What is Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction is a condition that causes inflammation on one or both sides of the sacroiliac (SI) joint. The SI joint connects the lower part of the spine (sacrum) with the two upper portions of the pelvis (ilium).

This condition causes deep aching or burning pain in the low back. In some cases, the pain may also spread into one or both buttocks, hips, or thighs.

What are the causes?

This condition may be caused by:

• Pregnancy. During pregnancy, extra stress is put on the SI joints because the pelvis widens.
• Injury, such as:
  • Injuries from car accidents.
  • Sports-related injuries.
  • Work-related injuries.
• Having one leg that is shorter than the other.
• Conditions that affect the joints, such as:
  • Rheumatoid arthritis.
  • Gout.
  • Psoriatic arthritis.
  • Joint infection (septic arthritis).

Sometimes, the cause of SI joint dysfunction is not known.

What are the signs or symptoms?

Symptoms of this condition include:

• Aching or burning pain in the lower back. The pain may also spread to other areas, such as:
  • Buttocks.
  • Groin.
  • Thighs.
• Muscle spasms in or around the painful areas.
• Increased pain when standing, walking, running, stair climbing, bending, or lifting.

How is this diagnosed?

This condition is diagnosed with a physical exam and medical history. During the exam, the health care provider may move one or both of your legs to different positions to check for pain. Various tests may be done to confirm the diagnosis, including:

• Imaging tests to look for other causes of pain. These may include:
  • MRI.
  • CT scan.
  • Bone scan.
• Diagnostic injection. A numbing medicine is injected into the SI joint using a needle. If your pain is temporarily improved or stopped after the injection, this can indicate that SI joint dysfunction is the problem.

How is this treated?

Treatment depends on the cause and severity of your condition. Treatment options may include:

• Ice or heat applied to the lower back area after an injury. This may help reduce pain and muscle spasms.
• Medicines to relieve pain or inflammation or to relax the muscles.
• Wearing a back brace (sacroiliac brace) to help support the joint while your back is healing.
• Physical therapy to increase muscle strength around the joint and flexibility at the joint. This may also involve learning proper body positions and ways of moving to relieve stress on the joint.
• Direct manipulation of the SI joint.
• Injections of steroid medicine into the joint to reduce pain and swelling.
• Radiofrequency ablation to burn away nerves that are carrying pain messages from the joint.
• Use of a device that provides electrical stimulation to help reduce pain at the joint.
• Surgery to put in screws and plates that limit or prevent joint motion. This is rare.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.

If you have a brace:

• Wear the brace as told by your health care provider. Remove it only as told by your health care provider.
• Keep the brace clean.
• If the brace is not waterproof:
  • Do not let it get wet.
  • Cover it with a watertight covering when you take a bath or a shower.

Managing pain, stiffness, and swelling

• Icing can help with pain and swelling. Heat may help with muscle tension or spasms. Ask your health care provider if you should use ice or heat.
• If directed, put ice on the affected area:
  • If you have a removable brace, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• If directed, apply heat to the affected area. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
  • Place a towel between your skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.

General instructions

• Rest as needed. Ask your health care provider what activities are safe for you.
• Return to your normal activities as told by your health care provider.
• Exercise as directed by your health care provider or physical therapist.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain is not controlled with medicine.
• You have a fever.
• Your pain is getting worse.

Get help right away if:

• You have weakness, numbness, or tingling in your legs or feet.
• You lose control of your bladder or bowel.

Summary

• Sacroiliac joint dysfunction is a condition that causes inflammation on one or both sides of the sacroiliac (SI) joint.
• This condition causes deep aching or burning pain in the low back. In some cases, the pain may also spread into one or both buttocks, hips, or thighs.
• Treatment depends on the cause and severity of your condition. It may include medicines to reduce pain and swelling or to relax muscles.