Is Your Back Pain coming from the Sacroiliac (SI) Joint? Exploring Causes and Solutions

Back pain is a common complaint that can arise from various sources. One often overlooked contributor is the sacroiliac joint (SI joint). This blog aims to shed light on SI joint pain, detailing who is susceptible to it, when to suspect it as the root cause of your back pain, and what steps to take when traditional treatments don’t provide relief. We’ll focus on image-guided injection treatments as potential solutions, supported by evidence from published articles and medical journals.

SI joint pain isn’t exclusive to a particular demographic. However, it’s more commonly observed in specific groups:

1. Pregnant Women : Hormonal changes during pregnancy can lead to increased SI joint mobility and instability, causing pain. A study in the Journal of Physical Therapy Science emphasized the prevalence of SI joint pain during pregnancy.
2. Athletes : Those engaged in activities that involve repetitive stress on the SI joint, like running or weightlifting, may experience SI joint pain. A study in the Journal of Bodywork and Movement Therapies linked SI joint pain to athletes.
3. Degenerative Changes : As we age, wear and tear can affect the SI joint. A Spine Journal study highlighted the role of degenerative changes in SI joint pain.
4. Arthritis Patients : Individuals with inflammatory arthritis, such as ankylosing spondylitis, are at a higher risk of SI joint pain due to inflammation affecting the joint
5. Accident Survivors : Trauma, such as a fall or a car accident, can disrupt the SI joint’s stability, leading to chronic pain

It’s crucial to recognize potential signs that your back pain may be originating from the SI joint:

1. Pain Location : SI joint pain often originates around the Posterior superior iliac spine and radiates to the buttocks and thighs. If your pain is primarily in these regions, consider the SI joint as a possible source.
2. Aggravation by Movement : Activities involving bending, lifting, or prolonged sitting can worsen SI joint pain. A study in the European Spine Journal emphasized the link between movement and SI joint pain. 
3. Unilateral Lower Back Pain : SI joint pain often presents as unilateral lower back pain. Research published in “Pain Physician” indicates that SI joint pain can be misdiagnosed as lumbar spine pain due to similar symptoms.
4. Pain While Transitioning Positions : Pain that worsens while moving from sitting to standing or vice versa may point to SI joint involvement. The “Journal of Back and Musculoskeletal Rehabilitation” highlights this as a potential SI joint pain indicator.
5. Pain with Single Leg Activities : Activities like climbing stairs or walking may trigger SI joint pain. A study in the “Journal of Bodywork and Movement Therapies” notes this as a common complaint among patients with SI joint dysfunction
6. Pain during Sleep : If you experience worsening pain when lying on one side or the other, the SI joint might be the culprit
7. Unaffected Neurological Symptoms : Unlike disc-related issues, SI joint pain doesn’t usually cause numbness, tingling, or weakness in the legs.

If pain persists despite medication and physiotherapy, image-guided injection treatments can provide relief:

1. Corticosteroid Injections : Administered under guidance, corticosteroid injections directly target the SI joint. A study in the Journal of Pain Research showcased the effectiveness of corticosteroid injections in SI joint pain management.
2. Platelet-Rich Plasma (PRP) : PRP injections use the body’s own healing components to alleviate pain. A study in the Journal of Orthopaedic Surgery and Research reported positive outcomes with PRP treatment for SI joint pain.
3. Radiofrequency Ablation (RFA) : RFA involves disrupting pain signals from the SI joint using radiofrequency energy. A study in the Journal of Pain Research highlighted the success of RFA in reducing SI joint pain.
4. Viscosupplementation : Injecting hyaluronic acid into the SI joint can provide lubrication and pain relief. A Journal of Clinical Medicine study discussed the potential of viscosupplementation for SI joint pain.
5. Prolotherapy : Prolotherapy entails injecting a solution that stimulates tissue growth around the SI joint. A study in the Journal of Orthopaedic Science demonstrated significant pain reduction after prolotherapy.

Sacroiliac joint pain can be elusive yet significantly impactful. Understanding its prevalence among specific groups, recognizing its characteristic pain patterns, and exploring alternative treatments when traditional options fail are vital steps toward relief. Image-guided injection treatments like corticosteroid injections, PRP, RFA, and viscosupplementation offer promising solutions, backed by evidence from published articles and medical journals. If you suspect SI joint involvement in your back pain, consult a healthcare professional for accurate diagnosis and tailored treatment.

1: Journal of Physical Therapy Science
2: Journal of Bodywork and Movement Therapies
3: Spine Journal
4: Sacroiliac Joint InjuryAlexander M. Dydyk; Stephen D. Forro; Andrew Hanna
5: European Spine Journal
6: Reference from a reliable medical source
7: Journal of Pain Research
8: Journal of Orthopaedic Surgery and Research
9: Journal of Pain Research
10: Journal of Clinical Medicine