Sacroiliac Joint pain
Sacroiliac joint (SIJ) pain is also known as sacroiliac joint dysfunction, and symptoms are felt in the lower back and legs. This pain can be quite intense, especially when felt in the legs and can be remarkably similar to sciatica.
The cause is altered movement within the sacroiliac joint: this joint is between the sacrum and the iliac bones of the pelvis. This joint transfers all the weight & load of the upper body into the pelvic girdle, and from there into the legs down to the ground. It therefore takes very large loads and is under tension in every position. It is an unusual joint in that it barely moves, but functions mainly to pass the load of the upper body. It is stabilised by very strong ligaments.
It is thought that pain in the sacroiliac joint is caused by either too much movement (hypermobility) or excessive imbalanced load, resulting in symptoms typically around the lower back and groin but can also cause pseudo-radiculopathy (sciatica like symptoms) in the legs. Sometimes the sacro-iliac joints can be affected by rheumatoid arthritis & similar conditions.
Sacroiliac joint dysfunction is difficult to diagnose as the symptoms can often be mistaken for other conditions, so Mr Cass will usually need to establish the cause with a physical examination, which may involve him stressing the joint to establish if this replicates the pain/discomfort. He may also advise an MRI scan to rule out any other causes such as a disc prolapse.
If Mr Cass feels that the symptoms are a result of sacroiliac joint dysfunction, he may likely suggest that a sacroiliac joint injection is tried. This is done under fluoroscopy/X-Ray guidance to ensure that this is done into the correct part of the joint. A local anaesthetic is used along with a steroid solution to reduce inflammation and in the joint and reduce pain. It can help confirm if your pain is indeed coming from the joint.
Further injections may be needed, and Mr Cass will refer you to a physiotherapist to ensure that you can work towards strengthening the muscles & ligaments around the joint.
Some patients with recurring sacro-iliac dysfunction or intractable pain may be considered suitable for a stabilisation of the joint, which is a surgical procedure to reduce the movement. When done in the correct circumstances the results of this procedure can be very good.
If you are troubled with sacro-iliac joint pain and would like to discuss it with Mr Cass, do please contact us on 01273 828098 for an appointment.