Sacroiliac Joint Pain

Definition

Sacroiliac Joint Pain is discomfort in the lower back in the area where the base of the spine meets the pelvis. This pain is simply a symptom that may come from a condition or a disease.

Causes

Doctors may be unsure if the pain starts in the joint or in its surrounding ligaments. Ligaments are bands of tissue that connect a bone to another bone.
The sacroiliac joint has many nerve endings, which send pain signals to the brain. Pain in this region may be caused by many factors:
  • Twisting, bending, or moving in a way that triggers sacroiliac joint pain
  • Infection of the joint
  • Osteoarthritis of the joint (more common in older adults)
  • Trauma, such as auto accidents
  • Stress fractures in athletes
  • Inflammation of the joint, such as with ankylosing spondylitis

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. Risk factors for sacroiliac joint pain include:
  • Poor posture
  • Weak muscles
  • Bending or twisting the back
  • Improper lifting
  • Ankylosing spondylitis
  • Psoriatic arthritis

Symptoms

Symptoms may include:
  • Mild to severe low back pain
  • Pain in the buttocks
  • Pain that seems deep in the pelvis
  • Pain in the hip or groin or back of the thigh
  • Pain that radiates down the leg on the affected side
  • Stiffness of the lower spine
  • Certain activities may increase the pain, including:
    • Walking
    • Twisting
    • Bending
    • Stooping
    • Rolling over in bed
    • Getting up from a chair
    • Climbing the stairs
    • Coughing
    • Sneezing

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Finding the source of Sacroiliac Joint Pain is often difficult. Tests depend on your medical history and the suspected cause.
Tests may include:
  • X-rays–of the pelvis and lower back
  • Bone scan – injection of radioactive material into the body followed by scanning with a machine that will find areas with higher concentrations of the injected material; these are areas of abnormal bone growth
  • CT scan – a type of x-ray that uses a computer to make pictures of the inside of the pelvis and sacroiliac joint
  • MRI scan – a test that uses magnetic waves to make pictures of the sacroiliac joints and the ligaments
  • Biopsy – removal of a sample of tissues from the joint for examination in the lab
  • Nerve blocks – injection of a drug that blocks nerve signals into the joint to determine if the pain starts in the joint

Treatment

Treatment depends on the cause of the pain. Any underlying condition would receive treatment specific for that disease. For stress fractures, doctors recommend limited weight bearing. Regardless of the cause, short-term rest is often advised.
Other treatment may include:
Medication
Your doctor may recommend or prescribe any of the following:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
    • Aspirin
    • Ibuprofen (Motrin, Advil)
  • Pain medication: Acetaminophen (Tylenol)
  • Steroid injections into the sacroiliac joint, to provide short-term relief
  • Antibiotics for infected joints
Physical Therapy
Physical therapy may include:
  • Exercises to stretch the muscles of the low back
  • Exercises to strengthen the muscles and support the area
  • Ice applied to the painful area
  • Ultrasound – the application of deep heat to the sore area
Back Care
Prevent stress to the painful area with the following:
  • Proper bending
  • Proper lifting
  • No twisting of the body

Prevention

Practicing good back care may help you avoid Sacroiliac Joint Pain.This includes:
  • Exercise regularly to keep muscles strong
  • Maintain good posture
  • Use proper techniques for bending or lifting