What Is Sacroiliac Joint Pain?
The sacrum is the triangle area below the lumbar spine. The iliac bone connects to where the hip is.The sacroiliac joint (SI joint) is a large and weight-bearing joint. All the weight of the body and upper extremities comes down the spine, down the SI joint through the iliac joints, and down the legs, so it’s a very important joint.
As people age, that joint starts to fuse and some people get arthritis in that joint. SI pain usually feels like low back and buttock type pain. Usually the pain doesn’t radiate below the knee, but in rare occasions it can.
Something that is very common is pain on the side of the legs, which is called bursitis. Whenever a person has pain the body moves just a little bit differently than if they didn’t have pain which is usually the cause of bursitis. This pain can be very severe and radiate from the front or back of the hips and legs.
We put a needle directly into the joint and watch the medicine spread into that area and check after a short time to see if the pain feels better.
For many people, this will give significant relief. Other treatments are physical therapy and active release techniques.
There are many strong ligaments and muscles that come into this area, and all of those need to be relaxed to ultimately get you moving the proper way again.
As joint pain doctors, we try to get patients out of pain, whether it be through injection or some other treatment, and then into therapy.
If we do an injection and a patient keeps moving the same way that they were before, the SI joint pain will come back and a lot of times the bursitis will come back as well.
Many times we will treat both bursitis and SI joint pain at the same time.
The other thing we will do for stubborn SI pain, is radiofrequency.
At the Minnesota Institute for Pain Management, we do a treatment called medial branch blocks and lateral branch blocks, where we numb the small joints in the lumbar spine and down to the SI joint.
Sometimes we do this a few times (called a double diagnostic block) and see if a patient feels relief. If they get significant relief then we can cauterize the nerves, which we test before cauterizing to make sure we are in the right area. If we cauterize the nerves the average pain relief is about a year.
SI pain can be difficult to treat sometimes because 2/3 of the nerves come from the back of the joint and 1/3 comes from the front. Pain doctors can only inject nerves in the back section, which is most common for pain.
If a patient’s pain is from the front nerves then there are other options such as a spinal cord stimulator, exercise, or stretching. Surgeons can actually fuse the joint in rare cases that don’t respond to any other joint pain treatment.
Joint pain treatments can greatly improve your comfort level and give you significant relief.