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The Sacroiliac joint, often called the SI joint, is located at the base of your spinal column. This SI joint is a strong and secure joint. It connects the sacrum bone (the spinal column end) to the hip bone (pelvic bone). Sacroiliac joint often dysfunctions due to various reasons and is most commonly seen in young and middle-aged women.

Around 15% to 30% of persons with persistent lower back pain might have problems with their SI joints. 

In India, almost 80% of adults will encounter lower back pain at some point in their lives. Lower back pain is one of the main reasons for job-related impairment and missed workdays.

Overview of SI joint

The sacroiliac joints are found in the lower back, where the sacrum meets the ilium. The sacrum is the triangle-shaped bone, and the ilium is one of the hip bones located just above your pelvis.

The SI joint supports your body and is responsible for distributing the weight across your pelvis evenly. During movement, your spine is protected by them as they act as shock absorbers.

Each SI joint has uneven bones that fit together like a puzzle. The edges keep the bones aligned. All the SI joint bones are held together by strong ligaments and muscles, which add stability and also control movement. Even though it is minor, this movement helps to keep one upright, including giving birth.

The cartilage that lines the joint bones also protects them against shock. In the SI joints, fluid fills the spaces between the bones, which provide lubrication. Free nerve endings within these spaces are responsible for sending pain signals to the brain.

The problems with the SI joint begin when the bones in the joints are misaligned or if the cartilage in the joint breaks down, making the bones rub against each other, which can be painful. 

Causes of SI joint pain

Inflammation may be the cause of the pain, such as when you play sports or suffer from an injury to your back when you fall down.

Prolonged constant activity, such as jogging or running, especially on uneven or hard surfaces may also lead to SI Joint dysfunction because it stresses the Sacroiliac joint.

Damage to the ligaments that hold the Sacroiliac joint together can also cause SI dysfunction. Ligament damage might lead to abnormal rotation of the Sacroiliac joint, resulting in pain.

Ankylosing spondylitis (AS) inflames the sacroiliac joints located between the base of the spine and pelvis. This inflammation, called sacroiliitis, is one of the first signs of AS. Inflammation often spreads to joints between the vertebrae, the bones that make up the spinal column.Sacroiliitis is one of the major signs of Ankylosing spondylitis (AS). Apart from the  sacroiliac joints hip joints and small joints and disc joints of spine can also be affected by Ankylosing spondylits.In some of the cases HLA B 27 may be positive .

Sacroiliac joint tuberculosis(SJT) is very rare, but if it occurs it may cause severe damage and functional disorders of sacroiliac joint. Approximately 1–5% of musculoskeletal infections are tuberculous in origin. 

Arthritis can also result in SI joint pain. Ankylosing Spondylitis (AS) is one of the arthritis forms that can cause severe damage to your Si joint, ultimately resulting in pain.

As we get older, the cartilage protecting the SI Joints wears away slowly. This may result in SI Joint dysfunction. 

SI joints can also be affected by pregnancy. An increase in the production of certain hormones during pregnancy might lose the SI joint and also increases its movement. This is necessary as the body prepares for the safe delivery of the child  through the normal passage.As a result, the SI joint becomes stiff and causes back pain.

Treatment options available for SI joint problem

  • In some cases, it is recommended that activities which increase the pain may be stopped.
  • Medications for pain relief may be prescribed by the doctor.
  • You can strengthen and improve your flexibility with exercise routines suggested by a physiotherapist. 
  • Treatment options like ultrasound, cold, and heat therapies are recommended for some people to alleviate pain.
  • Inflammation of the SI joint can be reduced by injecting Cortisone injections directly into the joint.( In a very selected cases)
  • If cortisone injections fail to reduce inflammation & alleviate pain, the doctor may choose the alternative treatment of numbing nerves surrounding the Sacroiliac joint to provide relief. A procedure known as prolotherapy (Prolotherapy, also called proliferation therapy, is an injection-based treatment used in chronic musculoskeletal conditions. It has been characterized as an alternative medicine practice) may be triedt.
  • If none of the conservative treatments mentioned above doesn’t provide relief, then the doctor may suggest surgical treatment like SI joint fusion. This is one of the best and commonly used treatment options to fix severe SI joint problems. In this procedure, the bones near the joint are fused with the help of pins and implants.

Don’t allow your lower back pain to let you down. Consult Dr. Surya Prakash, an Orthopedic Spine Specialist in Hyderabad, for a customized treatment plan. He has more than two decades of experience in treating various spine problems.

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