1. A Tale of Two Bones
The sacroiliac joints are located in the lower spine and are formed by the connection of two bones. The sacrum, which sits below the lumbar region, is a triangular shaped bone with five fused vertebrae. The sacrum is wedged between the two crests of the pelvis (iliac) bones. The sacroiliac joints are next to the spine where the sacrum and iliac connect on either side. Very strong for its size, the joint absorbs shock as it transfers energy from trunk movement into the hips and legs. A very strong band of ligaments also aids the sacroiliac joints in their mission.
2. Women Take One for the Team During Pregnancy
The sacroiliac joints don't allow for much movement. However, hormonal changes occur during pregnancy, which relax the ligaments to facilitate childbirth. That also allows for more movement in the sacroiliac joints, which in turn can increase stress on them. This makes women more prone to sacroiliac joint dysfunction than men. As with any weight-bearing joint, the sacroiliac joints are subject to arthritis, gout, psoriasis or any other ailment that affects other joints. Anything that causes a change in gait can also lead to sacroiliac joint dysfunction.
3. It Hurts Right Here, Doc
The result of sacroiliac joint dysfunction is pain, most commonly the lower back. However, pain in the buttocks, hips, groin and thighs may also occur. Sacroiliac joint pain is usually located on one side of the body, and it is usually lessened when lying down. Keep a log of your pain, including where it's located, what aggravates it and what relieves it.
4. Diagnosis Is a Tricky Business
While your symptoms may seem straightforward to you, diagnosis is no easy task for a doctor. After talking to you about your history, he may need to rule out other possible causes of the pain originating in the spine or hips. He may order x-rays, a bone scan, magnetic resonance imaging (MRI) or computed tomography (CT or CAT) scan. If these tests don't reveal another cause, he may want to inject the sacroiliac joint with an anesthetic such as lidocaine and a steroid to see if this relieves the pain.
5. Stretching and Exercise for Pain Relief
An injection of a steroid and anesthetic may temporarily relieve the pain. How long the relief lasts varies, and you can only have a few injections per year. Physical therapy is a good option for treatment of sacroiliac pain. The therapist will teach you exercises to stretch and strengthen abdominal and back muscles, easing the pain. Chiropractors and osteopath physicians can assist by providing manipulation if your physical therapist cannot. Your doctor may advise you to take anti-inflammatory drugs or have you try a sacroiliac belt that helps stabilize your sacroiliac joints.
