What Can Go Wrong With the SI Joint?

Sacroiliac (SI) joint problems are a common cause of lower back and buttock pain. Situated in the pelvis, the SI joint connects your pelvis to the lower part of your spine above the tailbone and acts as a shock absorber, supporting your upper body weight when you stand. 

Like any other joint, the SI joint is prone to degenerative changes, particularly in individuals who’ve had past lumbar fusions. If you have lower back pain, it’s best to visit a spine specialist for a comprehensive evaluation. An accurate diagnosis is crucial for treatment and management. 

The Spine Institute of Southeast Texas is your center of choice for treating spinal issues like SI joint dysfunction. If an SI joint problem is causing you lower back pain, board-certified orthopedic surgeon Thomas Jones II, MD, can discuss treatments to bring you relief. 

Who is prone to SI joint problems?

Anyone can develop SI joint issues; however, you’re more likely to develop them if you are overweight, are pregnant, or have had prior spine surgery. Additionally, women may be more prone to SI joint disorders because they have wider pelvises and greater lumbar spine curvature. 

SI joint problems and lower back pain

SI joint issues can affect people of all ages. They could be caused by physical trauma such as a fall, a car accident, or childbirth. Pregnancy and vaginal childbirth put a strain on the SI joint. 

The SI joint is a source of pain for a segment of patients with lower back pain, especially in patients who experience lower back pain following lumbar fusion. 

SI joint dysfunction symptoms 

SI joint problems typically cause pain in the buttocks, lower back, groin, or legs. Pain is usually most noticeable during activities such as lifting, running, or walking. You may experience:

• Lower back pain
• Groin pain
• Hip pain
• Pain when sitting
• Pain when standing
• Problems climbing stairs
• Leg weakness

Many people experience pain that worsens over time.

Diagnosing SI joint problems

Dr. Jones takes a thorough history and asks you about your pain and any difficulties standing. During a physical exam, he asks you to stand and walk and point to where you feel discomfort. 

Imaging tests such as X-rays, CT scans, and MRIs may assist in identifying the SI joint as the source of your pain. Injecting a local anesthetic into the SI joint is the most effective way to determine whether it’s the source of your symptoms. The injection is given under fluoroscopy or CT guidance to ensure that the needle is correctly placed in the SI joint.

If the anesthetic reduces your symptoms by at least 50%, the SI joint is most likely the source of, or a substantial contributor to, your lower back discomfort. If your symptoms don’t improve following SI joint injection, it’s less likely that the SI joint is involved. 

SI joint dysfunction treatment

Once the SI joint is identified as the source of your pain, Dr. Jones can discuss treatment options with you. Reducing inflammation around the SI joint is often the initial approach to relieving related pain. 

Many patients have already tried conservative approaches by the time they see Dr. Jones. Corticosteroid injections and radiofrequency ablation are often the next step when symptoms fail to improve with physical therapy and pelvic girdle stabilization.

When your pain persists despite trying nonsurgical treatments, Dr. Jones may discuss SI joint fusion. This involves inserting implants over the SI joint to eliminate movement and provide stability.

SI joint problems are common, but you don’t have to struggle with lower back pain. If you’re dealing with persistent SI joint pain, call our office in either Pearland or Lake Jackson, Texas, to schedule a consultation with Dr. Jones. You can also request an appointment online.