Sacroiliac joint conditions

Causes and treatment options

Back pain is very common in Germany. After colds, back pain is the second most frequent reason why people visit a doctor. The pain usually occurs in the area of the lumbar spine or the sacroiliac joints. In 25 per cent of cases, back pain in the lumbar spine region is caused by problems in the area of the sacroiliac joint, the sciatic nerve and the locomotor apparatus in the pelvic region.

In the case of back pain, it is important to determine the causes, and to start treatment early. This can prevent the pain from becoming chronic. The goal of back pain therapy is effective pain relief to enable those affected to quickly return to normal daily activities, and preventing back pain from recurring.

Causes of sacroiliac joint conditions

The sacroiliac joint, in short SI joint, is also known as the iliosacral joint. It connects the lower spine with the pelvis via tight ligaments. Owing to the firm support apparatus in place, the sacroiliac joint is not very mobile. It can, however, be shifted by applying a lot of force, or by bad posture. Even the smallest shifts in the sacroiliac joint can cause severe back pain. A blockage of the sacroiliac joint, a so-called SI joint blockage, can be caused by sudden force applied during exercise or an accident.

Pain in the sacroiliac joint can also occur due to wear (osteoarthritis), loosening of the symphysis during pregnancy, pelvic girdle instability, or ankylosing spondylitis. The muscles and tendons of the sacroiliac joint can also cause pain in the SI joint after overexertion and continuous poor posture or inappropriate mechanical stress.

Other causes of pain in the sacroiliac joint can be infections, herniated discs, broken bones, hip conditions, and also stress.

Typical pain in the case of sacroiliac joint conditions

Those affected feel pain in the area of the SI joint. However, pain can also radiate to the lumbar spine and the legs. Similar pain is triggered by conditions originating from the sciatic nerve. In the case of sciatica, numbness and paralysis in the legs as well as urination and bowel movement problems can occur alongside back pain.

In the case of a sacroiliac joint condition (SI joint syndrome), the pain in the back increases in intensity during the day. Straightening up, lifting of heavy objects, and long periods of standing are particularly painful.

Osteoarthritic pain in the sacroiliac joint initially only occurs with physical strain. Over the course of the condition, people start to experience pain even with ordinary strain, and later on also during rest.

Ankylosing spondylitis is a rheumatic condition that is associated with chronic, inflammatory processes at the SI joint commonly observed already at an early age. The first symptom of the condition is back pain at night.

How to diagnose sacroiliac joint conditions

Different diagnostic methods are used to determine the cause. The first element is a comprehensive discussion between patient and doctor and a physical examination. These may already give an idea of possible causes. During the physical examination, tests are carried out that are not only typical for the sacroiliac joint but that may also indicate involvement of the sciatic nerve. Generally, blood tests are not included in the diagnostics for SI joint syndrome. If ankylosing spondylitis is suspected, however, the doctor will also order laboratory blood testing. Chronic back pain at an early age can be an indication for the condition. Additionally, X-rays as well as computer tomography (CT) can determine potential herniated discs, vertebral fractures or dislocations as a cause.

Treatment of sacroiliac joint conditions

Physical exercise is an essential component in the successful treatment of SI joint syndrome. It is important that those affected move a lot, even if it hurts. Physiotherapy is prescribed as well. Using special exercises, the sacroiliac joint is stabilized and relieved during the treatment session.

Furthermore, the doctor can arrange a so-called infiltration therapy. In this treatment, numbing medication, so-called local anesthetics, are injected right where the pain originates. This causes the pain receptors to shut down. Additionally, anti-inflammatory medication and painkillers, such as cortisone can be injected.

Heat treatments such as baths, poultices, heat patches or infrared lamps effectively support therapy. If the back pain is caused by the sciatic nerve, heat treatments to reduce the symptoms are also a good idea.

If the SI joint syndrome has occurred only recently, it can usually be treated well. Treatment will be more difficult if the symptoms have lasted for a longer period or are constantly recurring.

In the case of an SI joint blockage, the joint blockage is loosened through manual therapy performed by a doctor or physiotherapist. This can happen in two ways: via mobilization or manipulation. In the case of mobilization, the affected joint is carefully stretched during physiotherapy to improve its mobility. During manipulation, the blockage is released using a brief application of force on the affected joint by the doctor.

Pain relief and prevention using back orthoses

Medical back orthoses can effectively support treatment of sacroiliac joint conditions, and prevent recurring symptoms.

The SacroLoc back orthosis supports the pelvic region in the case of sacroiliac joint conditions and other disorders of the locomotor apparatus in the area of the pelvis. Integrated friction pads activate circulation by massaging the sacroiliac joint, and loosen tense muscles. SacroLoc stabilizes and relieves the lower back right at the sacroiliac joints. The intensity of the stabilization can be individually adjusted using tensioning straps. Specially designed closures ensure easy donning. SacroLoc is comfortable to wear, adapts to the body during movement, and can hardly be noticed under clothes.