SI Joint Dysfunction Treatment in Baton Rouge

SI joint dysfunction is a general term used to refer to pain originating from the sacroiliac joint, possibly secondary to abnormal motion in the joint. The SI joints connect the spine to the remainder of the pelvis and lower extremities. With that, they are joints that are under high levels of stress. The joints normally move very little with normal activities, as they are stabilized by strong ligamentous complexes in the back. However, when these joints move too much (hypermobility) or too little (hypomobility), low back pain and discomfort can result.

As with any medical condition, there are conditions that lead to SI joint dysfunction. The most commonly recognized causes include:

• Trauma
  
  
• Osteoarthritis
  
  
• Scoliosis or previous spinal surgery
  
  
• Physical activity that stresses the joints
  
  
• Pregnancy
  
  
• Gait disturbances and/or leg length differences
  
  
• Other inflammatory conditions (gout, ankylosing spondylitis, etc.)
  

Regardless of the specific underlying cause, SI joint dysfunction is often hallmarked by some notable symptoms. These may include:

• Low Back Pain – SI joint dysfunction accounts for an estimated 15 to 30 percent of all cases of low back pain. For most, this pain is dull and aching and occurs on one side. Although some will experience pain on both sides of the body.
  
  
• Spreading Pain – Pain from SI joints can spread and radiate outwardly. Patients may feel pain in the hips, buttocks, or groin. 
  
  
• Pain that Mimics Sciatica – Pain originating from the sciatic nerve extends from the buttocks down the back of the thighs. It may feel like a stabbing, hot type of pain that can cause sensations of tingling or numbness. In some cases, SI joint dysfunction can mimic this same type of pain.
  
  
• Stiffness – SI joint dysfunction can make it difficult to move easily, reducing range-of-motion, particularly during activities like walking, jogging, or climbing stairs. During activities such as these or those that put increased pressure on the joints, pain tends to worsen.
  
  
• Feeling of Instability – As the SI joints shift and move unnaturally, it can lead to overall instability in the area. In turn, patients may report a feeling that the pelvis is too weak to sustain even activities as simple as standing and walking.
  

Fortunately, the majority of SI joint dysfunction cases can be resolved using conservative treatment methods. For most patients, these treatments will include a combination of the following:

• Rest – While resting for too long can contribute to pain and stiffness, a resting period of 1 to 2 days following injury or the onset of pain can prove helpful for some.
  
  
• Ice/Heat – Use ice to ease inflammation and heat to reduce muscle pain and stiffness.
  
  
• Medication – Over-the-counter pain medications such as ibuprofen can be useful to control discomfort and minimize inflammation. In some cases, prescription medications such as muscle relaxers may also be needed. Check with your doctor to determine if these are indicated. 
  
  
• Bracing – stabilizing the joint with a pelvic belt can reduce motion through the SI joints, providing temporary relief. These should be used as a temporary measure, as long-term use may lead to over-reliance and core muscle atrophy.
  
  
• Physical Therapy – strengthening your core and addressing any muscular deficiencies or soft tissue contractures through physical therapy can help take stress of the SI joints.
  
  
• Injections – Injection of a local anesthetic and anti-inflammatory medication can help provide longer-term relief from the pain and inflammation that accompanies SI joint dysfunction.

In the most severe cases of SI joint dysfunction, surgical treatment may be the only way to achieve relief and restore function. Typically, these cases have exhausted all possible non-surgical treatment options over a course of months and are still experiencing pain and loss of function in the joint. 

SI joint surgery involves fusion of the sacrum and ilium with devices to eliminate movement at the joint entirely. In order to avoid potential complications and achieve the best possible outcome, patients who undergo an SI joint fusion can expect a months-long recovery period that may involve medications, physical therapy and bracing.

Newer minimally invasive techniques for fusion have emerged over the last decade that have proven safer and effective for treatment of this condition. Patients often go home the same day or the following day after their procedure.

The first step in getting relief is determining the root cause of your discomfort. Diagnosing SI joint dysfunction can be challenging, as there are a number of other conditions that can present in a similar way. A proper history and physical examination performed by an experienced provider is the best way to diagnose SI joint dysfunction. X-rays and advanced imaging (CT, MRI, bone scan, etc.) are potentially useful to rule out other conditions, but their role in diagnosing SI joint dysfunction is limited. A diagnostic injection done under local anesthetic is often useful in confirming the diagnosis.

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