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Sacroiliac Joint Pain

Definition

The sacroiliac joint is in the low back where the spine meets the pelvis. Sacroiliac joint pain is discomfort in this area. This pain is a symptom that may come from a number of conditions or diseases.

Sacroiliac Joint
sacroiliac joint
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Causes

Pain may start in the joint, or in surrounding ligaments or nerves. Ligaments are bands of tissue that connect one bone to another. The sacroiliac joint has many nerve endings. The nerves send pain signals to the brain. Pain in this region may be caused by many factors.

  • Twisting, bending, or moving in a way that triggers sacroiliac joint pain
  • Infection of the joint
  • Osteoarthritis of the joint, which is more common in older adults
  • Trauma , such as an auto accident
  • Stress fractures , which is common in athletes
  • Pregnancy
  • Inflammation of the joint, which can occur with ankylosing spondylitis

Risk Factors

Factors that may increase your chance for sacroiliac joint pain include:

  • Weak muscles
  • Bending or twisting the back
  • Improper lifting
  • Inflammatory conditions, such as ankylosing spondylitis or psoriatic arthritis

Symptoms

Sacroiliac joint pain may cause:

  • Mild-to-severe low back pain
  • Pain in the buttocks
  • Pain that seems deep in the pelvis
  • Pain in the hip or groin or back of the thigh
  • Pain that radiates down the leg on the affected side
  • Stiffness of the lower spine
  • Certain activities may increase the pain, such as walking, twisting, or bending

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Finding the source of sacroiliac joint pain is often difficult. Tests depend on your medical history and the suspected cause.

Tests may include:

  • Imaging tests with x-rays or a CT scan
  • Joint injections or nerve blocks—drug injection to determine if the pain starts in the joint

Treatment

Treatment depends on the cause of the pain. Any underlying condition would receive treatment specific for that disease. Regardless of the cause, short-term rest is often advised.

Talk with your doctor about the best treatment plan for you. Options may include one or more of the following:

Medication

Your doctor may recommend:

  • Over-the-counter pain relievers, such as acetaminophen or other non-steroidal anti-inflammatory medications (NSAIDs)
  • Prescription pain relievers
  • Muscle relaxants
  • Steroid injections into the sacroiliac joint

Physical Therapy

Physical therapy may include:

  • Exercises to stretch the muscles of the lower back
  • Exercises to strengthen the muscles which support the area
  • Exercises to affect the motion of the sacroiliac joint
  • Applying ice to the painful area
  • Applying deep heat to the sore area

Prevention

To reduce your chance of developing sacroiliac joint pain, take these steps:

  • Exercise regularly to keep muscles strong
  • Maintain good posture
  • Use proper techniques for bending, lifting, or playing sports

Revision Information

  • American Academy of Orthopaedic Surgeons

    http://www.aaos.org

  • Arthritis Foundation

    http://www.arthritis.org

  • Arthritis Society

    http://www.arthritis.ca

  • Canadian Orthopaedic Association

    http://www.coa-aco.org

  • Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 2, 2013. Accessed July 24, 2013.

  • Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg . 2005 Nov;101(5):1440-1453.

  • d'Hemecourt PA, Gerbino PG II, et al. Pediatric and adolescent sports injuries: back injuries in the young athlete. Clinics In Sports Medicine . 2000 Oct;19(4):663-679.

  • Dreyfuss P, Dreyer S, et al. Positive sacroiliac screening tests in asymptomatic adults. Spine . 1994;19(10):1138-1143.

  • Inflammatory arthritis of the hip. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00396 . Updated August 2007. Accessed July 24, 2013.

  • Sacroiliac joint dysfunction. Orthogate website. Available at: http://www.orthogate.org/patient-education/lumbar-spine/sacroiliac-joint-dysfunction.html . Updated July 27, 2006. Accessed July 24, 2013.

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  • Speldewinde GC. Outcomes of percutaneous zygapophysial and sacroiliac joint neurotomy in a community setting. Pain Med . 2011;12(2):209-218.

  • Spinal injections. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00560 . Updated November 2009. Accessed July 24, 2013.