We hate to be the ones to tell you this but at some point in your life there is a good chance that you are going to end up dealing with low back pain. That is, if you aren't already dealing with it.
In 2002 a National Health Interview survey found that almost one third of those surveyed had complained of low back pain within the previous 3 months. Data published by research powerhouse, Statista, shows that in just 6 more years "in 2030, around 7.3 percent of the global population will be suffering from low back pain".
Back pain is a big concern and people want answers. What is causing it? How long is it going to last? How can they treat it? We are going to get you those answers - just keep reading!
Challenges In Diagnosing Low Back Pain
Back pain is extremely difficult to diagnose because there are so many different causes and conditions that can influence it.
MRIs and other diagnostic tools, while often recommended in the treatment and diagnosis process, are often actually rather useless because, in many cases, there is nothing specific to “see”. Pinpointing conditions with an x-ray, CT or MRI is often not actually possible, especially when it comes to conditions like degenerative disc disease or muscle spasms.
Added to this is the fact that there is also a lack of specificity with the current diagnostic techniques. Even if doctors see something unusual on your MRI (radiographic abnormalities) they are not always connected to, or responsible for, the low back pain that someone is experiencing.
There are other tests like EMG (electromyographic studies) and PET (positron emission tomography) scans that healthcare providers use from time to time to try and discover specific causes of pain. Occasionally these tests are helpful in determining if there is a surgically treatable condition present.
More often than not, however, the standard tests for spinal surgery workups fail to detect a definite cause of the pain. Because of this, many patients don’t actually need surgery but still need treatment for low back pain. This need has led surgeons to consider other types of causes for low back pain and SI Joint dysfunction is one cause that is gaining in popularity.
What Is SI Joint Dysfunction?
The sacroiliac joints (SI joints) connect your pelvis to your lower spine. These joints are composed of the bony structures that are located just above your tailbone and below your lower vertebrae, as well as the top part of your pelvis, called the ilium. SI joints are found on both sides of your lower back.
All of this anatomy is to say, when things go wrong with the way these joints move in this particular spot, you can end up with pain that is felt in your lower back or your legs. This is SI joint dysfunction.
What Causes SI Joint Dysfunction?
SI joint pain happens when the ligaments become either too loose, or too tight. When the movement in the pelvis isn’t equal on both sides it can start to cause pain. This can happen for a variety of reasons some of which include:
Falls
Injuries
Spine surgery (lumbar fusion or laminectomy)
Muscle inflammation
Fractures
Infections
Risk Factors For SI Joint Dysfunction:
Some common risk factors for developing SI joint dysfunction include:
Sustained intense athletic workouts
Pregnancy
Differences in leg length
Diagnosing SI Joint Dysfunction
Just like general low back pain, SI joint dysfunction can be difficult to diagnose since it looks like a lot of other back conditions. Healthcare providers must be sure to take a detailed history and test out appropriate physical movements that can indicate the presence of this condition.
Some specific diagnostic criteria for SI Joint Dysfunction are:
Pain must be in the SI joint area
Pain must be produced by specific movements
Injecting a local anesthetic into the SI joint should relieve the pain.
What Does SI Joint Pain Feel Like?
SI Joint pain is often described as a sharp, stabbing pain that radiates from your pelvis and hips, down to the thighs and up to your lower back. You might also feel a weakness in your legs.
SI joint pain is also often described as a dull, aching pain that is sometimes felt on only one side, but other times it can be felt on both. You can see why it can be challenging to diagnose!
Is SI Joint Pain Serious?
Symptoms of SI joint pain can range from merely mild discomfort to drastic and debilitating pain. When the pain becomes severe it can significantly impact people's lives, making daily activities a challenge.
How To Treat SI Joint Pain?
Fortunately most cases of SI joint pain are treatable and are often managed effectively with non-surgical options. Treatments often include:
Rest
Braces
SI joint injections
Over the counter pain relievers (acetaminophen and NSAIDs)
Who Treats SI Joint Pain?
When it comes to the treatment and management of SI joint pain, the most commonly recommended healthcare provider for the job is a physiatrist. Physiatrists specialize in treating illnesses or injuries that impact range of motion. They are trained in rehabilitation techniques and can often use non-surgical approaches to low back pain.
Top Treatments For SI Joint Pain
Physical Therapy: Physical therapy aims to strengthen the muscles around the SI joint, improve joint stability, and enhance flexibility. Therapists may use various techniques such as exercises, manual therapy, and stretching to alleviate pain and improve function.
2. Medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce inflammation and alleviate pain associated with SI joint dysfunction. In some cases, muscle relaxants may also be prescribed to relieve muscle spasms.
3. SI Joint Injections:
Corticosteroid injections directly into the SI joint can provide temporary relief from pain and inflammation. These injections can help confirm the SI joint as the source of pain and provide therapeutic benefit.
4. Radiofrequency Ablation (RFA):
RFA is a minimally invasive procedure that uses heat generated by radio waves to disrupt the nerves that transmit pain signals from the SI joint. This procedure can provide longer-lasting pain relief compared to corticosteroid injections.
5. Sacroiliac Joint Fusion:
For severe cases of SI joint dysfunction that do not respond to conservative treatments, surgical fusion of the SI joint may be recommended. During this procedure, the joint is stabilized by fusing the bones together, which can reduce pain and improve function.
Does SI Joint Pain Ever Go Away?
Fortunately, like many incidences of lower back pain injuries, in many cases acute SI joint pain actually resolves by itself within days or weeks. If it does happen to persist for more than three months it is then considered to be chronic.
Conclusions
Just like with low back pain, SI joint pain can range from being quite mild to being seriously severe. It can occur suddenly but it often resolves on its own within a few weeks.
Unfortunately, also just like low back pain, SI joint dysfunction can be very difficult to diagnose, making finding the right treatment extremely challenging for those experiencing it.
When SI joint pain becomes chronic it can be downright debilitating and it can have numerous negative effects on people’s lives. The good news is that there are some clear criteria for making a diagnosis as well as a variety of effective treatments that are available to help speed up the recovery process and get people back on their feet again and living their best lives.
If you suspect that you might be suffering from SI joint pain, make an appointment to see your healthcare provider and discuss your concerns. They should be able to do a thorough evaluation and let you know if you meet criteria and then be able to suggest some treatment options.
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