Sacroiliac (SI) Joint Dysfunction
The Sacroiliac (SI) joint plays a crucial role in connecting the spine to the pelvis. Dysfunction in this joint can lead to discomfort, pain, and limitations in mobility. Understanding the causes and symptoms of SI joint dysfunction is essential for proper diagnosis and treatment.
What is Sacroiliac Joint Dysfunction?
Sacroiliac (SI) joint dysfunction refers to pain or discomfort arising from abnormalities or imbalances in the sacroiliac joint, which connects the sacrum (the triangular bone at the base of the spine) to the ilium (part of the pelvis). This joint is essential for stability and load transfer between the spine and the lower body.
What are the symptoms?
The following signs and symptoms may indicate you have a vertebral compression fracture:
Lower back pain: Pain in the lower back, often on one side, is a hallmark symptom of SI joint dysfunction.
Buttock pain: Discomfort in the buttock area, which may radiate down one leg, is also common.
Hip pain: Pain or aching sensations in the hip, groin, or thigh region may occur due to SI joint dysfunction.
Pain with movement: Activities such as standing up from a seated position, walking, or climbing stairs may exacerbate pain.
Pain when sitting: Prolonged sitting, especially on hard surfaces, may worsen discomfort.
Tenderness to palpation: Gentle pressure over the SI joint area may elicit tenderness.
Pain during certain movements: Twisting, bending, or lifting may aggravate SI joint pain.
Sacroiliac joint inflammation: Inflammation of the SI joint can lead to warmth, redness, or swelling in the area. The back pain you experience with VCF commonly occurs near the break. You may notice sudden back pain near your waistline or slightly above or below it. The pain might become worse when you move around or change positions.
What are the causes of SI Joint Pain?
Trauma: Injuries such as falls, automobile accidents, or sports-related impacts can damage the SI joint, leading to pain and dysfunction.
Pregnancy: Hormonal changes during pregnancy can cause ligaments around the SI joint to relax, leading to increased mobility and potential irritation, inflammation, or strain on the joint, resulting in pain.
Degenerative Conditions: Conditions such as osteoarthritis or degenerative joint disease can affect the cartilage within the SI joint, leading to pain, stiffness, and reduced joint function over time.
Inflammatory Conditions: Inflammatory disorders such as ankylosing spondylitis, psoriatic arthritis, or inflammatory bowel disease can affect the SI joint, leading to inflammation, pain, and stiffness.
Leg Length Discrepancy: Significant differences in leg lengths can cause uneven stress distribution on the SI joint, leading to pain and dysfunction.
Overuse or Repetitive Stress: Activities that involve repetitive movements or excessive stress on the SI joint, such as certain sports (e.g., running, cycling) or occupations (e.g., heavy lifting, prolonged standing), can lead to SI joint irritation and pain.
Muscle Imbalance: Weakness or imbalance in the muscles surrounding the SI joint, including the muscles of the pelvis, hips, and lower back, can affect joint stability and contribute to pain.
Sacroiliitis: Sacroiliitis, which is inflammation of the SI joint, can occur due to various underlying causes, including infection, autoimmune diseases, or other inflammatory conditions, leading to pain and discomfort.
Structural Abnormalities: Structural abnormalities such as sacralization or lumbarization (anomalies in the sacrum or lumbar spine) can affect the biomechanics of the SI joint, potentially leading to pain and dysfunction.
Stress Fractures: Fractures or stress fractures in the pelvis or sacrum can lead to SI joint pain, especially with weight-bearing activities.
How is SI Joint Dysfunction diagnosed?
Diagnosing SI joint pain can be complex and typically involves a combination of medical history, physical examination, and diagnostic tests. Often times, patients with low back pain with “normal” imaging may have sacroiliac joint pain that has been overlooked. SI joint pain can affect patients in many different ways. Typically, patients experience pain on one or both sides of their lower back. Sometimes it feels like pain across the belt line. The pain can mimic other types of pain generators in the low back and therefore often goes misdiagnosed. X-rays & advanced imaging can be helpful, but often times the SI joint is typically listed as “unremarkable.” Diagnosis is a combination of history and physical exam. Additionally, diagnostic injections can be performed to confirm the joint as a pain generator.
What treatment options are available?
Dr. Weisbein may recommend one of the following treatments for SI Joint dysfunction, depending on the type and severity of your injury:
SI Joint Injections
SI-Bone - iFuse INTRA & iFuse TORQ
If you’ve been diagnosed with SI Joint Dysfunction, schedule an appointment with Dr. Weisbein. To schedule a new patient appointment, please call (707) 254-7117 or submit an Online Appointment Request here: New Patient Intake Form. If you are an existing patient, please call (707) 603-1078.
“Dr. Jacqueline Weisbein performed a “right sacrioloac joint fusion” in April 2024.
Prior to this, I have had low back pain for seven years. And have been a pain clinic
patient since then – the past two at Napa Valley Orthopaedics, under Dr. Weibein's care.
I eat well, have a healthy diet and weight. I stretch daily, use hot and cold packs on my
low back, and do moderate amounts of activity/exercise. I also take two hydrocodone
daily. Up until the joint fusion, I would say my pain has been managed. But with
moderate successful and time-consuming activity – and constant vigilance.
From the day after the joint fusion, I was nearly pain-free at the site of the pain source.
Over the past six weeks, I have had minimal pain at the joint site. I am increasing my
activity tolerance daily while easily decreasing the amount of hydrocodone I take.
I have spent each morning doing significant yard work this Memorial Day weekend. I
find that I am able to tolerate this while only taking ½ – 1 hydrocodone daily. My goal
is to eventually taper off the hydrocodone completely. This is a goal I previously
thought was unattainable.
I am still doing daily stretching, ice, and heat on the pain site while doing increasing
physical activity daily. There is still some low back stiffness, most likely due to the lack
of meaningful activity while fully recuperating from the operation.
I am stunned by the results of this fusion. The lack of pain at the traditional source is
unbelievable. I am so thankful to Dr. Weisbein – and Kim Bellows for their assistance
in making this happen. I hope others find this as satisfying as I do. Thank you.”
