The sacroiliac joint, commonly referred to as the SI joint, links the pelvis with the lower spine. That part of your lower spine, which extends to your tailbone, is called the sacrum. Your pelvis is shaped like a bowl that surrounds your organs. The iliac bone, the large bony protrusion that makes up your hip bones and travels around to the back of your abdomen, meets the sacrum in the rear. The SI joints connect the iliac bone to each side of the sacrum.

The SI joints are often responsible for lower back and hip pain. If you’re experiencing aches and pains, it’s important to get a proper diagnosis so that you can follow an effective care plan and achieve relief.

What Is Sacroiliac Pain?

The SI joints play an important role in stabilizing your pelvis. They’re surrounded by ligaments that support the area, allowing the joints to move only about two to four millimeters. But the joints allow the pelvis to shift, rotate and tilt. This function is essential for just about every movement that you make, including walking.

Strain, injury, degeneration and instability in the joint can lead to inflammation and discomfort. Sacroiliac pain stems from one or both of the SI joints, but it can extend to several areas, including the following:

• Low back
• Buttocks
• Hips
• Groin
• Leg

The pain is often described as sharp and stabbing and worsens with certain movements, such as:

• Standing for long periods of time – Prolonged standing puts a great deal of pressure on the spine, especially if you have other misalignments or weaknesses. Poor posture can strain soft tissues in the network with the SI joint, causing pain as your pelvis supports the weight of your body.
• Walking – Your SI joint is made of two interlocking bones. This opposing force helps you support your weight on one leg as you move the other. But the movement of the joint allows you to tilt your pelvis to lift one leg up and take another step.
• Running – Because they absorb so much shock, the SI joints can incur damage and cause pain with high-impact activities.
• Putting weight on one side more than the other – Repetitive, frequent or prolonged motions that shift or tilt the pelvis can negatively impact the SI joints.
• Prolonged sitting – A sedentary lifestyle leads to muscle weakness and imbalances that make your SI joints take more impact than they need to. Prolonged sitting can cause contractions and lengthening in the soft tissues that support your SI joints. That’s why you often need to stand up and reverse the movement to achieve relief.

What Causes Sacroiliac Pain?

Sacroiliac pain is caused by dysfunction in the SI joints. This dysfunction may be generated by:

• Injury – Damage to the area can change the ligaments and bones, creating inflammation, tightness and misalignment. Hip, spine and pelvic fractures can lead to pain in the SI joint. Using an improper lifting technique when moving heavy objects can also cause injury.
• Congenital anomalies – Malformations in the skeletal structure can hinder proper joint function.
• Arthritis – The SI joints interlock, which generates significant friction. Cartilage damage can cause sacroiliac pain.
• Pregnancy – Pregnant women secrete a hormone that makes their joints more flexible to support pelvic movement during childbirth. This reduces their stability and stretches the ligaments in different ways. Changes in gait during pregnancy can also strain the SI joint, causing discomfort.
• Autoimmune diseases – Some medical conditions cause the body to attack healthy tissue in the joint. For example, people with lupus have an increased risk of developing sacroiliac joint pain.
• Biomechanical conditions – Changes in posture and gait from wearing sneakers with inadequate support or accommodating a walking boot after an ankle sprain can cause degenerative wear in the SI joint.
• Aging – The mobility of the SI joints, particularly rotation, decreases with age. Your connective tissue also deteriorates as you get older, making you more susceptible to this condition. Protecting your SI joints throughout your life can prevent this from happening.
• Hip or spine surgeries – Unfortunately, changing the structure of the spine can cause a domino effect that influences the SI joint. Sometimes, surgery allows for more movement in the SI joints than the patient is used to, generating discomfort.

Initially, the pain may be intense and acute. Over time, it usually gets worse. It can lead to deep aches and stiffness that limit your mobility. The pain may wake you up at night or cause numbness, tingling and instability.

Diagnosing Sacroiliac Issues

When diagnosing problems with the sacroiliac joint, identifying the root cause of the pain is crucial. At the practices of Dr. Craig Callewart, you’ll experience comprehensive care with a focus on getting to the source of the problem.

A single test cannot diagnose the condition. An understanding of your medical history and a thorough physical exam helps Dr. Callewart to pinpoint the problem. Some of the techniques that Dr. Callewart uses to diagnose sacroiliac issues include:

• A comprehensive medical exam
• Examination of your medical history to identify or rule out associated conditions
• Examination of symptoms
• Tests that require you to get into specific positions and identify the location of the pain
• Manipulation and palpation of the area
• Imaging studies, such as X-rays

Treating Sacroiliac Pain – SI Fusion

Conservative treatments for sacroiliac pain include physical therapy and epidural injections. However, the shape and nature of the SI joints make them susceptible to degenerative damage. Sacroiliac fusion is a minimally invasive treatment that provides relief when other options haven’t.

This cutting-edge technique allows Dr. Callewart to stabilize the exact location where the problem is stemming from. It involves making a small incision in the buttocks or lower back and inserting a device to hold the SI joint in place. A bone graft may also be performed to encourage bone growth.

When it’s in place, the implant increases the weight-bearing capacity of the joint. After you heal, you should experience less pain and increased mobility.

The type of implant depends on several factors. Dr. Callewart will explain your options so that you can make an informed decision before undergoing the treatment. The procedure is usually performed on an outpatient basis and has a high rate of success.

A full recovery can take several months, but patients usually get back to their regular routines within a few weeks. Dr. Callewart has been performing sacroiliac fusion treatments in Dallas for more than 30 years and will provide detailed instructions for maximizing the success of the procedure.

Protecting your SI joints is helpful for minimizing the progression of pain before or after surgery. Practicing proper posture, maintaining your strength and agility, nourishing your body and avoiding unhealthy habits, such as smoking, can prevent sacroiliac pain in the long run.

Do You Need Relief From Sacroiliac Joint Pain?

If you’re suffering from pain and tightness in your lower back or pelvis, you can get relief. Although you may be frustrated that the pain continues to return, Dr. Callewart can help you identify the source of the discomfort so that you can resolve it effectively. 

Schedule an appointment at the offices of Dr. Craig Callewart to discuss a treatment plan and learn more about whether SI fusion is right for you.