History of sacroiliac (SI) joint disorders
Sacroiliac (SI) joint disorders and the associated symptoms have been well known for over a century. In fact, in the early 1900s symptoms which seemed to arise from the back were frequently attributed to the sacroiliac (SI) joint, and open surgical procedures were used to treat the joint.
In 1934, a paper was published on the spinal disc as a source of pain in the back. As a result, disc treatment became the most common operation for orthopedic surgeons, and the sacroiliac (SI) joint was all but forgotten.1 Now, 70 years later, orthopedic and spine surgeons have recognized that the disc is not the only source of low back pain (LBP).
According to scientific data, it's common for pain from the SI joint to mimic disc or low back pain. To avoid unnecessary lumbar spine surgery, SI joint disorders should be strongly considered in low back pain diagnosis.2
The sacroiliac (SI) joint and low back pain
Like any other joint in the body, the sacroiliac (SI) joint can become arthritic or its support ligaments can become loose or injured. When this happens, people can feel pain in their buttock and sometimes even well above their buttock and higher on the skeleton. This is especially true with lifting, running, walking or even sleeping on the involved side.
It is important to note that on occasion, patients who have not had symptomatic relief from lumbar spine surgery may actually have had other issues to begin with. This could include the SI joint, the hip, the spine separately or any combination of these three pain generators.
Possible causes of SI joint pain or SI joint dysfunction:
- Degeneration of the SI joint: degenerative sacroiliitis
- Disruption of the SI joint: SI joint disruption, SI joint laxity
- Congenital problems: sacral dysplasia
- Inflammation of the SI joint: ankylosing spondylitis, Reiter’s syndrome, or associated with inflammatory bowel disease
- Acute or chronic infection
- Bone disease: hyperostosis, sickle cell anemia
- Tumor: benign or malignant
1. Mixter, WJ, and JS Barr. “Rupture of the Intervertebral Disc with Involvement of the Spinal Canal.” New England Journal of Medicine 211, no. 5 (1934): 210–215.
2. Weksler, Velan, et al. The role of Sacroiliac (SI) Joint dysfunction in the genesis of low back pain: the obvious is not always right. Archives of ortho and trauma surgery. 2007 Dec; 10(127) 858-888.