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Sacroiliac joint 

Often-overlooked source of back pain

It’s time to consider the sacroiliac joint when treating patients with lower back pain

Low back pain is a leading cause of disability worldwide1. 

Australian back pain statistics:2,3,4

 

One in six Australians suffer from low back pain or back pain

 

Back problems are the second most common reason people visit their GP

70–90% of people will suffer from lower back pain at some point in their lives

 

Between 15% and 25% of patients with axial low back pain can attribute their pain to the sacroiliac joint (SIJ)5. The SIJ may be an even more common cause contributing to low back pain in patients with prior lumbar fusion5,6.

Although the SIJ accounts for a significant proportion of low back pain, it is often overlooked or underdiagnosed7. The early and appropriate management of lower back pain may reduce the risk of recurrence and progression to persistent or chronic low back pain8.

 

Sacroiliac joint (SIJ) pain

You can play a crucial role in identifying sacroiliac joint dysfunction, treating this condition, and referring to further care. 

What causes SIJ pain?

The SI joints are the two diarthrodial joints connecting the sacrum to the two ilia4. They are designed for stability and transmitting forces between the upper and lower body4. Predisposing factors for SIJ pain include true and apparent leg length discrepancy, older age, inflammatory arthritis, previous spine surgery, pregnancy, and trauma4.­­

Signs and symptoms commonly associated with SIJ dysfunction may include low back pain, buttock pain, hip discomfort, groin pain, and even radiating leg pain8. 

sij-anatomy-labelled

How to diagnose SIJ dysfunction?

Clinical assessment including history and physical examination, diagnostic injections and appropriate imaging tests can be used to diagnose SIJ dysfunction6. 

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What treatments are available for SIJ dysfunction?

Treatment options for SIJ dysfunction include conservative care, such as physical therapy, chiropractic medicine, medications, and injections. When a patient has persistent moderate to severe pain, functional impairment, and failed a minimum of 6 months of conservative care, surgical options may also be considered based on careful consideration of the patient's clinical condition and in consultation with a specialist6.

GP Resources

 

Play a crucial role in helping your patients find appropriate care. Useful resources about SIJ pain and a doctor discussion guide below you can share with your patients.

*Scroll through to the next page to see more.

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Find the nearest SI Joint Specialist

Find an SI joint specialist near you or near your patient.

Medtronic provides this listing as a service. We have no vested interest in any specific physicians, nor do we provide any recommendation, assurance,  or guarantee with respect to their service. This listing may not be a complete list of all physicians who provide this service. Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

  1. World Health Organization (2023), Low back pain. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/low-back-pain
  2. Australian Institute of Health and Welfare. (2020). Back problems. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems.
  3. Britt, H., Miller, G., Henderson, J., Bayram, C., Harrison, C., Valenti, L., Pan, Y., Charles, J., Pollack, A., Wong, C. and Gordon, J. (2016). General practice activity in Australia 2015-16 Bettering the Evaluation and Care of Health GENERAL PRACTICE SERIES NUMBER 40. https://ses.library.usyd.edu.au/bitstream/2123/15514/5/9781743325148_ONLINE.pdf.
  4. Australian Institute of Health and Welfare 2019. Back problems. Cat. no. PHE 231. Canberra: AIHW. https://www.aihw.gov.au/getmedia/0d9f8959-2a1c-4c99-8c7e-0c8a878f4d6c/Back%20problems.pdf.aspx?inline=true
  5. Cohen, Steven P. Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Diagnosis, and Treatment. Anesth Analg2005;101:1440-1453.
  6. Liliang P-C, Lu K, Liang C-L, Tsai Y-D, Wang K-W, Chen H-J. Sacroiliac joint pain after lumbar and lumbosacral fusion: findings using dual sacroiliac joint blocks. Pain Med Malden Mass. 2011;12(4):565–570.
  7. Falowski, S., Sayed, D., Pope, J., Patterson, D., Fishman, M., Gupta, M. and Mehta, P. (2020). A Review and Algorithm in the Diagnosis and Treatment of Sacroiliac Joint Pain. Journal of Pain Research, Volume 13, pp.3337–3348. doi:https://doi.org/10.2147/jpr.s279390.
  8. Primary Health Network Implementation Guide - Low Back Pain Clinical Care Standard. (2022). Available at: https://www.safetyandquality.gov.au/sites/default/files/2022-08/low_back_pain_clinical_care_standard.pdf.