Sacroiliac joint pain is as a dull, aching pain that is felt on one side of the lower back. It is also felt on both sides of the back. It spreads to your hips, buttocks, upper back or side of the thigh and groin. It is the commonest cause of low back pain, when your MRI scans are normal. The soft cushions (discs) between the spine are also normal.
Where is your Sacroiliac joint?
Your sacroiliac joint is where your spine joins your pelvis on either side on your back. There are 2 dimples at your back just above the bikini line. These dimples roughly indicate where your sacroiliac joint is located and your back pain is exactly in the same area.
As your sacroiliac joints join the pelvis your spine, all the movements between your spine and your pelvis occur at the sacroiliac joint on either side. It is the common cause identified if all your MRI scans show no other problems.
During pregnancy, these joints expand to keep the baby in the pelvis.
What are the causes of Sacroiliac joint pain?
1) Repeated Activities:
- Fall or injury to the joint
- Contact sports
- Regular heavy lifting
- Wrong Lifting habits
- Mechanical jobs
- Poor posture
- Longer periods of sitting or standing
- Alignment problems in the leg
- Pregnancy
It is the repetition of these activities that causes inflammation of the joint.
2) Changes in Posture:
Posture is the most common cause. The way we hold our body during sitting, standing and walking determines the amount of pressure on the sacroiliac joint.
- Curvature in your spine (Scoliosis)
- Limping in walking due to muscle weakness
- Difference in your leg lengths
- Poor sitting posture
- Pregnancy
3) Pregnancy:
Pregnancy causes weight gain and this increase in weight can put pressure on one side of the pelvis more than the other side. During your pregnancy, your body produces a chemical substance to loosen all the joints of the pelvis.
The sacroiliac joints are also relaxed. After the pregnancy, these joints may not fit in properly. This causes stress and movement across the joints leading to Sacroiliac joint pain.
4) Injuries:
Sacroiliac joint injuries can occur from fall, road traffic accidents and work injuries. These can cause fractures in the joint and lead to sacroiliac joint inflammation. The joints may be out of place due to these injuries and may not fit in properly. All these injuries ultimately causes inflammation of the joint.
5) Inflammation of many joints (Inflammatory Arthritis):
Some arthritis are caused by inflammation in all your joints of the body. Sacroiliac joint pain and arthritis is part of this inflammation process. These are:
– Psoriasis
– Gout
– Reiters Disease
– Ankylosing spondylitis
What does the pain feel like?
Sacroiliac joint pain is usually over the one side of the joint at the lower back. Sometimes it can be felt on both sides. It can spread to your hips, buttocks or over the upper and sides of your thigh. You may feel a sharp, stabbing pain with tingling and numbness of your legs.
Sacroiliac joint pain can cause stiffness of your lower back due to tightness and spasm of the muscles around the joint leading to low back pain. There are occasional symptoms like sciatica.
What aggravates the pain?
It gets worse while climbing stairs, running, jogging or lying on the same side. Prolonged sitting or standing, a long car journey, helping a friend to move house or furniture, sudden exercises or sporting activity or previous injury to the joint.
What are my treatment options?
1) Rest:
A period of rest for 1-2 days will be very useful to reduce the pain and swelling around the lower back. The tissues get a chance to recover. Any longer period in bed is worse as it will make your pain and stiffness worse. Read my blog – Bed rest is bad rest for your back.
2) Ice Packs:
Ice is the best painkiller available today for most swollen and painful conditions. It reduces the inflammation, muscle tension and spasm, takes the heat off the area. Some find heat application to the area of pain to be most helpful. Either moist heat (heat from a wet towel) or dry heat (heat from a water bottle) can be used.
3) Medication:
Simple over the counter painkillers like paracetamol, neurofen or codeine can be used to control the pain and help you move around. This adds to relieve the spasm and swelling around the area. You will be able to manage the exercises to stretch the muscle, improve muscle tone and tighten the ligaments around the joint.
4) Injection:
Sacroiliac joint injections are the best way to control the pain and inflammation. This spine injection is a mixture of a steroid and a local anaesthetic (numbing solution) that is injected into the joint precisely in a hospital setting, It reduces the inflammation and swelling rapidly as it acts directly on to the area of inflammation and pain.
5) Surgery:
Surgery for sacroiliac joint pain is aimed at stopping all the movements at the joint. It involves passing a screw across the joint so that the surfaces of the joints are squeezed together and jammed. This stops all the movement in the joint and there is fusion across the joint.