints. Affected women are more at risk of suffering from arthritic SI joints – and the risk increases further with each additional pregnancy.
  • Walking patterns: Having an improper gait (walking pattern) can lead to SI joint issues. Walking issues can arise for many reasons because of pain in one leg from an old injury or medical condition or from having one limb shorter than the other. Pregnant women also tend to walk awkwardly during pregnancy. If possible, you can correct these things with physical therapy, and your SI joint pain will disappear. In most cases, SI joint issues associated with pregnancy should get better on their own after birth.

How Are Si Joint Issues Diagnosed?

How is SI diagnosed

Diagnosing SI joint issues is a challenge. It isn’t easy to test their motion or examine them as they are located deep within the body.

Usually, SI joint damage is not found in tests like CT scans, MRIs, or X-rays.

In addition, since the symptoms are like other medical issues like hip arthritis, bulging discs, and sciatica, it is even harder to make the correct diagnosis.

However, as experienced physical therapists who work with patients with SI joint dysfunction, we can usually diagnose it for you by taking some of these steps:

Getting you to make specific movements, including stretches that help us locate the origin of your pain.

Ruling out other conditions with standard tests like CT scans, MRIs, and X-rays.

Another option is for a doctor to Inject a drug like lidocaine to numb the pain in the SI joint. If the pain dissipates in a while, your pain is likely coming from an SI joint issue. But ideally, you want to avoid that with physical therapy.

How To Treat SI Joint Pain

How to treat SI

The good news is that we can treat Sacroiliac joint pain, so you don’t have to go on enduring it. You can get your life back and live pain-free again.

We recommend Physical Therapy to treat Si Joint Pain over and above all other types of therapy.

Because we know we can treat the issue without painkillers, different types of medication – like muscle relaxants and anti-depressants, or dangerous, invasive surgeries.

In the scientific literature, physical therapy has proven to be especially effective in pain management and restoring range of motion in SI joint dysfunction cases.

At Interior Physical Therapy, we offer all new patients a free 30-minute consultation.

Over the telephone or at our office to talk through your pain issues and for you to get some advice on the best course of treatment from one of our Physical Therapists.

You can book yours here now.
But for information purposes, here are some of the other treatments that are available for SI joint pain:

Non-surgical therapy and Medication: In cases where chronic SI joint pain is a result of ankylosing spondylitis. Your doctor may prescribe non-surgical treatment with medication such as:

 Corticosteroid injections for a brief period
 Oral steroids for a limited duration only
 Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen and aspirin
 TNF (tumor necrosis factor) inhibitors for AS (ankylosing spondylitis)
 Muscle relaxants
 RF (radiofrequency ablation) for deactivating nerves to reduce pain

Heat Therapy: Hot and cold packs are easy-to-use options among the various ways to relieve pain and swelling in the SI joint. First, use a cold pack to ease the pain, and when the pain diminishes, you can apply a heat wrap.

Massage and yoga: Although not revolutionary in correcting the root cause of your SI joint pain issues, these complementary therapies can both be helpful to relax the body and reduce pain levels.

Sacroiliac Belt: There is not much scientific evidence to support their use. But some patients like to use a Sacroiliac Belt – worn around the hips – to support the SI joint and relieve pain.

Surgery: The surgical option for SI joint pain is only used in severe cases that do not respond to any other form of treatment. In such instances, your surgeon may recommend Sacroiliac Joint Fusion Therapy – where screws and small plates are inserted into the bones to fuse them eventually.

Andrew Vertson