What are sacroiliac joints (SIJ) and where are they located?
The sacroiliac joint is large, strong joints between lower end of the spine and the pelvis. There are two sacroiliac joints, one on each side. These joints play an important role in transmitting the upper body weight to the hips and legs and hence undergo a significant amount of stress in day to day life. They function as shock absorbers and are reinforced by multiple strong ligaments. Sacroiliac joints are supplied by a number of nerves which when irritated can hurt.
What causes sacroiliac joint pain?
Sacroiliac joints do not allow much movement as both too much and too little movement can become a source of pain. Some of the causes of SIJ pain include
- Trauma/ injuries involving the joints or the surrounding ligaments such as following a fall on the buttock or a road traffic accident.
- Mechanical stress due to various reasons such as previous spinal fusion surgery or leg length discrepancy leading to altered weight bearing. As per some studies 75% of patients with previous fusion surgery can develop SIJ degeneration after 5 years.
- Inflammation. Sacroiliitis is a term used inflammation of the sacroiliac joint. Ankylosing spondylitis is a type of inflammatory arthritis which can affect the SIJ and the spine. This is seen more commonly in young men. In severe cases it can cause fusion of the sacroiliac and spinal joints leading to pain with reduced range of motion.
- Normal wear and tear (degenerative changes.) These are more common with advancing age.
- Infections and tumors are fortunately not as common as the other causes of sacroiliac pain.
What are the symptoms of sacroiliac joint pain?
As many as fifteen to twenty percent of all lower back pain cases can be attributed to the issues related to the sacroiliac joint. SIJ pain can mimic pain arising from hip or spine and affects all ages.
Patients with sacroiliac joint pain generally present with buttock or lower back pain and stiffness. Pain is deep aching in character although may be sharp/ stabbing in character. It can involve one or both sides and spread towards the groin, hip, thigh and leg. Activities such as getting up from sitting position, getting in and out of car, climbing stairs, walking and sitting may become painful. Young adults suffering from ankylosing spondylitis generally present with pain and stiffness, worse in the morning and improving with exercises.
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