Sacroiliac joint (SI joint) pain and dysfunction

Sacroiliac joint dysfunction, also known as sacroiliitis, is the inflammation of one or both of the sacroiliac joints, the joints that link the pelvis and lower spine by connecting the sacrum to the iliac bones. Sacroiliac joint dysfunction may be caused by injury, pregnancy, osteoarthritis, degeneration of cartilage, or inflammatory joint disease. At times, a structural abnormality, such as legs of differing lengths or severe pronation, may put increased stress on the joint, resulting in this problem. Patients with sacroiliac joint dysfunction typically experience pain in the buttocks and lower back that worsens when running or standing. While a traumatic injury may cause this problem, it more often develops gradually over a long period.

The most common symptom of sacroiliac joint dysfunction is pain, either in one side of the lower back or in the hip. Pain usually increases when the patient bends, stands after a long period of sitting or reclining, or climbs stairs, and decreases when the patient lies down. Sacroiliac joint dysfunction is diagnosed through physical examination, during which the physician moves the patient’s legs and hips into varying positions, and through imaging tests like X-rays or a CT scan. Anesthetic injections may also be used as a diagnostic tool.

Conservative treatment methods are usually sufficient to treat sacroiliac joint dysfunction. The most important of these, when acute pain is present, is rest. Patients are instructed to restrict activity, particularly activity that increases pain levels. Other techniques to reduce pain include application of ice for 20 to 30 minutes two to three times a day and intermittent application of heat to help loosen tight muscles. Massage, physical therapy, or chiropractic treatment may also be helpful. Over-the-counter pain medication is usually prescribed and sometimes corticosteroid injections are administered as well. Surgery is normally not considered to treat this condition.

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