They are located in the lowermost part of your back. There is one on the right and one on the left side. These joints as the name implies are formed by the sacrum in the middle as a wedge in between the right and left iliac bone. On top of the sacrum sits the lumbar spine. Strong ligaments in front and in the back hold the bones together. The actual articular surface of each joint is very irregular.
What is SI joint dysfunction?
It is improper movement of the joints that connect the sacrum to the iliac bones.
What can cause it?
*Pregnancy or recent childbirth
*Lower lumbar fusion
*Leg length disparity
*Regular heavy lifting, or labor-intensive jobs
*Pelvic or low back muscles unconditioned combined with prolong sitting
*Direct result of injury or trauma, such as the jolt from a fall
What are the symptoms?
Lower back pain usually unilateral dull and aching. Pain usually spread to the hips, buttocks and groin. Sciatic-like pain from sacroiliac joint dysfunction rarely extends below the knee and may include numbness and tingling. Reduced range-of-motion in the lower back, hips, pelvis, and groin, which may cause difficulty with movements such as walking up stairs or bending at the waist.
How to diagnose SI joint dysfunction?
There is no single test to diagnose it. Among the test used we have the sacral thrust test, the distraction test and the Faber test. However an injection of the SI joint in question is the gold standard for diagnosing that the SI joint is the source of the pain.
What are the treatment options?
After a good diagnosis is made, basically the treatment will depends on the severity and on how long you have been suffering from it. Conservative therapy is always better than surgery and much less risky. Initially and if not too severe or prolonged, prescription NSAID along with prescription muscle relaxants ice or heat and physical therapy including manual manipulation may be best. A pelvic brace or support may be useful for a hypermobile joint.
If all of the above fails, the most successful treatment by far with minimal risk is Proliferative therapy injections using hypertonic dextrose or Plasma rich in platelets. On each Proliferative therapy session, the ligaments that hold the joints together are injected precisely where they attach to the bone. This points are called Enthesis. Injection these point with the proliferant solution, stimulates the local local tissues to grow and strengthen the ligaments. These in turn strengthens the joint. The goal here is to strengthen the ligaments that hold the joint together. Usually four or five sessions separated three to four weeks apart wil do the trick.