andre panagos MD

The sacroiliac joint transmits vertical forces from the spine to the lower extremities. It does not have muscles that cross and stabilize the joint so the ligaments that surround the joint also stabilize it. It is thought to be the cause of 15% to 30% of chronic low back pain cases but it is often not considered in the assessment. Unfortunately, one third of lumbosacral spinal fusion patients also develop sacroiliac joint pain.

 

Pain originating from the sacroiliac joint may be caused by inflammation, fracture, ligamentous injury, arthritis or infection. It can be very difficult to differentiate between these diagnoses.

 

Symptoms:

• Pain may be felt in the buttocks, lower back, groin, abdomen, lower leg and  foot

• The pain is often on one side.

• The pain is often worsened with entering or exiting a car

• Often a pop is heard that results in pain relief

 

Other diseases that can mimic [diagnosis] include:

• Ankylosing spondylitis

• Lumbar disc pain

• Hip osteoarthritis

• Malignancy

• Myofascial pain

• Radiculopathy

• Referred visceral pain

• Rheumatoid arthritis

• Trochanteric bursitis

• Facet joint pain

 

Treatments

• Nonsteroidal anti-inflammatory medications such as naprosyn or ibuprofen

• Analgesics

• Sacroiliac joint belt, especially in pregnancy related pain

• Focus on correcting strength and muscle imbalance

• Pelvic girdle muscle strengthening

• Joint mobilization

• Fluoroscopically-guided contrast-enhanced sacroiliac joint injection

• Ultrasound-guided sacroiliac joint injections

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References

 

Foley BS, Buschbacher RM. Sacroiliac joint pain: anatomy, biomechanics, diagnosis,  and treatment. Am J Phys Med Rehabil. 2006 Dec;85(12):997-1006.

Panagos A. Rehabilitation Medicine Quick Reference-Spine (ed. Buschbacher R.M.)  New York: Demos Publishing; 2010. p. 136-137.