What causes sacroiliac joint pain?
It is not yet known what causes the pain, but it is believed that changes in the normal movement of the joint cause it.
There are two main sources of sacroiliac joint dysfunction that cause pain:
Hypermobility / instability- Excess movement
Hypomobility / rigidity- Little movement
Hypermobility is the most common issue. Hypomobility is usually associated with pathologies that tend to harden the sacroiliac joints such as ankylosing spondylitis. It is the most common cause of back and neck pain.The dysfunction of the sacroiliac joint is one of the most frequent causes of back pain. The sacroiliac joints are located in the lower part of the spine and connect the bone of the pelvis to the sacrum. This dysfunction is more frequent in young or middle-aged women.
The dysfunction of the sacroiliac joint occurs when the abnormal movement of these joints produces pain.
Among some of the causes are:
Hypermobility or hypomobility of the sacroiliac joints:
Ligament injuries or pregnancy are some of the causes of excess movement (hypermobility) in the sacroiliac joints. Although the lack of movement in these joints (hypomobility or fixation), as a result of a degenerative disease such as arthritis, for example, can also be causing pain in the area.
In some cases, the sacroiliac joints over compensate problems in nearby joints and this can cause pain. For example, in the case of lumbar spinal fusion, patients manifest pain in the sacroiliac joint because of reduced movement in the lumbar spine segments.
Have one leg shorter than the other
The most common symptoms are back pain and buttocks. The pain can affect one side or both joints.
The pain usually gets worse while standing and walking. It usually improves when you lie down, but not always.
Pain may radiate to the leg and foot. It can be confused with disc herniation in the lumbar spine (lower back).
Pain may radiate to the groin area.
Muscle spasm (painful contraction) in one or both muscles of the buttocks.
Sometimes it can be painful to sit up and cross-legged.
Leaning forward, climbing stairs, climbing slopes and getting up when you are sitting, can also cause pain.
Diagnosis of sacroiliac joint dysfunction:
The accurate diagnosis of sacroiliac joint dysfunction is usually difficult, because the symptoms are similar to other common conditions of the back. The diagnosis begins with:
The doctor will ask questions about:
Symptoms, positions or activities that make your symptoms worse or better, previous injuries.
It is useful to rule out other causes. The doctor will try to determine the cause by moving the joint.
He will review posture, how he walks and where the pain is located.
The sensations of the skin, muscle strength and reflexes are put to the test.
Tests to show symptoms of sacroiliac dysfunction.
A complete physical examination is the best method to evaluate the dysfunction of the sacroiliac joint.
- Treatments may include:
- Rest, cold and heat
The initial treatment may include the use in intervals of 15 to 20 minutes of cold to reduce inflammation. This should be accompanied by rest and is indicated especially in the acute and intense pain stage. The heat can help the healing process but not at the stage of more pain.
In the first stage of treatment, drugs for pain and inflammation can be indicated.
This type of treatment is very effective when the joint is locked. Not so if you have hypermobility.
Physiotherapy and exercise:
Physiotherapy helps to strengthen the muscles that surround the affected joint and to increase the range of mobility. All kinds of low impact physical activity favor the increase of blood flow in the area.
Injectables in the sacroiliac joint:
Anesthetic injection such as lidocaine that produces immediate pain relief