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Sacroiliac Joint Pain

The backbone and the pelvic bone join to form the sacroiliac joint. The backbone has a triangular section where it ends called the sacrum. Sacrum merges with the uppermost part of the pelvis called the ilium. The joints absorb shock and provide stability to the body. Sometimes an underlying condition of the joint or injury causes pain in the lower back, hips or legs.

We requested more details from Dr Vijay Kumar Sohanlal – a highly experienced orthopaedic surgeon and a senior specialist in joint replacement and orthopaedics at MGM healthcare and Mahi Clinic – Chennai. Dr Vijay explained that there is hardly any movement at the joint. It’s further strengthened by several types of ligaments. Muscles and tissues around the joint provide additional stability. The minimal movement of the joint helps in the flexibility of the body.

Cause

There is a possibility that the muscles and ligaments around the joint may loosen or tighten beyond the normal limits. The patient may experience pain when this happens. Several reasons may lead to this condition, including a car accident or a severe fall. Pregnancy and childbirth can also cause this as the pelvic bone widens in preparation for childbirth and stretches the ligaments attached.

Osteoarthritis can also play a role in sacroiliac joint pain as the cartilage may start wearing off due to osteoarthritis. The bones may start rubbing against each other causing pain. Ankylosing spondylitis is also known to be responsible. It’s another type of arthritis that causes inflammation in the joints of the spine.

Some people may be born with legs of unequal length. That can cause uneven movement of the pelvis and this may lead to joint pain.

Symptoms

The most common symptom is lower back pain that may range from mild to severe. It’s usually on one side but may be possible on both sides also. Pain may also be felt in the hips and thighs. In some cases, the pain may be similar to sciatic pain – sharp and stabbing along with numbness and tingling.

Mobility issues may be experienced by the patient while climbing stairs or bending as the joint becomes stiff. This may be accompanied by a feeling of instability and discomfort when bending over.

Diagnosis

The doctor evaluates the medical history of the patient related to any injury or operation as well as physical problems in standing or climbing stairs. It’s usually difficult to diagnose this condition, so the doctor does some tests to rule out other underlying causes. The specialist may ask the patient to make some movements and inform about the pain areas.

Another special diagnosis that the specialist may perform is by giving local anaesthesia in the sacroiliac joint. The specialist evaluates the pain level before and after the injection. If the pain reduces considerably then it’s very likely that the problem is in the sacroiliac joint.  

Treatment

The most important step is to take a rest from the activity that increases the pain and minimize other movements also. It helps to apply an icepack on the lower back. When the pain subsides, a hot pack may be applied. Support belts are available in the market that may reduce some pain. Anti-inflammatory medicine and muscle relaxants are also helpful.

If the above treatments don’t give the desired result, then surgery may be recommended by the specialist. The surgery is done to fuse the bones using screws and plates.

Expected Outcome

The pain may not last long if the cause is temporary like pregnancy or injury but may be chronic in other cases. In any case, treatment is usually beneficial.

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