It’s been suggested that 15%-30% of people who experience long-term lower back pain are caused by sacroiliac (SI) joints, which connect the pelvis with the spine. How to treat sacroiliac joint pain must be exciting information for those who have had persistent lower back pain. A pain that makes standing up at times a very painful experience.
What The Pain Feels Like
A dull or sharp which begins at your SI joint but can travel to your buttocks, thighs, groin, or upper back. Other times the pain is felt only on one side of your lower back. It may be bothersome in the mornings and get better as the day progresses.
Reasons Why You Get The Pain?
Inflamed sacroiliac
When your SI joint is inflamed, you get the pain, due to many reasons. During sports for instance or a fall can trigger SI pain. You might also get this problem from an activity that gives the affected part consistent pounding like running or jogging.
Uneven strides
Taking uneven strides during walking could cause SI joint pain. Or when the ligaments that hold your SI joint together are damaged. This can make the joint move abnormally and start the pain.
Arthritis
Arthritis that affects the spine can damage the SI joint and lead to pain. You’ll also feel pain when the cartilage over the SI joint erodes as you age.
Pregnancy
Pregnancy may also trigger SI joint pain. Your body releases hormones that cause your joints to loosen up and move more, which leads to changes in the way the joints move.
How To Treat Sacroiliac Joint Pain: Diagnosis
However, it’s not easy for doctors to link the SI to the problem. Since the sacroiliac is embedded inside the pelvis. And also because SI is the biggest joint in the body, it’s difficult for doctors to see any problems during a physical exam. Or during imaging tests to get high-quality pictures that can show it. Consequently, SI joint problems can be confused with other painful conditions, like sciatica and hip arthritis. It is regular exams that can point out what’s really the issue.
So, if you’ve been having this perpetual excruciating lower back pain that refuses to go, perhaps it’s time to visit your doctor and do more tests.
Doctors usually rely on the results of three or more tests to diagnose SI joint dysfunction. You can have most of them in your doctor’s office.
How To Treat Sacroiliac Joint Pain: Doctor’s Exams
Your doctor will begin the examination by inquiring about your medical history. A physical exam thereafter will include inspecting your posture and how well you walk. He will then commence some tests to determine where the pain is coming from and how well your SI joint moves. Common exams include:
Cranial shear test
The doctor will put pressure on your tailbone to check for pain, while you lie on your stomach on an exam table.
Flamingo test
The doctor asks you to stand on the leg where you have pain and hop.
Gaenslen’s test
While you lie face up, your doctor bends and presses one knee toward your chest while pressing the other leg, outstretched, off the side of the table.
Gillet test
You stand with your feet about 12 inches apart, one leg raised and bent. The doctor stands behind you and pushes on each side of your tailbone with his thumbs, checking for correct movement.
Pelvic compression test
The doctor presses down on your upper hip, while you lie on your side.
Pelvic distraction test
The doctor presses down on both sides of your pelvis at the same time, while you lie face-up on the table.
Patrick’s test (FABER test)
The doctor presses against the knee and the opposite pelvis at the same time, while you lie face up with one foot that hurts against the opposite knee.
Sacroiliac shear test
The doctor puts one hand on top of the other over your tailbone and pushes down, looking for motion in your joint, while you lie face down.
Thigh thrust test
The doctor puts one hand under your buttock while bending your hip and knee at a 90-degree angle, while you lie face-up on the table.
Imaging Exam
Since it’s important to rule out other problems that can cause similar symptoms, X-rays can help the doctor look for changes in the SI joint. In this instance, imaging exams to get pictures of the inside of your low back and pelvis are crucial. For instance, computed tomography (CT), a powerful X-ray scan, can give your doctor even more details. Other times, magnetic resonance imaging (MRI) is used to take pictures of organs and structures inside the body.
Injection Exam
The best way to know if you have SI joint dysfunction is through an injection of numbing medicine into your joint. An X-ray guides the doctor to where to put the needle in. If the pain goes away after the shot, you know the joint is the problem. It’s a little bit riskier than other exams, so it’s only done if doctors can identify the cause after other tests.
How to treat sacroiliac joint pain: What Treatment Helps?
You have many choices for treatment. The first step is simply to stop the things that make you hurt. Your doctor will tell you to lay off any sports that inflame your joint. He may also prescribe some pain drugs. Some other treatments that provide relief:
Physical Therapy
Exercise can improve strength and make you more flexible. For instance, bad habits picked over time, like when you were trying to avoid pain such as walking with a limp may be corrected by your therapist using ultrasound, heat and cold treatments, massage, and stretching.
Injections
A shot of cortisone to cut down the inflammation in your joint may be given. If that doesn’t help, your doctor may numb the nerves around your SI joint to give you relief.
Your doctor might also inject a solution of natural ingredients, such as saline, and numbing drugs into your joint. This would help tighten loose ligaments if that’s the cause of your SI joint problem.
Chiropractic treatment
Adjustments by a chiropractor can help relieve pain. Techniques that move your muscles and joints will be used.
Nerve treatment
Your doctor may use a needle to damage permanently the nerve that sends pain signals from your SI joint to your brain. He may also freeze it with an injection, though not a popular technique.
What If Treatment Doesn’t Work?
The aim of these treatments is to reduce inflammation and subsequently pain in your joint. However, if you’re still hurting, which is rare, surgery may be an alternative recommendation by your doctor. In a surgery called SI joint fusion, a surgeon uses pins and implants to join the bones near the joint.
https://www.webmd.com/back-pain/si-joint-back-pain
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