Stemcelldoc's Weblog

September 22, 2012

Sacroiliac Joint Dysfunction: A Cause of Back, buttock and Leg Pain

At the Centeno-Schultz Clinic we acknowledge that sacroiliac joint can be a cause of lower back and buttock pain.

The sacroiliac joint (SIJ) is the joint between the sacrum and the ilium of the pelvis.  It is a  synovial joint characterized by a capsule surrounding the articulating surfaces and synovial fluid.  The stability of the SI joint is maintained through an extensive number of ligaments.  Stability is critical as discussed in Ortho 2.0.

The function of the SIJ is to dissipate loads of the torso through the pelvis to the lower extremities.

Clinical presentation varies but commonly involves unilateral back and buttock pain  originating at the PSIS which can be dull ,sharp, stabbing, or knife-like

Slipman demonstrated pain in various areas including lower back (72%), buttock (94%) and lower leg (50%).

Causes of SI joint dysfunction include mechanical dysfunction, inflammation, lumbar fusion, trauma, degeneration and pregnancy.

 A comprehensive study at Hopkins demonstrated the incidence of sacroiliac joint pain is between 15% to 25% in patients with axial low back pain.

Diagnosis can be made by provocative physical examination manuevers which include Gaenslen and FABER test.

The gold standard is injecting SIJ under intermittent x-ray with local anesthetic and steroid with the patient reporting signficant reduction in pain.

Treatment options include physical therapy, IMS, prolotherapy, PRP and autologous stem cells.

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