Sacroiliac Joint Dysfunction

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What is Sacroiliac Joint Dysfunction?

Sacroiliac Joint Dysfunction, also referred to as SI pain, SI joint pain, or Sacroilitis, can occur due to inflammation of the joint between the sacrum and the right and left ilium bones. Your sacrum is a solid structure composed of five fused vertebrae located on the spine between the lumbar and coccyx (tail bone) regions of the column. The ilium is the largest and uppermost section of the hip bone, the structure that we most often associate with our hips.

The sacroiliac joints are located within the inside of the pelvis on either side of the spine, and are held together by a combination of interlocking bone and ligaments. Two layers of cartilage fit between the two bones and ligaments surround the structure on either side. Nerves are also found between the bones of the joint and function as messengers to the brain.

The two main functions of the sacroiliac joint are shock absorption of forces from the upper body and weight distribution into the legs, or base of the body. There is typically very little movement associated with this joint, but when the joint is strained, injured, or affected by a chronic condition or illness, the joint can become unaligned, exposing or pinching nerves, and generating searing pain.

Knowing that the sacroiliac joint is a shock absorber and stabilizer of the entire upper body, it is not surprising that there are many things that can strain or irritate it. Chronic conditions such as Osteoarthritis, Rheumatoid Arthritis, or less common forms of arthritis can cause age-related breakdown of the tissues lining and protecting the joint. Pregnancy and childbirth can produce strain and weakening of the SI joint due to changes in hormones and increased weight in this area of the body. Gout, or an increase in the body’s uric acid content, can also affect this joint. Other possible cause of SI joint dysfunction can include: injury, strain during exercise or sports, or abnormal walking patterns.

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What are the Symptoms of Sacroiliac Joint Dysfunction?

Sacroiliac Joint Dysfunction (SJD) can be somewhat challenging to diagnose, as these specific joints are nestled deep within the body. The symptoms of SJD are also very similar to the symptoms of arthritis, sciatica, bulging discs, or other common disorders of the spine. And if that weren’t enough, the sacroiliac joints often do not show any signs of damage through the use of imaging techniques such as MRIs, X-rays, or CT scans.

Despite the difficulty in diagnosing this specific dysfunction, it is definitely not impossible. Keep in mind that almost 30% of the cases of lower back pain can be attributed to Sacroiliac Joint Dysfunction.

Symptoms of sacroiliac joint dysfunction to keep a watchful eye out for include the following:

  • Pain: Discomfort is the main symptom of SJD, and can be felt in the lower back, buttocks, and hips. In some cases, pain can even be felt on the front or back of the legs. Radiating pain can occur as well, shooting down the front or the back of the legs.
  • Stiffness: One can feel stiffness in the lower back or pelvic regions.
  • Tingling or Burning: There can be a tingling or burning sensation in the lower back, hips, or buttocks region.
  • Pain Associated with Certain Movements: Increased pain could occur when performing certain movements such as standing from a seated position or rolling over in bed.
  • Legs That Buckle: One may experience a feeling that the legs may buckle or “give in”; or a general feeling that your legs can’t support your body.

Have you been experiencing any of these painful or troubling symptoms? Dr. Frazier at NYC Spine has over 20 years of experience in diagnosing and treating lower back pain that is associated with Sacroiliac Joint Dysfunction and other spinal disorders.

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What are the Treatments for Sacroiliac Joint Dysfunction?

Because the symptoms of sacroiliac joint dysfunction can be so similar to those of other spine and low back conditions, these related disorders must be ruled out through diagnostic procedures such as physical examinations or scans such as MRIs, x-rays, or CT scans. Diagnosis is often reached through means of orthopedic movement, meaning that your physician may ask you to move in certain ways that will provoke movement of the sacroiliac joint. If the sacroiliac joint is the problem, then pain may be triggered by this prescribed movement.

Your physician may also perform a procedure called a sacroiliac joint block. In this procedure, your physician will, with the help of x-ray imaging, inject the sacroiliac joint with a numbing serum. If this injection relieves the pain, then it can be inferred that the sacroiliac joint is the problem.

Once a diagnosis of sacroiliac joint dysfunction is reached, your physician will work with you to find the least invasive treatments to relieve your pain.

Minimally invasive treatments for sacroiliac joint dysfunction may include any of the following:

  • Physical therapy
  • Chiropractic interventions
  • A hot/cold regimen
  • Acupuncture and Massage
  • Medications such as NSAIDs to manage pain
  • Injections with an anti-inflammatory such as a corticosteroid
  • Radiofrequency ablations to remove nerves causing the pain

In extreme cases, there may be individuals who do require surgical treatment. In such instances, our Harvard-trained, board certified surgeon, Dr. Frazier may recommend a Sacroiliac Joint Fusion. This procedure fuses either one or both of the joints with the use of small plates and screws. This minimally invasive technique eliminates excessive or painful movement of the sacroiliac joint and requires only a short hospital stay.

If you are looking for relief from your sacroiliac discomfort, Dr. Frazier will be able to work one-on-one with you to find the relief options. At NYC Spine, individualized treatment and compassionate care is our chief priority!

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Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.

After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.

Education & Training

  • MD / cum Laude, Boston MA

    Harvard Medical School

  • Residency, Boston MA

    Harvard Combined Orthopedic Residency

  • Chief Residency, Boston MA

    Harvard Mass. General Hospital

  • Spinal Deformity Fellowship, Miami FL

    Doctor's Hospital, Shufflebarger Fellowship

  • Academic Appointments, NY, NY

    Columbia University; SUNY Downstate

  • Consultant, Lecturer

    Nuvasive, Depuy & Stryker International Spine Cos.