Leg pain from sacroiliac joint dysfunction can be particularly difficult to differentiate from radiating leg pain caused by a lumbar disc herniation sciatica as they can feel quite similar. Sacroiliac joint dysfunction refers to pain in the sacroiliac joint when they move either too much or too little. Watch Sacroiliac Joint Dysfunction Video. The sacroiliac joint connects the hip bones iliac crests to the sacrum , the triangular bone between the lumbar spine and the tailbone coccyx.
The primary function of the sacroiliac joints is to absorb shock between the upper body and the pelvis and legs. See Sacroiliac Joint Anatomy. The sacroiliac joint typically has little motion. The joint is reinforced by strong ligaments surrounding it, some of which extend across the joint in the back of the pelvis.
Once you understand where the SI joint is located and what it is, it's easier to understand how it can be injured or degenerate over time and cause low back or spine, pelvic, leg, or buttock pain. Mechanical strain and injury to the SI joint are produced by either a combination of vertical compression and rapid rotation i. Injuries of this type can produce ligamentous laxity and allow painful abnormal motion, in other words, SI joint pain.
Instability of the sacroiliac joint can also arise from lumbar spine surgery in which a large portion of the ilio-lumbar ligament is injured. SI joint pain can also be caused by leg length discrepancy, gait abnormalities, prolonged, vigorous exercise, trauma, traumatic birth, and long scoliosis fusions to the sacrum.
Need More Help? More Related Resources Here's a quiz to determine whether your SI joint is a contributor to pain in your lower back, pelvic region, buttocks, or legs.
Sacroiliac SI joint dysfunction refers to a few conditions that cause instability and pain of the SI joint.
SI Joint Strain, Injury, and Instability Once you understand where the SI joint is located and what it is, it's easier to understand how it can be injured or degenerate over time and cause low back or spine, pelvic, leg, or buttock pain.
Common Causes of SI Joint Dysfunction and Pain Mechanical strain and injury to the SI joint are produced by either a combination of vertical compression and rapid rotation i. Do you have SI joint pain? Talk to a doctor trained in SI joint diagnosis and treatment. There are specific tests to determine whether the SI joint is the source of pain. You may be asked to stand or move in different positions and point to where you feel pain.
Your doctor may manipulate your joints or feel for tenderness over your SI joint. Imaging studies, such as X-ray , CT , or MRI , may be ordered to help in the diagnosis and to check for other spine and hip related problems. A diagnostic SI joint injection may be performed to confirm the cause of pain. The SI joint is injected with a local anesthetic and corticosteroid medication. The injection is given using X-ray fluoroscopy to ensure accurate needle placement in the SI joint. Your pain level is evaluated before and minutes after injection, and monitored over the next week.
If your pain level does not change after the injection, it is unlikely that the SI joint is the cause of your low back pain. Nonsurgical treatments: Physical therapy, chiropractic manipulation, and stretching exercises help many patients. Some patients may require oral anti-inflammatory medications or topical patches, creams, salves or mechanical bracing.
Joint injections : Steroids can reduce the swelling and inflammation of the nerves. Joint injections are a minimally invasive procedure that involves an injection of a corticosteroid and an analgesic-numbing agent into the painful joint Fig. While the results tend to be temporary, if the injections are helpful they can be repeated up to three times a year. Surgery: If nonsurgical treatments and joint injections do not provide pain relief, your physician may recommend minimally invasive SI joint fusion surgery.
Through a small incision, the surgeon places titanium metal implants and bone graft material to stabilize the joint and promote bone growth. The surgery takes about an hour. The patient may go home the same day or following day.
For several weeks after surgery, the patient cannot bear full weight on the operated side and must use crutches for support. A positive attitude, regular activity, and a prompt return to work are all very important elements of recovery. If regular job duties cannot be performed initially, modified light or restricted duty may be prescribed for a limited time.
This information is not intended to replace the medical advice of your health care provider. At Mayfield, patients who come to us with neck and back problems are given a rapid review of their medical condition within a few days
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