Sacroiliac Joint Pain Causes and Treatment | Frequently Asked Questions

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Sacroiliac joint pain may be what’s causing your lower back discomfort. Find out how to remedy it here.
RELATED: An Overview Of Back Pain and Facet Joint Disorders
In this article:

  1. What Is a Sacroiliac Joint?
  2. Is Sacroiliac Joint Disease Painful?
  3. What Causes Sacroiliac Joint Pain?
  4. How Is Sacroiliac Joint Pain Diagnosed?
  5. What Sacroiliac Joint Provocative Tests Are There?
  6. What Sacroiliac Joint Pain Relief Options Are There?

A Guide to Sacroiliac Joint Pain

What Is a Sacroiliac Joint?

The sacroiliac joint is also known as the SI joint. It is located in between the sacrum and the pelvis. This joint supports the weight of the upper body and connects the left and right ilium bones of the pelvis.

Is Sacroiliac Joint Disease Painful ?

The most common description for sacroiliac joint pain is “lower back pain”. It is characterized by the following:

  • Sharp, stabbing pain in the groin, thighs, and buttocks. This type of pain is described as sciatic-like and hot. There is also a tingling and numbing sensation in the areas.
  • Stiffness. This causes less movement in the lower back, making walking up the stairs or bending down difficult.
  • Pain that worsens with activity. Activities such as climbing stairs, jogging, walking, or putting weight on one side can add pain to the sacroiliac joint.
  • Feeling unstable in the pelvis and/or lower back. People with this condition feel like their pelvis will buckle when standing, walking, or moving from a standing to a sitting position.

What Causes Sacroiliac Joint Pain?

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Sacroiliac joint pain is caused by several factors. The most common cause is when the cartilage covering the bone becomes damaged or worn out.
This causes the bones to rub against each other and degenerative arthritis occurs. Others include:

  • Pregnancy.

During pregnancy, the ligaments holding the SI joint becomes relaxed in preparation for childbirth. This causes additional motion in the joints that adds stress and abnormal wear.
Pregnant women gain weight and change their walking patterns which brings additional stress to the sacroiliac joints.

  • Existing inflammatory disorders.

These may include several types of arthritis such as rheumatoid arthritis, psoriatic arthritis, reactive arthritis, and ankylosing spondylitis.

  • Gait issues.

For patients with scoliosis or leg length discrepancy, the uneven pressure on the pelvic area can cause sacroiliac joint pain.

  • Previous lower back surgery.

A study on risk factors for sacroiliac joint pain shows fusion surgery displaces pressure on the joints. Hip replacement surgery and bone grafts also cause sacroiliac joint pain.

  • Sports injury.

Activities that repeatedly add pressure to the joints can lead to sacroiliac joint pain such as contact sports, heavy lifting, or labor-intensive jobs.

  • Improper posture.

Posture plays a big role in keeping our bones and joints healthy. Years of improper posture can strain the spine and joints causing pain and inflammation.

How Is Sacroiliac Joint Pain Diagnosed?

A rheumatologist can recommend several tests to check the cause of sacroiliac joint pain:

  • An X-ray exam which will show the bones in the hip area.
  • A CAT or CT scan can provide a more detailed look of the patient’s joints and bones.
  • An MRI is also recommended to evaluate the condition of the soft tissues such as muscle and ligaments. This test can also determine if there is excessive fluid in the joint that causes inflammation.
  • General back pain exam will pinpoint where the source of the pain is and rule out any red flags.

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What Sacroiliac Joint Provocative Tests Are There?

These tests will reproduce or provoke the pain to confirm if the patient has sacroiliac joint pain disorder. At least three or more positive tests confirm that the pain comes from the sacroiliac joints, and at least one should be a compression or thigh thrust.

  • FIBER Provocative Test. This test will focus on the front parts of the sacroiliac joints. The patient is asked to lie down and put pressure on the hip area.
  • Compression. As the name suggests, this test applies compression to the sacroiliac joints. It will create pressure across the pelvis.
  • Thigh Thrust. This test will apply sliding and shearing pressure on the joints.
  • Distraction Provocative Test. This test will “distract”or stretch apart the sacroiliac joints.
  • Gaenslen Provocative Test. This test applies pressure to the joints by pushing the knee to the abdomen.

What Sacroiliac Joint Pain Relief Options Are There?

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Home Remedies
There are several ways to relieve sacroiliac joint pain. Try simple home remedies first:

  • Resting for one to two days may help relax the joints to alleviate pain.
  • Apply ice or hot compress to help reduce inflammation on the joints and relax the muscles.
  • Using support or braces helps patients sit and stand up straight.

Sacroiliac Joint Medications
A common home remedy is to take oral anti-inflammatory medication such as ibuprofen. Also, doctors commonly prescribe oral steroids for short periods of time and suggest taking joint care supplements to reduce pain and inflammation.
Sacroiliac joint injections help alleviate inflammation that causes pain.
Do note that it is important to consult a medical professional prior to taking these pain medications.
Physical Therapy
Physical therapy is a great way to relieve sacroiliac joint pain. The therapy may involve stretching and stabilizing exercises to minimize the pain.
Patients may also be given sacroiliac belts that wrap around the hips to stabilize the joints.
Exercises such as yoga and pilates may also be recommended by health professionals to those who suffer from sacroiliac joint pain but it is not always the case. Aerobic exercises may help elevate the blood flow as well.
Like with medication, we advise you to get a proper diagnosis and see a physical therapist first before performing any exercise for your condition.
Back Surgery
If all else fails, surgery is the last option for sacroiliac joint pain treatment. The surgery will remove the cartilage in between the joint and replace it with plates and screws.
Learn the causes and treatment of sacroiliac joint pain from nabil ebraheim:

Many factors cause sacroiliac joint pain. Undergoing tests designed to diagnose the condition may help identify the underlying cause.
How do you manage lower back pain? We’d love to hear from you in the comments section!
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