When Is Low Back Pain Caused By My Sacroiliac Joint?
The Sacroiliac Joint (SI Joint) is located in the pelvis; it links the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone). It is an essential component for shock absorption to prevent impact forces during walking from reaching the spine.
What is Sacroiliac (SI) Joint Disruption and Dysfunction?
Like any other bone and joint in the body, the large bones of the pelvis and the SI joint can become damaged either through injury or normal wear and tear. The joint can become disrupted or its support ligaments can become loose or injured, e.g., after an injury or pregnancy. Symptoms may be immediately obvious (acute) or over time (chronic). When this happens, people can feel problems in their upper leg(s), buttocks and sometimes even higher on the spine. This is especially true with sitting, lifting, running, walking, or even sleeping on the involved side. In all of these cases, the symptoms can be felt anywhere from the upper leg to the lower spine.
The SI joint is a real yet under appreciated pain generator in an estimated 15% to 25% of patients with axial low back pain.1
Who is most at risk for Sacroiliac (SI) Joint Problems?
There are several groups of patients where sacroiliac (SI) joint problems are more likely:
* Significant trauma with bone fracture and/or disruption of the SI joint may result in acute or chronic dysfunction of the SI joint.
* If the motion in your pelvis is asymmetric, then dysfunction can occur in your sacroiliac joint. You could have asymmetric motion if your legs are significantly different in length, such as from birth or a condition like polio or scoliosis. Having one leg weaker than the other can also cause asymmetric motion and/or instability. Even wearing inappropriate footwear can alter your gait and cause repetitive stress to your sacroiliac joint.
* Over half the time, SI joint problems are related to a specific event, often an injury from accidents or an event such as pregnancy/childbirth. In addition to pregnancy/childbirth, women may be at increased risk for sacroiliac joint problems because of their broader pelvises, the greater curve of their necks, and shorter limb lengths.
* Other potential causes of SI joint problems include history of trauma, such as occupational lifting.
The SI joint is often missed as a low back pain generator because it is difficult to diagnose. The most significant indication is specific location of pain below the L5 joint.
* It’s common for SI joint problems to mimic spinal disc pain, so SI joint dysfunction may not get diagnosed if your clinician is not evaluating your SI joint
* SI joint dysfunction can occur in conjunction with other non-SI joint spinal problems, such as herniated disc, degenerative disc disease, osteoarthritis, or sciatica
* Patients who are still in pain after lumbar spine surgery may have actually had an SI joint problem instead or in addition to another spinal problem
* Patients who have had prior lumbar spine surgery may develop issues with their SI joint. The SI joint is a pain generator in low back pain of 43% of post-lumbar and lumbosacral fusion patients, the so-called ‘failed back surgery’ patients.2
These diagnostic challenges make it important for patients to bring up the possibility of SI joint dysfunction with their doctors and surgeons.
1Cohen, Steven P. Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Diagnosis, and Treatment. Anesth Analg 2005; 101:1440-1453.
2DePalma, Michael J., et al. Etiology of Chronic Low Back Pain in Patients Having Undergone Lumbar Fusion. Pain Medicine 2011; 12: 224–233.
This information is not intended to take the place of a doctor’s advice. Please keep in mind that treatment and outcome results vary among patients. Consult with your doctor about possible treatment benefits, complications and risks. Your doctor can provide a complete list of indications, precautions, warnings, clinical results, and other important medical information.
As with any surgery, there are risks and potential complications. Please review the iFuse Implant System® Package for more information regarding product use, precautions and complications.