Sacroiliac joint problems are a common yet frequently overlooked cause of low back pain. In fact, 21% of patients who see a doctor with low back pain have a sacroiliac joint problem.
You may suffer from this problem if you've had persistent pain in your lower back or buttocks, or pain going down your leg, that has escaped diagnosis. Perhaps you've had disc surgery, but you continue to hurt. Maybe you've tried lots of different treatments, including physical therapy or chiropractic, but nothing really helps or brings relief for long. Or maybe you've been told, "The pain is in your head."
There's an excellent chance your pain is real. Your sacroiliac joint may be causing it.
Discs have gotten the attention
For the past 50 years, the vast majority of research and writing done on low back pain has focused on disc problems. Physical therapists and chiropractors have recognized that the sacroiliac joint is a source of pain, but orthopaedists have tended to neglect it.
Sacroiliac joint troubles are hard to pin down because x-rays often don't show anything suggesting a problem. That, of course, doesn't mean no problem exists.
In our practice, if we strongly suspect a sacroiliac joint problem, we will send the patient to an interventional radiologist, who will help us make a definitive diagnosis.
During the diagnostic procedure, a CT ("Cat") Scan is performed and the radiologist injects anesthetic into a portion of the sacroiliac joint. If it makes the pain go away, then we know that's where the pain is coming from. If not, then the pain is coming from somewhere else.
What causes sacroiliac joint problems?
Many activities and mishaps can take a toll on your sacroiliac joint: a slip on the ice, a twisting injury, lifting something the wrong way, overstriding when running, and more. What happens is that fluid inside the sacroiliac joint leaks out and irritates nerves, which you experience as pain.
Treatment
Most of the time, sacroiliac joint problems can be treated without surgery. Conservative treatment measures include wearing a sacroiliac belt, repeated injections with local anesthetic and cortisone medication, injections that tighten ligaments, or physical therapy.
For someone who has a problem that hangs on for 6 months to a year and doesn't get better, sacroiliac fusion surgery can be very helpful.
This particular operation takes approximately an hour to an hour and a half. The patient stays in the hospital for about 3 days, and remains on crutches for about 2 months. No body cast is required.
With surgery, the success rate is between 70 - 90%. This is true even for people who've had lower back pain for many years. If you suffer from low back pain, and can't seem to get to the cause, suspect that sacroiliac joint.
Editor's Note: Dr. Moore is an orthopaedic surgeon with The Colorado Spine Center, 1455 South Potomac Street, Suite 307, Aurora, Colorado 80012-4533 U.S.A., (303) 696-1234. The Colorado Spine Center is one of the few medical groups in the country that regularly performs sacroiliac fusion surgery. For more information about the procedure, contact Dr. Moore at the address above.Home | More Health Articles | Men | Women | Stress | Sexuality