The sacroiliac joints are located at the bottom of the back, on each side of the spine. The joint connects the sacrum and the iliac crest to form the rear part of the pelvic girdle that supports the spine and hips. Unlike the rest of the movable vertebrae of the spine, the sacrum can only rotate up to four degrees. The sacrum is the triangular-shaped bone located below the lumbar spine. The sacroiliac joint is a strong joint that holds the sacrum and the iliac bones together with strong fibrous ligaments. However, these joints do not have the capacity to support the entire weight of the upper body (which it usually has to) because of the normal activities carried out by the rest of the body. The constant twisting and compressing while performing various activities places a large amount of stress on this joint. This leads to wear and tear of the cartilage of the joints, which ultimately leads to inflammation.
The most common cause of this condition is the development of osteoarthritis, a form of degenerative arthritis. Damage to the cartilage that works as a shock absorber between the bones lead to friction and wearing out of the bones. Other forms of arthritis, like, rheumatoid arthritis, spondylitis, gout, etc. may also lead to this condition. Sacroiliac joint strain may sometimes be the result of an accident or injury which may be caused due to sudden impact to the spine, hip, or pelvis. Chronic stress fractures, muscle imbalance, hormonal changes, or dislocations may also lead to this condition. Pregnancy is seen as a common cause of dysfunction of this joint. Hormonal changes in the pregnant woman's body relaxes all the connective tissues, which facilitates pelvis stretching during childbirth. Relaxed ligaments in the sacroiliac joint, combined with additional weight and altered walking patterns places excessive stress on the joints. Apart from this, bad posture may also lead to development of this condition.
One of the most common signs of inflammation of this joint is excruciating pain, which may be described by some as a searing and shooting pain in the lower back or back of the hips. Stiffness may also be experienced, especially after a period of restricted hip and back movement, like, after long car journeys, when waking up in the morning, turning over in the bed, etc. Pain in lower back, hips, and thighs after a period of some activity, like walking or sexual activity, is also a symptom of this condition.
It is often confusing for an individual to pinpoint the exact location of the pain, however, modern diagnostic tests may not only help to determine the location, but also play a part in its treatment. After a physical examination and study of the history of other medical problems, most doctors recommend X-ray, computed axial tomography scan (CAT/CT scan), or a magnetic resonance imaging (MRI) of the pelvis, hips, or lumbar spine. This is done to identify fractures, bone abnormalities/tumors, or soft tissues like muscles and ligaments.
Physical therapy helps to stabilize the spine, relax the muscles, and de-stress the nerves around the joints. It is done by identifying the localized trigger points and using the techniques of compressing and stretching to ease the pain. A sacroiliac belt may also be used which is also a part of the physical therapy. The belt is wrapped around the hips to help stabilize the joints and prevent it from receiving shocks while performing any activity. A physical therapist may suggest specific exercises for sacroiliac joint pain that will aid in relieving the pain. Medications include, both steroidal as well as non-steroidal anti-inflammatory drugs (NSAIDs) and injections. In some cases, to reduce inflammation in and around the joints, cortisone injections may be prescribed. Surgical treatment is recommended in cases where any other treatment option could not provide relief. Surgery involves fusion of the sacroiliac joints by removing the surface cartilage and holding the bones together with the help of plates and screws, until the connective tissues grow back and fuse together.
One must immediately consult a doctor or an orthopedic if any of the aforementioned symptoms are observed. Sacroiliac joint dysfunction can never be completely cured, however, with good management that includes maintaining a good body weight, healthy diet, physical therapy, and medication, it is possible to alleviate pain, and lead a normal healthy life.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.