The sacroiliac joints connect the lower spine and pelvis. These joints are held together by very strong ligaments, which if damaged by injury, poor biomechanics, or inflammatory disease, can lead to chronic pain. Sacroiliac joint pain is usually located either to the left or right of the lower back, although it is sometimes described as a band of pain across the lower back at about the belt line. The pain can range from an ache to a sharp pain which can restrict movement. Sacroiliac joint pain may radiate out into your buttocks and low back and will often radiate to the front into the groin and occasionally the testicles. Very occasionally there may be referred pain into the lower limb which can be mistaken for sciatic nerve pain.
Classic symptoms also include difficulty turning over in bed, struggling to put on shoes and socks as well as pain getting your legs in and out of the car. Stiffness in the lower back when getting up after sitting for long periods and when getting up from bed in the morning is common. There is likely to be aching to one side of your lower back when driving long distances.
The pain from the sacroiliac joints is often treated with a combination of injection therapy and physical medicine. A multipronged treatment approach that combines the benefits of Physical Therapy, Chiropractic or Sports Massage will yield the best results and is made possible by the rapid pain relief following injection therapy.
Injection therapy of the sacroiliac joint involves the administration of a local anesthetic and anti-inflammatory medication (corticosteroid) into or around the joint and the nerves that innervate it. A good result immediately following injection therapy indicates the correct area has been identified as the source of the pain. Pain relief from injection therapy can be immediate and may last days, weeks or months. Your doctor may recommend a follow-up treatment called Radiofrequency Ablation of the Sacroiliac Joint to provide even longer lasting pain relief.
There are several causes of sacroiliac joint pain including:
Unequal leg length can cause inflammation and pain in the sacroiliac joint as well as discs and facet joints of the lower lumbar spine.
Traumatic injury from a vehicle accident or fall can damage the joints.
Arthritis from wear-and-tear can occur in sacroiliac joints as well as ankylosing spondylitis – a type of inflammatory arthritis that affects the spine.
Pregnancy also affects the sacroiliac joints as they loosen and stretch to accommodate childbirth. The added weight and altered gait during pregnancy can cause additional stress on these joints and lead to abnormal wear.