Causes

History of sacroiliac (SI) joint disruption and dysfunction

Sacroiliac (SI) joint disruption and dysfunction and the associated symptoms have been well known for over a century. In fact, in the early 1900’s 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 disc as a source of symptomology 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. Now, 70 years later, orthopedic and spine surgeons have recognized that the disc is not the only source of low back pain (LBP) in the axial skeleton.

According to published scientific data, it’s common for pain from sacroiliac (SI) joint dysfunction to mimic disc or low back pain. Many patients go on to receive lumbar fusion instead of sacroiliac (SI) joint fusion – so sacroiliac (SI) joint dysfunction should be strongly considered in diagnosis of low back pain.1

Causes of the sacroiliac (SI) joint in back and pelvic symptomology

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 axial 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:

  • New onset or chronic low back pain +/- trauma
  • Inflammatory
  • Previous lumbar surgery
  • Post-partum pain

1. 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) 858-8.