Symptoms, Diagnosis and Treatment for SI Joint Dysfunction

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Sacroiliac Joint Dysfunction

Sacroiliac joint seen from above.
Sacroiliac joint seen from above. MedicalRF.com/MedicalRF.com/Getty Images

Sacroiliac Joint Dysfunction Symptoms

If you have sacroiliac joint dysfunction or derangement, pain is likely to be your most pronounced symptom. You may feel it in the low back, buttocks, groin and/or thighs; sitting, standing or walking may make things worse while lying down may help it feel better.

If inflammatory arthritis is the cause of your sacroiliac joint dysfunction, you may also experience stiffness and/or burning in your pelvis.

Anecdotally speaking, some people with SI joint dysfunction report feeling that their hips are rotated or otherwise don’t fit right. Common complaints also include weakness and/or “getting stuck,” i.e., not being able to move, for example, into or out of a car seat.

Something similar happened to me. One day long ago, I bent down to pick up my cat, and because of this poor movement choice, I subsequently spent several hours on the floor, unable to get up.

To learn about diagnosis and treatment of sacroiliac joint dysfunction, slide on.

Sources

Driver, C., MD, Shiel, W. C., MD, FACP, FACR. Sacroiliac Joint Pain. MedicineNet website. http://www.medicinenet.com/sacroiliac_joint_pain/page2.htm

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Sacroiliac Joint Pain Diagnosis

Anatomical figure in a seated position, with a pained sacroiliac area.
Anatomical figure in a seated position, with a pained sacroiliac area. maya2008

Getting a Diagnosis for Your Sacroiliac Joint Pain

Diagnosing SI joint pain is can be very challenging for clinicians.

But getting this one right may make a big difference in your treatment and your life. The one mistake you likely don’t want made is an incorrect diagnosis of any of the SI joint-related maladies in the list below, especially if the recommended follow-up treatment is surgery.

  • Instability
  • Hypermobility
  • Displacement
  • Relaxation
  • Sprain
  • Slipped or slipping
  • Unstable.

The reason is that surgery tends to be a permanent solution with the potential for complications. So unless the pain you feel is really coming from the sacroiliac joint, surgery, which is usually a fusion of the joint, is probably not a good idea.

While a number of diagnostic methods exist for SI joint pain, most cannot definitely tell you that this is the area from which your pain arises. The one exception may be a diagnostic injection.

Diagnostic SI Joint Injections

In general, doctors and researchers agree that using an injection into the joint to test for pain relief is the most reliable way to know if, indeed, the problem is coming from your sacroiliac. Zelle and associates, in their systematic review entitled, "Sacroiliac joint dysfunction: evaluation and management," which was published in the September-October 2005 issue of Clinical Journal of Pain, found that injecting the joint (using radiological guidance) with a local anesthetic was a reliable diagnostic technique for identifying the SI as the pain generator.

Sources

Spinal instabilities, lumbosacral region. 2015/16 ICD-10-CM Diagnostic Codes. ICD10Data.com

Zelle BA1, Gruen GS, Brown S, George S. Sacroiliac joint dysfunction: evaluation and management. Clin J Pain. 2005 Sep-Oct;21(5):446-55. http://www.ncbi.nlm.nih.gov/pubmed/16093751

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Sacroiliac Joint Dysfunction Treatment

A skeleton of the pelvis, sacrum, lumbar spine, hip joints and femur bones.
A skeleton of the pelvis, sacrum, lumbar spine, hip joints and femur bones. sciencepics

Sacroiliac Joint Dysfunction Treatment

From personal experience with sacroiliac dysfunction, I can say that what people who injure their sacroiliac joint usually want the most is joint realignment. For them, treatment is matter of putting the sacrum bone back in to place, now. In other words, those who actually experience the agony of an SI joint that is “out” are urgently looking for a way to get it back in (and to keep it there). If you’ve experienced this type of joint dysfunction, you likely know what I mean. A slow fix is not a palatable solution.

Chiropractic or Conventional Medicine?

Many people, myself included, turn to their chiropractors for this. If you'd like to learn more about chiropractic (manual therapy) for SI joint pain, along with other treatments, check out: 7 Treatments for Sacroiliac Joint Pain and Dysfunction.

The good news is that if you seek conventional medical treatment (not surgery) for your sacroiliac joint dysfunction, your chances for improvement are pretty good. Zelle and associates' systematic review entitled, "Sacroiliac joint dysfunction: evaluation and management," found that most patients who had non-operative treatment for their SI joints responded well.

Sources:

Zelle BA1, Gruen GS, Brown S, George S. Sacroiliac joint dysfunction: evaluation and management. Clin J Pain. 2005 Sep-Oct;21(5):446-55. http://www.ncbi.nlm.nih.gov/pubmed/16093751

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