Sacroiliac PainSacroiliac pain is an often misunderstood symptomatic syndrome which can be blamed on soft tissue problems surrounding the joint, structural problems with the joint itself or a combination of the 2 terrifying circumstances. SI joint pain is often described as being similar to sciatica in its usual expression. There is often radiating pain or weakness in the legs and buttocks, as well as general lower back pain. SI Joint pain is a diagnosis on the rise throughout the orthopedic community.The sacroiliac joint is a small but incredibly strong joint that connects the sacrum to the pelvis. This joint acts as the main shock absorber between the torso and the legs. The SI joint is so durable in fact that concentrated force applied to it will shatter the pelvis before the joint itself is damaged in any way! This makes it hard to believe that this bastion of fortitude might cause the type of agonizing symptoms often associated with the diagnosis. It is not completely understood what exactly causes most SI joint pain conditions, which can be a sign of a potential psychoemotional causation or contribution in some patients.
Diagnosis of Sacroiliac PainThe diagnosis of most cases of sacroiliac symptoms is made on the basis of exclusion. If there is no evidence of a lumbar spinal condition to blame for pain, then SI joint syndrome is often diagnosed, without or without supporting evidence. There are some tests to be done during examination, but they might elicit discomfort in ANY back pain condition, not just SI dysfunction.An injection of anesthetic is often given into the SI joint under live x-ray (fluoroscopy). If the pain goes away, then the SI joint is blamed. However, the anesthetic can affect virtually any regional nerve and might relieve pain not caused by sacroiliac issues. This is the unfortunate problem with conditions that are diagnosed by exclusion. “We know what it is NOT, so therefore it MUST be…” Even when arthritic change is seen in the sacroiliac, there is usually no need for alarm. Remember that osteoarthritis is truly universal as we age and affects most or all of our major joints, leaving evidence which can be visualized on diagnostic studies. If OA were to blame for most SI pain conditions, then we would all be completely debilitated by the time we turned 50. Treatments for Sacroiliac PainHere are some of the most popular therapies used for diagnosed SI pain. Notice that they are ALL symptomatic in nature and will do basically nothing to resolve the supposed structural issues thought to be causative here…
Luckily, surgery is rarely necessary for SI joint concerns. More information on conservative therapies can be found on my page detailing
back pain treatments. Recommendation for Sacroiliac Joint PainSacroiliac pain is a real enigma in my eyes. I see the facts of the anatomical structure involved and also observe how doctors will diagnose the basically normal and expected age-related changes found everywhere in the body to explain the symptoms. How can such minor processes affect such a mighty piece of the anatomy? It makes little sense in most cases.Of course, there are times when the SI joint is truly horribly degenerated or affected by a significant soft tissue (ligament, tendon or muscle) issue in the area. These cases may require monitoring or even professional treatment. However, from my experience, these are the minority of cases and do not even begin to explain the huge number of diagnostic verdicts pronounced each and every year. If you have tried to find relief using the usual methods and have not found any success, it may be time for a shift in your approach. There may be another reason why you are in pain. I highly recommend seeking some new diagnostic opinions from a variety of different types of doctors. Most of all, I recommend learning the facts of SI joint pain and look for any holes in your own diagnostic theory by comparing your symptoms to the clinical expectations of the condition. Back Pain 7/11/06 Revised 1/7/12 |
Sensei Adam Rostocki
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