March 1, 2023

Treating SI Joint Pain

What is SI-Bone?

SI-Bone specializes in diagnosing and treating sacroiliac (SI) joint dysfunction. They have innovative products, including minimally invasive surgical techniques and implants designed to stabilize the SI joint and alleviate pain caused by SI joint dysfunction.

What is the SI Joint?

The SI joints are between the iliac bones and the sacrum, connecting the spine to the hips. When you walk, run, or engage in physical activities, the SI joint helps distribute the load between the upper and lower body, which helps you maintain stability.

This joint acts as a bridge, allowing forces to pass between the spine and the pelvis, ensuring efficient movement and support throughout the body. It is also a synovial joint with a lubricating fluid-filled capsule that allows smooth movement and absorbs shock.

SI Joint Pain Symptoms. What Does SI Joint Pain Feel Like?

SI joint pain symptoms vary widely and can be misdiagnosed as other conditions affecting the spine, hips, or lower back. At times the pain from SI joints is minimal, but as your pain increases, it can significantly impact your ability to do the things you love.

Here are the most common symptoms that could indicate SI joint pain treatment is needed:

• Lower back pain: The pain may range from a dull ache to a sharp, stabbing sensation, typically felt on one side of the lower back.
• Hip, groin, or buttock pain: Pain may radiate from the SI joint to the hip, groin, or buttocks, mimicking the symptoms of hip joint problems.
• Leg pain: In some cases, SI joint pain can cause pain or aching sensations that extend down the back of the thigh or even further down to the knee.
• Generalized pain or stiffness during movement: SI joint dysfunction often causes lower back and hip stiffness. Walking, standing up from a seated position, or transitioning from sitting to standing may exacerbate SI joint pain.
• Lower extremity pain, numbness, tingling, weakness: With SI joint pain, it’s common to feel like your legs are unstable or experience them buckling under normal circumstances.
• Sleep disturbances: Laying in one position for a long time or frequent tossing and turning can cause SI joint pain to increase. Patients often complain of waking multiple times during the night due to pain from SI joints.
• Pain while sitting or rising from a seated position: SI joint pain and stiffness can significantly increase when you’ve been sitting for an extended time. Standing up can be excruciatingly painful, even when sitting for a short time.

What are the Common Causes of SI Joint Pain?

As we age, our joints experience gradual wear and tear, which can lead to pain from SI joints. Some people have injured or stretched the ligaments around the SI joint, which can no longer provide the needed stability. SI joint pain can occur when the ligaments are too tight or loose.

Common injuries that can damage your SI joint:

• Motor vehicle accidents.
• Injuries from contact sports.
• Falls on the buttocks or hips.
• Strenuous lifting, twisting, or awkward movements.
• Pregnancy and childbirth.

Common causes of SI joint degeneration:

• Lumbar or joint replacement surgery.
• Osteoarthritis.
• Previous iliac crest bone graft (ICBG).
• SI joint infections.
• Scoliosis or other structural abnormality of the back, legs, or hips.

If your low back pain may be coming from the SI joint, chat with us to find a spine surgeon who offers SI-BONE procedures like iFuse.

How is SI Joint Pain Diagnosed?

A comprehensive evaluation by a doctor is necessary to make sure your pain is related to SI joint pain. A combination of accurate health history, physical exam, and imaging will provide the most accurate diagnosis.

Before your appointment, you’ll be asked for a detailed history of your pain, any injuries or chronic conditions, and any SI joint pain treatments you’ve tried.

During your appointment, the doctor will ask you to bend, stretch, and move in ways that help them determine the source of your pain. They will also check for tenderness or swelling that may indicate the source of your pain.

X-Rays, a CT scan, or MRI can provide additional information about the condition of your SI joint. They may or may not provide conclusive results, but they help rule out other issues or confirm your pain has multiple root causes.

Provocative tests are also used to identify SI joint pain. You will lie on your back or side while your physician applies varying degrees of pressure to your hips, knees, and surrounding areas. They’re paying close attention to when and where you have pain during these movements. If three or more positions cause significant pain near your SI joint, SI joint dysfunction is likely the source of your pain.

Your physician may also order SI joint injections to see if your pain decreases after the injection. If your pain level doesn’t change after the injection, your physician will order additional testing to evaluate other possible causes.

What Are the Non-Surgical SI Joint Pain Treatments?

Once your physician determines your pain is likely due to SI joint degeneration or injury, they will probably recommend you begin with non-surgical interventions. The first recommendation is to stop doing things that cause (or increase) your pain. Reducing activities and alternating heat and cold packs while you rest can reduce SI joint pain symptoms.

In addition to restricting your activities, your doctor may recommend the following:

Medication

• Pain relievers (over-the-counter or prescription, if needed).
• Anti-inflammatory meds (such as nonsteroidal anti-inflammatory drugs or NSAIDs).
• Muscle relaxants (to help reduce muscle spasms).
• Cortisone shots placed in the SI joint.

Therapy

• Physical therapy including range-of-motion, stretching, and strength-building exercises.
• Massage therapy to ease sore muscles and increase flexibility in the joint, hip, and low back.
• Occupational therapy to evaluate your environment and routine to determine if adjustments will decrease the strain on your SI joint.

What are the SI-Bone Treatment Options?

If all other treatments don’t relieve your SI joint pain symptoms, your doctor may recommend joint fusion surgery, where the two bones in the SI joint are fused together to provide more stability.

Here are two types of surgical SI joint pain treatment:

iFuse

The iFuse Implant System® is a minimally invasive SI joint fusion surgery that significantly reduces joint pain with less recovery time than traditional surgery. In the hour-long procedure, your surgeon makes a one to two-inch incision along the side of the buttock and uses specialized equipment to place three small titanium implants across the SI joint.

The implants stabilize the joint and provide the stabilization you need to resume your normal activity level. Depending on your health and additional medical conditions, surgery can occur in a hospital or ambulatory surgery center.

Traditional “Open” Surgery

Open surgery for sacroiliac joint fusion typically lasts a few hours and occurs in a hospital. Surgeons make an incision to access the joint and remove damaged cartilage from the joint. They then use screws to attach bone grafts strategically and fuse the joint. Following open surgery, patients typically require a hospital stay of several days to monitor healing, protect from infection, and begin physical therapy.

What Should I Expect After iFuse Surgery?

The iFuse method minimizes damage to surrounding tissues, decreasing postoperative pain and significantly shortening recovery time. You will likely receive pain medications, instructions to use ice packs on the surgical site, and a referral to a physical therapist. Your surgeon may also recommend gentle exercises and walking before your first therapy appointment.

You may spend a few weeks on crutches, and post-op pain typically fades within the first week or two. Healthy patients often quickly return to full weight-bearing. Patients with associated health conditions such as age, osteoporosis, altered bone health, impaired balance and gait, or other musculoskeletal disorders require a more extended rehabilitation period.

Your surgeon will schedule a follow-up visit, and they may order X-rays or scans to see how your SI joint is healing. They’ll also ask you to report your SI joint pain symptoms and changes to your activity level, sleep, and range of motion.

Your doctor will advise you when it is appropriate to resume your daily and weight-bearing activities and when you can return to work.