Breaking Free from Sacroiliac Joint Pain: Your Path to Relief Starts with Understanding the Source

For countless individuals in Queens and throughout the New York area, chronic lower back pain can be a debilitating mystery that affects every aspect of daily life. While many people assume their discomfort stems from common spinal issues, approximately 15-30% of chronic low back pain can actually be attributed to sacroiliac (SI) joint dysfunction. This often-overlooked condition affects the joints connecting your spine to your pelvis, and understanding its complexities is the first step toward effective treatment.

Understanding Sacroiliac Joint Dysfunction

The sacroiliac joints are located on each side of your lower spine, where the sacrum (the triangular bone at the base of your spine) connects to your pelvis. These joints serve as shock absorbers for the spine and transmit forces between the upper body and lower limbs, experiencing forces of shearing, torsion, rotation, and tension. When these joints become dysfunctional, they can cause significant pain and mobility issues.

Women are more likely to present with SI joint dysfunction than men, as the SI joint in women is more mobile, resulting in larger stress, load, and pelvic ligament strain. SI joint dysfunction is particularly common in pregnant and postpartum patients, though it can affect anyone regardless of age or gender.

Recognizing the Symptoms

One of the challenges with SI joint dysfunction is that the symptoms mimic other common conditions, such as leg pain from a lumbar herniated disc or back pain from facet joint arthritis. Patients with SI joint dysfunction may present with pain that is localized to the area at or just inferomedial to the posterior superior iliac spine or along the gluteal area, lateral hip, lower extremities, and groin.

This joint inflammation can cause pain in the buttocks or lower back, and the pain can go down one or both legs. The leg pain can be particularly difficult and may feel similar to sciatica or pain caused by a lumbar disc herniation.

The Diagnostic Process

Diagnosing sacroiliac joint dysfunction involves a combination of clinical evaluation, imaging, and diagnostic injections. To appropriately diagnose a dysfunctional sacroiliac joint, your doctor will likely require your health history, including symptoms, a physical examination including the SI joint provocative maneuvers, and imaging studies, while also ruling out other sources of low back pain such as the hip or spine.

The gold standard method for diagnosing the SI joint as the pain source is an injection test, but 3 or more positive tests can be used in early clinical decision making to reduce the number of unnecessary injections. Healthcare providers use various orthopedic tests, including the sacral thrust test and FABER test, to help identify SI joint dysfunction.

Treatment Options: From Conservative to Advanced

The good news is that effective treatment options exist for SI joint dysfunction. Conservative treatment consists of a multimodal program combining patient education, pelvic girdle stabilization with focused stretching, and manipulative therapy, which can be performed by physical therapists or clinicians trained in manipulative therapy.

Physical therapy to rehabilitate the sacroiliac joint typically includes stretching to reduce muscle tension and spasms in the lower back, hips, and pelvis, including the piriformis, gluteus maximus, and hamstring muscles, as tension in these muscles caused by sacroiliac joint dysfunction can be the primary cause of pain.

For patients in Queens and the broader New York area seeking comprehensive care, specialized Back Pain Treatment in New York offers advanced diagnostic techniques and personalized treatment plans tailored to each patient’s specific needs.

Advanced Treatment Options

When conservative treatments don’t provide sufficient relief, more advanced options are available. Treatment of SI joint pain usually involves a multi-pronged approach, utilizing both multi-modal medical pain control and interventional pain/surgical techniques such as steroid injections, radiofrequency nerve ablation, and minimally invasive sacroiliac arthrodesis.

Cooled radiofrequency ablation of the L4 and L5 medial branch and lateral sacral branches is beneficial in patients with a positive response to a diagnostic SI joint block. Radiofrequency ablation is a minimally invasive procedure aimed at providing relief from pain in patients with conditions such as sacroiliac joint pain.

For the most severe cases, patients who do not report improvement in pain symptoms after conservative and less invasive interventions may benefit from surgical fusion of the SI joint.

Finding Expert Care in New York

At NY Spine Medicine, the approach to treating sacroiliac joint dysfunction embodies their core philosophy that “surgery should be a last resort for treatment of your pain,” as they “exhaust all possible medical options to help our patients recover from their pain as safely and as painlessly as possible”. Their holistic approach encompasses minimally invasive procedures to relieve pain, promote healing, and prevent future injury, utilizing the most advanced technology and treatment options available.

Patients with SIJ pain report some of the lowest quality of life scores of any chronic disease, making it crucial to seek proper diagnosis and treatment. Sacroiliac joint pain is best managed by an interprofessional team that includes a physical therapist, pain specialist, nurse practitioner, primary care provider and an orthopedic surgeon, with the key being to educate the patient on changing lifestyle including maintaining a healthy body weight and regular exercise.

Your Journey to Recovery

If you’re experiencing persistent lower back pain that may be related to SI joint dysfunction, don’t let it control your life. Early intervention and proper diagnosis are essential for effective treatment. With the right combination of conservative treatments, advanced interventional procedures when necessary, and ongoing support from experienced healthcare providers, you can find relief from SI joint pain and return to the activities you love.

Remember that exercises for sacroiliac joint dysfunction are designed to gently return the joint to normal function and mobility, reducing pain and other symptoms, though exercises may be individualized and vary from case to case. Working with qualified healthcare professionals who understand the complexities of SI joint dysfunction ensures you receive the most appropriate and effective treatment for your specific situation.