Sacroiliac Pain
Sacroiliac Pain is an often underdiagnosed cause of low back pain, hip pain and/or buttock pain. It is also known as sacroiliitis or sacroiliac dysfunction. The sacroiliac, or SI joint, is the junction between the pelvis and the sacrum. All of the weight bearing forces are transferred through the SI joints with standing, walking and sitting.
SI problems often present as pain across the low back and often into one or both buttocks. It can also cause pain with sitting and rising from the seated position.
Xrays, MRI, and CT are rarely useful in diagnosing SI dysfunction. When the diagnosis is suspected based on physical examination, an injection of anesthetic medication is placed into the SI joint. If the injection gives significant relief, the SI joint is likely the culprit. If not, other causes of back and/or buttock pain must be excluded.
Treatment
Treatment for sacroiliac pain usually involves exercise and stretching. Regular, low impact cardiovascular exercises such as swimming and cycling have been shown to decrease SI pain over time when done 3-5 days per week for at least 30 minutes. Exercises should include hip and buttock muscle strengthening. Daily stretching, especially hamstrings, should also be done. Flexibility exercise, such as yoga, is helpful. Exercise programs supervised by physical therapists can be tailored to the individual’s needs to get the best results. Chiropractic care can also be beneficial.
Anti-inflammatory medicines such as ibuprofen or naproxen can help decrease pain and are generally safe. Always consult with your primary care physician when taking any new medication.
Narcotic pain medicines and so called muscle relaxants are generally ineffective for anything but very short term use and often lead to problems due to their habit forming nature.
Injections are useful for occasional painful flareups that occur with SI dysfunction. They provide temporary relief of variable duration, so they are not usually used for the day to day SI pain.
Lastly, surgery can be effective for SI pain when other treatments fail. This can be done with a less invasive technique often as an outpatient procedure.
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