The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the iliac bones of the pelvis. Thus, there are Two SI joints, one on the left and the other on the right. It is a strong joint supported by strong ligaments and supports the entire weight of the upper body. Their main job is to carry the weight of your upper body when you stand or walk and shift that load to your legs.
Sacro-Iliac joint pain accounts for 15-30% of the patients with lower back pain.
Signs and Symptoms
- Continuous or intermittent sharp pain in the lower back and the buttocks
- Pain may radiate to the lower limb
- Localized tenderness over the SI joint may be present
- Difficulty in weight bearing on the involved side.
- Aggravated on prolonged standing or climbing stairs
- Age related degeneration: loss of joint cartilage causing fusion of bones and decreased mobility causing pain
- Acute injury due to fall on buttocks
- Overuse of the joint example in labourers who do repetitive movement while working
- Autoimmune conditions: Ankylosing spondylitis, Rheumatoid arthritis
- Pregnancy: Due to the release of hormone called Relaxin during pregnancy there is hypermobility in the SI joints which predispose them to injury and pain
JEEVISHA protocol for management Sacro-Iliac joint syndrome:
Conservative management strategies includes
- Work ergonomics correction: Changing the Ergonomics at work place plays a very important role in management of these patients. Expert faculty at JEEVISHA analysis the problems and helps the patient bring changes in their daily life.
- Posture correction: With facilities like Posture Analysis machine, the root cause for the development of these painful conditions is identified and patient are trained to overcome this problem in a step wise manner.
- Medications: In the initial course of the management of this condition, patients may be prescribed some anti-inflammatory medications. Some other medications may be prescribed depending on the condition of the patient, which is individualized from patient to patient basis.
- Physiotherapy: Physiotherapy plays a very important role in fighting these painful conditions. With a team of dedicated physiotherapist, patient is further evaluated and accordingly a plan is prepared for first reducing pain and then focusing on improving joint mobility.
If conservative treatment fails, various Minimally invasive percutaneous spine Interventions [ MIPSI] are offered to patients according to the severity of their pathology.
- Fluoroscope/ Ultrasound guided intra-articular injections in the SI joints
- Prolotherapy if periarticular ligaments are found to be at fault
- Fluoroscope guided denervation of the SI joint using Radiofrequency ablation.
- Fluoroscope guided denervation of the SI joint using Cryoablation