SI joint sacroiliitis is a diagnosis involving pain and inflammation inside the actual sacroiliac joint, as opposed to the ligament issues linked to sacroiliac joint dysfunction. SI pain is a common back pain scapegoat, since many of the completely typical aging processes are mistakenly implicated in causing pain here, often without any definitive evidence of pathology at all. Although the joint is incredibly durable, arthritic changes are normal, just like in many other major joints in the anatomy.
In some instances, SI pain may be present and sourced by severe structural issues, but in many other cases, the theory of symptoms enacted by changes in the SI joint is incorrect. Remember, there can be many potential structural explanations for pain in the low back, buttocks and hip regions and a great number of possible nonstructural sources, as well.
This narrative delves into the diagnosis of SI joint pain problems that might be created by age or trauma.
The most common cause of true sacroiliitis is osteoarthritis. This is a normal degenerative process which affects people almost universally to one extent or another. It is found in many anatomical locations and involves a breakdown of the protective measures in the joints.
Although osteoarthritis can cause some discomfort, it is rarely the source of severe or chronic pain, especially in the back or SI joints. Extreme cases can be the exceptions to this rule and may require drastic or even invasive treatments.
Typically SI joint symptoms will feel like they exist in the hip area, although some can express themselves more towards the depths of the buttocks or lower back. In some cases, sciatica is blamed on SI joint concerns, although this diagnostic theory is often incorrect.
Lower back and hip pain is sometimes ruled out as being sourced in the lumbar spine, so the quest continues to seek out a potential causation. In many patients, this expression is eventually diagnosed as piriformis syndrome or sacroiliac joint issues, which are rarely accurate conclusions.
The SI joint is implicated when imaging studies show degeneration, but it is crucial to remember that degeneration is normal and part of the typical life of this and almost all joints.
Actual cases of structural joint pain in the SI region are rare. They do occur, but not typically from the normal osteoarthritic processes most commonly blamed.
Ankylosing spondylitis and rheumatoid arthritis can cause severe sacroiliac pain, but these diagnoses are far more verifiable than the osteo form of arthritic process. Many sacroiliac joint issues are blamed on ligament laxity or tension issues, but in my experience, these are almost always illogical and ridiculous diagnostic theories, although they may affect an occasional patient.
To summarize, when considering sacroiliac joint pain, it is key to remember that the SI joint is one of the strongest and best engineered in the body and is less susceptible to injury and degeneration than most other locations. While true structural concerns can occur in extreme cases, the majority of SI joint issues are simply scapegoats on which back and hip pain issues are blamed.
If you have been diagnosed with joint issues in the sacroiliac, make sure to fully understand the nature of your condition and demand diagnostic testing to determine the extent of the deterioration. Once you have test results, be sure to take these to at least one other doctor for evaluation before acquiescing to any drastic treatment modality.