SI Joint Disease SACROILIAC JOINT DYSFUNCTION

About the Sacroiliac Joint

Every time you stand erect, thank your sacroiliac (SI) joints. These two joints work hard; they connect your spine to your pelvis, support your upper body, and act as a shock absorber. Yet they don’t get much attention —that is, until they start to hurt.

Bone Model Demonstration - SI Joint Anatomy

Using a bone model of the pelvis, Dr. Carter Beck shows the location of the SI joint, between the sacrum and the ilium. It connects the pelvis with the spine. Dr. Beck is a neurological surgeon at Montana Neurosurgical Specialists in Missoula, Montana.


Sacroiliac Joint Pain Symptoms

When you have sacroiliac joint disease, you are likely to have pain in your leg, buttocks, groin, or lower back. The pain can occur when you stand up, walk, sit, or sleep. In short, SI joint pain can make you miserable.

Common Symptoms Associated with SI Joint Pain

Dr. Carter Beck describes the symptoms commonly associated with SI joint pain, such as pain in the hip and buttocks. Dr. Beck is a neurological surgeon at Montana Neurosurgical Specialists in Missoula, Montana.

Normal wear and tear of the joint, trauma, and inflammation can lead to painful walking, sitting, sleeping, getting in and out of a car, and other activities.

Typical Patient Experiencing SI Joint Pain

Dr. David Rouben shares his perspective on the majority of patients who come to him with SI joint pain. Dr. Rouben is an orthopedic surgeon at Norton Spine Specialists in Louisville, Kentucky.

Although it is not always clear what causes sacroiliac pain, it is estimated that 15%-25% of patients with axial low back pain can attribute their pain to the SI joint.1

Classic Location of SI Joint Pain

Dr. David Rouben shows the two locations that point to the sacroiliac joint as a potential source of low back pain. Dr. Rouben is an orthopedic surgeon at Norton Spine Specialists in Louisville, Kentucky.


Conditions Causing Sacroiliac Joint Disease

Sacroiliac joint disease typically results from one of two conditions:

  • Inflammation of the SI joint, called “degenerative sacroiliitis”
  • Too much or too little motion in the SI joint, known as “sacroiliac joint disruption”

Diagnosis and Treatment

Your doctor will determine whether you have sacroiliac joint disease by reviewing your medical history, taking x-rays, and reviewing the results from other tests you have completed. Sometimes doctors make a definitive diagnosis through treatment. Doctors may also perform a series of provocative tests.

Is the SI joint the cause of my pain?

Dr. Carter Beck describes the process of ruling out other causes of the pain that may mimic the symptoms of SI joint disease. He says the main diagnostic tool for SI joint disease is an injection directly into the SI joint. Dr. Beck is a neurological surgeon at Montana Neurosurgical Specialists in Missoula, Montana.

Confirming the SI joint as the source of pain

Dr. David Rouben describes diagnostic tests used to identify the sacroiliac joint as the source of pain. Dr. Rouben is an orthopedic surgeon at Norton Spine Specialists in Louisville, Kentucky.


Nonsurgical Treatments

Often doctors will recommend starting with a nonsurgical treatment, such as:

  • Physical therapy
  • Chiropractic medicine
  • Medications
  • Injections

Therapeutic options for treating SI joint pain

Dr. Rouben describes some of the nonsurgical optionsthat can be used to diminish the pain that keeps a patient from living life to its fullest.Dr. Rouben is an orthopedic surgeon at Norton Spine Specialists in Louisville, Kentucky.


Surgical treatments

If physical therapy, chiropractic medicine, medications, or injections don’t help, your doctor may recommend that you consider surgery to stabilize your sacroiliac joint through fusion (joining bones together into one solid structure). SI joint fusion surgery with the Rialto™ SI fusion system is a minimally invasive surgery. You and your medical team can decide if surgery is a good option to treat your sacroiliac joint disease.

The best treatment for you depends on your unique situation. Discuss treatment options with your doctor.

Need help finding a doctor who specializes in the SI joint? Use our handy search tool.


1

Cohen, Steven P. Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Diagnosis, and Treatment. Anesth Analg2005;101:1440-1453.