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Is SI Joint Dysfunction Common?

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SI Joint Q & A
Is SI Joint Dysfunction Common?

It is commonly reported in clinical literature that 15-30% of chronic lower back pain is attributed to the SI joint. But the number may be higher than that, because the condition is often overlooked by medical providers.

Sacroiliac (SI) Joint Complaints

Some people who complain of lower back pain actually have problems in their sacroiliac (SI) joint.¹ There may be up to a million patients annually with low back complaints who have SI joint conditions like sacroiliac joint disruption and degenerative sacroiliitis.

A review study by Cohen shows that 15-25% of chronic low back pain is sacroiliac joint in origin and that the diagnosis of sacroiliac joint disease is frequently overlooked by physicians.⁴¹

Differential Diagnosis Is Required to Rule Out SI Joint Dysfunction

Weksler, et al., report that sacroiliac joint dysfunction can feel like discogenic or radicular low back pain.²⁶ In fact, many low back pain patients go on to receive lumbar fusion surgery instead of sacroiliac joint fusion. In light of this, sacroiliac joint disease must be strongly considered in differential diagnosis of low back pain.

A study by Ha, et al., shows that the incidence of SI joint degeneration in patients who had undergone lumbar fusion surgery is 75% at 5 years post-surgery, based on imaging.¹⁶ Studies by DePalma and Liliang, et al., demonstrate that 40-61% of post-lumbar fusion patients with continued or new onset pain were symptomatic for SI joint disorders based on diagnostic blocks.^14,15

More and more orthopedic, trauma, and spine surgeons are now recognizing that the disc is not the only source of low back pain, and are learning the appropriate tests to check for SI joint conditions.

How Do I Prepare for SI Joint Physical Therapy?

These questions may assist you in getting the most out of your physical therapy appointment. After an initial evaluation, your physical therapist should have the information needed to answer the following questions.