Sacroiliac Joint Dysfunction: Causes, Symptoms, Treatment, Prognosis
What is Sacroiliac Joint Dysfunction?
Sacroiliac Joint Dysfunction which is also known by the names of Sacroiliac Joint Disorder or Sacroiliac Joint Syndrome.
Sacroiliac Joint Dysfunction is a condition in which an individual experiences pain in the sacroiliac or SI joint region with the main reason behind this pain being abnormal motion of the sacroiliac or SI joint which may be either too much motion or hypermobility, or too little motion or hypomobility. This abnormal motion results in the sacroiliac or SI joint to get inflamed causing excruciating pain for the individual.
This pain experienced due to Sacroiliac Joint Dysfunction can be so severe that it can render an individual disabled and unable to perform even basic routine tasks of daily living.
Coming to the anatomy of the Sacroiliac Joint, this joint connects the sacrum to the pelvis and is supported by a number of very strong ligaments. The Sacroiliac Joint has minimal movement if any and remains fixed most of the time. This joint acts as a shock absorber for the body.
What are the Causes of Sacroiliac Joint Dysfunction?
The most common cause of Sacroiliac Joint Dysfunction is osteoarthritis which is a condition in which the cartilages covering the bone get degenerated causing the bones to rub against each other causing irritation and pain.
Degenerative Arthritis is common to the Sacroiliac Joint as it is to other parts of the body.
Pregnancy is another cause for Sacroiliac Joint Dysfunction. When a female gets pregnant, hormones are released in the body which causes the ligaments to relax so as to get the body to prepare for birth of the child. Similar thing happens to the ligaments of the Sacroiliac Joints and the strong ligaments holding them relax allowing abnormal motion of the joint resulting in increased stress and wear of the joint resulting in Sacroiliac Joint Dysfunction causing pain. Also, as the pregnancy advances, the gait pattern of the mother also changes putting more pressure on the Sacroiliac Joint resulting in Sacroiliac Joint Dysfunction.
Any condition which puts pressure on the Sacroiliac Joint can result in Sacroiliac Joint Dysfunction. Any condition in which an individual has an altered gait pattern like a leg length discrepancy, arthritis, problems with the hip, knee, or ankle, or a lumbar spine issue resulting in an altered gait pattern can result in Sacroiliac Joint Dysfunction. Some of the medical conditions that can cause Sacroiliac Joint Dysfunction are gout, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
Trauma or a direct fall on the Sacroiliac Joint area may also result in Sacroiliac Joint Dysfunction.
What are the Symptoms of Sacroiliac Joint Dysfunction?
The classic presenting symptom of Sacroiliac Joint Dysfunction is pain in the Sacroiliac Joint. People with Sacroiliac Joint Dysfunction will experience symptoms of pain in the low back or behind the hips. They may also have pain in the groin or thighs. This pain tends to worsen with standing and walking and gets better when lying down. It also becomes difficult for the individual to sit or stand for prolonged periods of time or getting up from a seated to a standing position. The individual with sacroiliac joint dysfunction may also feel stiff in the pelvis area and may have burning sensation in that area.
How is Sacroiliac Joint Dysfunction Diagnosed?
In order to diagnose Sacroiliac Joint Dysfunction, the physician will begin by taking a detailed history of the patient. The physician may ask as to when the symptoms started. The physician may also ask as to whether the patient had a fall or experienced any trauma to the pelvic or back region. It should be mentioned here that it is quite difficult to diagnose Sacroiliac Joint Dysfunction as the symptoms are quite similar to other problems of the spine.
The physician will perform some tests to find out the source of the pain and whether the pain is coming from the Sacroiliac Joint or any other source. The physician may place the patient’s legs and hips in certain positions and apply pressure on them to identify the Sacroiliac Joint as a source of the patient’s pain and confirm a diagnosis of Sacroiliac Joint Dysfunction.
The next thing the physician will do is order radiological studies in the form of x-rays, CT or MRI scans of the hips and pelvis to look at the internal structures of these regions and to look at the Sacroiliac Joint looking for any possible abnormalities. In case if Sacroiliac Joint Dysfunction is suspected, then to confirm this, an injection is performed to numb the tender area and identify the source of the pain. This injection is done directly to the Sacroiliac Joint. If there is immediate relief of pain and inflammation then the diagnosis of Sacroiliac Joint Dysfunction is virtually confirmed. The pain relief experienced during this diagnostic approach may be temporary but it may confirmatively diagnose Sacroiliac Joint Dysfunction and further treatment plan may be formulated.
What is the Treatment for Sacroiliac Joint Dysfunction?
Sacroiliac Joint Injections as stated above can be used both for therapeutic and diagnostic purposes. Once Sacroiliac Joint Dysfunction is confirmed, these injections can be done on a periodic basis for pain relief and calming down inflammation. The duration of pain relief from sacroiliac joint dysfunction varies and may range from a few days to even months. Apart from this, usually NSAIDs like Tylenol and Advil can be used for calming down pain and inflammation. At times, oral steroids are also used as a mode of treatment for Sacroiliac Joint Dysfunction.
The next step towards treatment of Sacroiliac Joint Dysfunction is physical therapy which has been shown to be very helpful in treatment of Sacroiliac Joint Dysfunction. As Sacroiliac Joint Dysfunction is mostly caused by too much or too little motion of the SI joint, this is where a therapist can come to the rescue teaching various stretching or stabilizing exercises to help with the pain and inflammation. Additionally, braces in the form of a sacroiliac belt can be used for stabilization of the Sacroiliac Joint.
If all the above conservative measures mentioned above fail to provide relief to the patient suffering from Sacroiliac Joint Dysfunction, then surgery is the route preferred by the physicians. The surgical procedure for Sacroiliac Joint Dysfunction involves fusion of the Sacroiliac Joints. During the procedure, the cartilages covering the bones are removed and the bones are held together with plates and screws till the times the bones join together or fuse. By doing this procedure, there will be no motion of the Sacroiliac Joint and hence Sacroiliac Joint Dysfunction will be treated. It should be noted here that this procedure is only done as a last resort when all other treatments have failed to provide relief to the patient.
What is the Prognosis of Sacroiliac Joint Dysfunction?
The prognosis for Sacroiliac Joint Dysfunction is variable and depends on the causes. If pregnancy is the cause of the Sacroiliac Joint Dysfunction then rest is the only thing required as the condition improves after the delivery of the child.
If Sacroiliac Joint Dysfunction is caused by medical condition like ankylosing spondylitis or psoriatic arthritis then treatment for these conditions decide on the prognosis for Sacroiliac Joint Dysfunction. Degenerative arthritis causing Sacroiliac Joint Dysfunction cannot be reversed but today lot of treatments are available which can be very effective in keeping in control the symptoms caused by Sacroiliac Joint Dysfunction.