Sacroiliac Joint: Frequently Asked Questions

As with all major invasive surgical procedures, some complications are possible with SI joint fusion surgery as well. They include:

• Anesthesia
• Thrombophlebitis
• Infection
• Nerve damage
• Implant/hardware issues
• Nonunion/pseudarthrosis
• Ongoing pain

Your doctor and/or surgeon will advise you about these risks the SI joint fusion surgery can pose.

Your hip pain may be caused by the following conditions:

• Arthritis: Osteoarthritis and Rheumatoid arthritis
• Hip fractures
• Bursitis
• Tendinitis
• Muscle/tendon strain
• Hip labral tear
• Cancers
• Avascular necrosis

So, if you have a hip pain that hinders your day-to-day activities, you are advised to consult your doctor and talk about the symptoms.

Whether you have just recovered from your SI joint dysfunction or you are looking to avoid one in the future, you need to do the following exercises. These can be collectively called “Lumbopelvic Stabilization Training”, which means they can effectively train your lower back and pelvis.

This training will include body weight exercises, stretches, as well as yoga poses. Doing these exercises will help decrease your risks of facing an SI joint injury for the following reasons:

• Increased flexibility will help prevent strain from the tissues that contribute to joint degeneration
• Increased strength in the muscles will give better protection for the bones and joints, thereby, reducing the likeliness of getting injured.

Recommended exercises are as follows:

• Knee-to-chest stretch
• Piriformis stretch
• Knee swipes
• Pelvic tilt
• Bridges
• Cobra pose
• Triangle pose
• Child’s pose
• Bird dog pose

A general tip for preventing injury is to avoid participating in competitive sports like:

• Contact sports
• Weightlifting
• Running
• Basketball
• Volleyball
• Hard twisting movements of your torso

In addition to this, you should also follow the below tips to avoid recurrence:

• Use proper lifting techniques
• Maintain good posture
• Do regular stretching and strengthening exercises
• Maintain an ergonomic workplace
• Take good nutrition
• Maintain healthy weight
• Follow proper stress management and relaxation methods
• Avoid smoking

Remember, as with any other medical condition, surgery should be the last resort for SI joint pain too. In many patients, non-surgical treatments like physical therapy, stretching exercises, and chiropractic manipulation will help.

Some patients will require other treatment options like:

• Oral anti-inflammatory medications
• Topical patches
• Creams
• Salves
• Mechanical bracing
• Joint injections
• Nerve ablations

If these non-surgical treatments don’t provide you the pain relief, your doctor may prescribe minimally-invasive sacroiliac joint fusion surgery.

During this surgery, a small incision will be made through which the surgeon will place metal implants and bone graft to stabilize your joint and to enhance bone growth.

Thousands and thousands of people suffer from lower back pain. In the US, it’s a common complaint which can persist for several months or years. In most cases, much of what is believed as lower back pain is actually due to a sacroiliac joint dysfunction. Unfortunately, sacroiliac joint pain is one of the common causes of lower back pain, which is highly misdiagnosed.

SI joint dysfunction doesn’t usually show up on the imaging tests, such as X-ray, which makes it difficult to diagnose accurately.

Usually, the first step in diagnosis is a physical examination. During this, you will be asked about your medical history to determine whether you have any other underlying condition that could cause the pain. As part of this physical exam, your doctor will perform some simple tests to identify the source of pain.

Examples of these tests include:

• Flexion Abduction External Rotation (FABER) test
• Fortin finger test
• Pelvic gaping test
• Pelvic compression test
• Sacral thrust test
• Thigh thrust test
• Gaenslen’s test
• CAM impingement test
• Rotation and extension tests

However, ruling out other causes of your back pain can be harder than you think. So, if your doctor is still not sure the cause of your pain, he/she will order additional tests, such as X-rays, CT scans, MRI scans, bone scans, and lab work.

When it comes to X-ray, your physician may order imaging results of pelvis, hips, and lumbar spine in order to determine the underlying cause of your pain.

If none of the tests show any sign of SI joint dysfunction, your doctor may utilize an SI joint infection to accurately diagnose your condition. If this injection alleviates the pain immediately, it is a sign that the SI joints are most likely the cause of your pain. This injection will be done with the help of an X-ray in order to ensure that it goes into the SI joints.

SI joint pain will be felt in your lower back and the butt. Usually, this pain is the result of any damage or injury to the joint that is located between your spine and hip.

It’s to be understood that the SI joint pain can mimic some other conditions like a herniated disc or a hip problem. This makes it important for the patient to get diagnosed accurately so as to start the proper treatment.

When you have an SI joint dysfunction, pain can be caused by the inflammation of the joint. This will be commonly felt on one of the sides of your lower back to the right/left of the midline where your joint is located.

When your SI joint dysfunction is very severe, you can feel the pain in your hip. The pain can also refer to the other regions like groin, butt, and back of the thighs.

The sacroiliac or SI joint is located in your pelvis and connects the iliac bone (pelvis) to your sacrum (the lower extremity of your spine – just above your tailbone). This SI joint is responsible for transferring weight, as well as forces between the upper body and the legs. Thus, it acts as an essential component for energy transfer between your torso and the legs.

The sacroiliac joint in humans is stabilized by a group of ligaments and muscles.

It’s often not so easy to diagnose the SI joint problems, especially as the primary symptom is lower back pain. As you should be aware, this is a common symptom of several different spinal disorders. So, it won’t be always easy for your doctors to recognize the SI joints as the issue.

Even though the sacroiliac joint is one of the largest joints in the body, it’s deeply buried inside the pelvis. The placement of the joint is another reason why it’s hard for your doctor to locate the issue during the physical examination. Furthermore, it can also be hard for imaging tests to capture the issues with the joint.

So, there are possibilities that SI joint problems are confused with other conditions, such as sciatica and hip arthritis. And, routine tests cannot always pinpoint where actually the issue is.

So, doctors will usually rely on the results of more than one test to diagnose the SI joint problem. Apart from the physical examination and medical history, common tests that are conducted by doctors are:

• Cranial shear test
• Flamingo test
• Gaenslen's test
• Gillet test
• Pelvic compression test
• Pelvic distraction test
• Patrick's test
• Sacroiliac shear test
• Thigh thrust test
• Imaging Tests
• Injection Test

In general, if you have an SI joint dysfunction, you will experience pain and impaired function in the following areas:

• Lower back
• Spine
• Buttocks
• Pelvis
• Groin
• Legs

However, it’s important to note that sacroiliac joint symptoms can be similar to those of some other conditions of the pelvis, hip, and lumbar spine. The common symptoms of SI joint pain are:

• Lower back pain
• Feeling of pain, numbness, weakness, and/or tingling in the lower extremity
• Feeling of leg buckling or giving way
• Sleep disturbance due to pain
• Inability to sit for long or needing to sit on one side
• Pain that gets worse with standing and/or walking and improves upon lying down

Sometimes, SI pain is reported to elevate during sex and menstruation in women.

To confirm if your SI joint is not functioning properly, you will require an appropriate interpretation of your medical history, clinical examination, and imaging results. A healthcare provider who is trained in SI joint dysfunction treatment and diagnosis will be the best person to diagnose your SI joint issue accurately and set you on the right path for last relief.

If you have difficulty sleeping comfortably, feeling that your knee is giving way, tenderness in your buttocks, or pain in certain bending or lying positions, you must speak to your doctor and get properly diagnosed.

A person will be considered to be at risk for SI joint problems if:

• She is a woman. Women have broader pelvises and greater curvature of the lumbar spine that lead to different sacroiliac joint biomechanics.
• She is pregnant. Often, pregnancy will lead to stretching of the SI ligaments.
• He/she has had lumbar spine surgery.
• He/she is smoking.
• He/she has a poor physical condition.
• He/she has a positive family history.
• He/she has occupational exposure to recurrent trauma to the sacroiliac joint.

The SI joint problems are more common than you think. For decades, the SI joint was thought to be a common cause of lower back and/or leg pain, even though the difficulty in accurate diagnostic testing left several people in the medical field skeptical. In the present day, it’s estimated that the SI joint is behind the 15 to 30% of cases of lower back pain.

According to the statistical data, it’s more common in young, as well as middle-aged women. Also, women who are in their pregnancy or who have recently delivered a child are more prone to SI joint pain.

Some studies have shown that some patients develop SI joint problems following lumbar spine surgery.

While it’s true that most of the joint replacement surgeries are performed in the people of 55 to 80 years, it’s to be understood that older or younger age isn’t a contraindication to any surgery. Rather, doctors are keener in your overall health. Therefore, a younger individual may be considered unsuitable for some surgeries, while an elderly individual can easily breeze through the evaluation.

When it comes to a joint replacement surgery, your orthopedic surgeon will focus on the following factors:

• Your health status
• Your physical strength
• Your cognitive ability

You may be excluded from a joint replacement surgery if:

• Have severe osteoporosis
• Have an existing infection
• Are a smoker
• Have obesity
• Are an alcohol consumer
• Are a victim of substance abuse
• Have a mental illness

Strangely, you may also be considered ineligible if you are too young. This is because the joint prostheses have a short lifespan and the doctors will often delay the joint replacement surgery as much as possible in order to make sure that the new joint can stay for the rest of your life.

In a joint replacement surgery, damaged or diseased part of a joint will be removed and replaced with a new, man-made part. Typically, this would help get rid of the pain that you might be experiencing as the diseased cartilage and bone are removed. In addition, a joint replacement will enhance the functionality of your joints.

However, recovery and rehabilitation after a joint replacement surgery will vary from one person to another. The major factors that have roles to play in the success of joint replacement surgery include:

• Physical condition
• Bodyweight
• Activity levels
• Anatomy
• Willingness to follow your surgeon’s instructions

Most patients will feel temporary pain in the replaced joint as the surrounding muscles will be weak due to inactivity and your body is adapting to the new joint. This pain should go away in a few months.

It’s to be noted that exercise is a critical part of the recovery. Please consult with your doctor to know about the specific exercises to help regain movement and strengthen the joint.

After a joint replacement surgery, most patients will be able to perform day-to-day activities easily. However, as with other major surgeries, there are risks associated with joint replacement surgery as well. Your orthopedic surgeon is the best person to determine if the replacement surgery is right for you. You should also keep in mind that the individual results may differ, although normally people can expect improvement in pain and mobility after joint replacement surgery.

You should understand that there are no set rules when it comes to a hip replacement surgery. However, according to doctors, the surgery should not be the first option. Most often, patients try out simpler things before they end up for surgery. The simpler options would include:

• Anti-inflammatory drugs
• Cortisone injections
• Physical therapy
• Braces
• Crutches or walkers

Practically, you may need a hip replacement if you have the following symptoms:

• Hip pain that makes you stay awake or that awakens you at nights
• Hip pain that decreases your ability to rise up from the chair, climb up the stairs, or get into the car
• Hip pain that makes it less or not possible for you to engage in activities
• Hip pain doesn’t go away after trying other treatments for several months

Normally, your doctor would be the best person to decide on whether you need a hip replacement or not.  He/she will recommend a hip replacement when he/she realizes that non-surgical or less-complicated surgeries wouldn’t help or when the tests indicate advanced arthritis or joint damage. A hip replacement will also be prescribed in the cases where you suffer from severe side effects from the drugs for your hip or knee pain.

Ice that is applied to your lower back and pelvis regions can help reduce inflammation and relieving pain, as well as discomfort. It will also help:

• Decrease the swelling
• Numb the sore tissues
• Stop the nerve impulses
• Loosen the tighter lower back muscles

To do this, you should lie on your side by placing a pillow underneath your head. Now, gently rub the frozen cup of ice in a circular movement around the area of pain. Make sure you are not exceeding five minutes in your ice massage. Repeat this process for 2 to 5 times a day.

If you think this ice massage is not for you, you can go for simpler options, such as a bag of ice wrapped in a piece of cloth.

On the other hand, heat that is applied around the SI joint may help alleviate pain by decreasing the muscle tension and/or spasms.

To do this, it is best to apply heat to the lower back as this is the region where the nerve root will be pinched and/or irritated. While applying heat therapy, it’s important to know that the temperature should be warm and not hot. The duration of the heat therapy should be 15 to 20 minutes per session if the pain isn’t severe. In case of severe pain, you can extend up to 30 minutes to 2 hours.

Note: As a general rule of thumb, ice therapy is recommended for the first 2 to 7 days after the onset of SI joint pain. Once the acute pain is subsided, you can start applying the heat therapy.

The good news today is that there are several options to treat the SI joint pain. Each of the treatment options will be delivered with the primary aim of relieving your SI joint pain while also improving the quality of life. But, before you start trying out any treatment, you must completely stop or avoid any activity that is causing the pain.

The next step towards relieving your SI joint pain will involve a mix of rest, medications, and exercises.

Medications:

• Acetaminophen can help your SI pain. But, it’s to be noted that this medication will not help reduce the inflammation.
• Non-steroidal anti-inflammatory drugs will help reduce both pain and inflammation.

Make sure to consult with your doctor before taking the over-the-counter drugs. If these over-the-counter medications are not working for you, your doctor may prescribe corticosteroids. These can be taken orally or as injections.

Physical Therapy:

Physical therapy can help relieve the stress applied to the SI joints. There are some specific stretching exercises and range of motion exercises to help strengthen your SI joints.

Interventional Pain Management:

The interventional pain management methods, such as radiofrequency ablation and electrical stimulation can help relieve your SI joint pain.

SI Joint Brace:

The SI joint braces will wrap around the hips so as to hold the SI joints together, thereby reducing the pain.

Rest:

To help relieve your SI joint pain, it’s crucial that you get enough rest and sleep. Try to sleep for at least 7 to 8 hours during the night because this will help you recover quickly. Also, you must make sure that you rest your body all through the day by either sitting or lying down to help relieve your SI joint pain.

Ice and Heat:

Applying ice and heat in turns will help relieve your SI joint pain, as well as swelling.

Surgery:

Surgery for SI joint pain is rare. If your pain doesn’t respond to any of the above non-surgical treatments, your doctor may recommend surgery.

While not all cases of SI injury can be treated, some exercises can be helpful toward alleviating SI joint pain. At the same time, exercises can help cure lower back pain and can even prevent SI joint dysfunction from re-appearing.

Although intense exercises can put pressure on the SI joints and cause pain, your doctor and/or physical therapist will recommend specific stretches and exercises as part of your SI joint treatment. See the recommended exercises below:

Stretching Exercises:

Following are the recommended stretches:

• Piriformis stretch
• Lower trunk rotation
• Bridge

Yoga:

For several people with back pain, yoga is the best choice. The following yoga poses can be particularly beneficial:

• Child’s pose
• Cobra pose
• Triangle pose

Apart from these, you can also try water therapy, bike riding, pilates, and Tai chi martial arts for achieving best results.

Are you really struggling with sciatic pain? Read this article here.

Walking is a good way to keep your lower back healthy. If you are suffering from an SI joint dysfunction, you are advised to start slowly, let’s say 20 minutes, 2 times a week. While walking, make sure you use comfortable footwear. The low-heeled version shoes are better. If you do not feel any pain with this walking frequency, you can add more time to your walking session or you can speed up the pace. You can go up to 30 minutes per day.

Most cases of sacroiliac joint pain can be effectively managed at home by following the tips below:

Rest: Your SI joint pain can be alleviated by giving it the sufficient rest period. At least one or two days of rest is recommended.

Ice or Heat: Both hot and cold therapies are found to be effective in SI joint pain relief. An ice pack applied to the lower back, as well as pelvis, will help reduce inflammation and alleviate SI joint pain and discomfort. On the other hand, heat applied to the region will help relieve pain by decreasing muscle tension and/or spasm.

Pain Medications: OTC pain relievers like acetaminophen and NSAIDs like ibuprofen and naproxen can help relieve mild to moderate SI joint pain. However, if you are experiencing severe pain episodes, you may have to take prescription medications like narcotic painkillers after consulting with your doctor.

SI Joint Brace: If your SI joint is too loose, an SI joint brace can be wrapped around your waist and pulled snugly in order to immobilize the region. In most cases, SI joint braces can be helpful when your SI joint is inflamed and painful. Look at the SI joint braces here.

Manual Manipulation: Your doctor may provide tips to make physical adjustments to the SI joint and lower back in order to reduce the joint fixation and muscle tension and to restore the normal range of motion. By following this at home, you can alleviate your SI joint pain.

Physical Therapy: Physical therapy can help rehabilitate your SI joint and to relieve your SI joint pain. Some stretching, strengthening, and aerobic exercises can help you with managing your SI joint pain. So, speak to your doctor and develop an exercise routine today.

For deep insight into the SI pain treatment, please read this article here.

Sacroiliac joint pain or SI joint pain can range from mild to severe based on the severity and the underlying cause of injury. Accordingly, an acute SI joint pain will occur suddenly and is more likely to heal in several days to weeks. On the other hand, chronic SI joint pain will last longer, usually over 3 months. This type of SI joint pain can be felt all the time or it may worsen with certain types of activities.

There are several factors that can contribute to the actual recovery time after a hip replacement surgery. However, typically, hip surgery patients can go back to their normal day to day activities within 1 to 6 months after the surgery.

You must understand that the recovery time the recovery time would vary based on the individual and the kind of surgery he/she received. Also, it’s important that you follow the advice and recommendations the doctor gives you on taking care of your hip after surgery.

In the usual scenario, you will be in the hospital for around 3 to 5 days during which the staff will help you to get out of the bed and walk. A physiotherapist will teach you exercises to help strengthen your hip and how to sit and bend.

After going home, it’s essential that you continue the exercises that your physiotherapist gave you. Generally, you will be able to stop using the crutches in 4 to 6 weeks and you will start feeling normal in about 3 months. By this time, you will be able to carry out your normal activities. You can drive your car in about 6 weeks. And, you will be able to go back to work in 6 to 12 weeks after the surgery. When it comes to your sex life, you will be able to have sex after 6 to 8 weeks after the operation.

If your physician is not prescribing surgery for the hip pain, you can try the following non-surgical options to alleviate the pain and to enhance your mobility:

Medications:

Simple pain relievers like acetaminophen and anti-inflammatory, over-the-counter medications like ibuprofen and naproxen can help reduce pain and inflammation in the joint.

Injections:

Cortisone injections can help provide relief from pain when at the same time reducing inflammation. Alternately, viscosupplementation, which involves injecting hyaluronic acid into the joint, can help the joints to function properly by acting as a lubricant.

Weight Loss:

Many people with hip pain will be overweight. In these people, weight loss can help reduce stress on the weight-bearing joints like the hip. Thus, it can result in decreased pain and increased functionality.

Exercise:

Not only will an exercise routine help increase the range of motion and flexibility, but also they will help strengthen your muscles. Physical exercises are often found to be effective in decreasing pain and enhancing functionality. You can talk to your doctor and can develop a customized exercise program to meet your needs and lifestyle.

Physical Therapy:

Physical therapy can help with everything from improving strength and range of motion to help maintain your muscle tone. Work with a physical therapist and develop a plan to fix your problem. Normally, if you have arthritis in your hip, you will receive physical therapy for 6 to 10 weeks, 2 to 3 times a week.

Braces and Splints:

A brace can help with stability and function. You can view the hip braces here.

Alternative Therapies:

You can try alternative therapies, such as acupuncture and magnetic pulse therapy for getting some relief. However, the data on these methods are somewhat inconclusive.

If you are suffering from hip pain, try the following simple remedies:

RICE:

Almost everyone can try the following RICE method:

In addition to the above RICE method, you can also try the Sacroiliac Joint Pain Exercises as long as you are not experiencing too much pain while doing them.

The signs and symptoms linked to hip pain will vary based on the underlying cause. Such as an individual with hip pain can experience the following symptoms:

• Limping
• Pain in the hip joint
• Pain in the groin region
• Loss of mobility in the hip region
• Warmth
• Swelling
• Tenderness
• Difficulty sleeping on your hip

To put it collectively, an individual may feel the discomfort in the following parts of the body depending on his/her hip pain’s underlying cause:

• Thighs
• Inside of his/her hip joint
• Groin
• Outside of his/her hip joint
• Butt

It’s to be understood that the intensity of the hip pain will also vary from person to person. It could range from mild to severe depending upon the severity of the condition and the underlying cause. In some people, hip pain can even be a cause of disability.

Not everyone experiencing a hip pain should have an issue in their hips. Sometimes, pain from other parts of the body that can also radiate to the hips. Examples include back pain and groin issues.

People with hip pain can see that their pain getting worse doing certain activities. This is more predominant if the pain is caused by arthritis.