Do you experience sharp pain in your lower back, buttocks, or hips when you stand up after sitting for a long time, climb stairs, or walk after standing for a while? Sometimes this pain can also travel down your leg. While many people think this is just a simple backache, it could be due to a problem somewhere you don't think. That problem is SI joint pain , which we're talking about today.
What is the SI joint and its associated pain?
Okay, let's first look at what the SI joint is. SI is short for Sacroiliac. Simply put, the two joints that connect the sacrum, the lowest, triangular-shaped bone in our spine, and our iliac bone, are called the SI joints. Remember those two little hollows on either side of your lower back? That's where these two most important joints are located.
The main function of these joints is to distribute the weight of our upper body, hips, and legs correctly when we stand and walk. They also act as shock absorbers to absorb the vibrations that come to our body.
Now there are two ways this pain can occur:
- Sacroiliitis: This is when the SI joint becomes inflamed , causing swelling and pain, due to some cause (e.g., infection, arthritis).
- SI joint dysfunction: This occurs when the ligaments that hold the joint together become too loose or too tight, causing abnormal joint movement and pain.
What are the symptoms of this pain?
The main symptom of SI joint pain is pain in the lower back. It can sometimes be a dull ache, but other times it can be a sharp stabbing pain. Check out this information to see if you have any of these symptoms.
| Characteristic | More details |
|---|---|
| Pain when changing position | The pain increases when you change positions (sitting or standing) for a long time. |
| Pain when turning the body | The pain increases when you rotate your upper body or hips, or when you turn over to the other side of the bed. |
| Pain during certain activities | The pain may increase when climbing stairs, running, or walking with large steps. |
| Spreading pain | The pain spreads from the lower back through the hips, buttocks, thighs, and sometimes all the way to the feet. |
| Numbness or loss of sensation | You may feel numbness or tingling in your legs. |
| Morning stiffness | The back and hip area may be stiff for more than an hour upon waking in the morning. |
What causes SI joint pain?
The main cause is that the ligaments that hold the SI joint together are too loose or too tight. This can be caused by a variety of things.
- A fall or accident
- Pregnancy and childbirth
- Previous hip or spine surgery
- Uneven distribution of body weight due to one leg being shorter or weaker than the other
Specific causes of sacroiliitis
There are several other specific causes that contribute to this condition of joint inflammation .
- Arthritis: This is the main cause. It can be caused by osteoarthritis, which occurs with age, or autoimmune diseases such as Ankylosing Spondylitis and Rheumatoid Arthritis, where our own immune system attacks our joints.
- Pregnancy: Hormones released during pregnancy can loosen the ligaments in the SI joint. Also, the increased body weight can put pressure on the joint and cause pain.
- Infections : This joint pain can also occur as a reaction to some bacterial infections.
- Intestinal diseases: Inflammatory bowel conditions such as Crohn's disease and ulcerative colitis can also affect the SI joint.
How does the doctor diagnose this? (Diagnosis)
When you go to see a doctor with these symptoms, they will first ask you about the pain. How it started, what you do, and whether it gets worse. Then they will examine your back, hips, and legs. They may also press on the areas where you feel pain.
The most important thing is to see a qualified doctor and get an accurate diagnosis, rather than self-diagnosing, as these symptoms can also occur in other medical conditions.
In addition, the doctor may recommend several tests, such as:
- Blood tests to check for infections or other inflammatory conditions
- X-ray to see if the SI joint is damaged
- A CT scan or MRI scan to get a clearer image
Sometimes, the doctor can inject a numbing medication into the painful SI joint. If the pain goes away after the injection, then it is almost certain that the problem is in the SI joint.
What are the treatments for this?
Treatment depends on the cause of your pain and its severity. Usually, a combination of one or more of these treatments is recommended.
Physical Therapy
This is the main and most common treatment for SI joint pain. A physical therapist will teach you specific stretches and exercises to strengthen your hip and back muscles and increase flexibility. This will reduce the pressure on the joint and stabilize it.
Medications
Depending on your pain and its cause, your doctor may prescribe different medications.
- Painkillers: Over-the-counter painkillers (NSAIDs) such as ibuprofen and naproxen can be used for short periods of time. But remember, do not take these continuously for more than 10 days without medical advice. If the pain is severe, your doctor will prescribe stronger painkillers.
- Muscle relaxants: These help relieve pain by reducing muscle stiffness.
- Specific medications: If your pain is caused by an autoimmune disease like arthritis, your doctor will prescribe specific medications, such as biologics or disease-modifying antirheumatic drugs (DMARDs), for that disease.
Surgery and other procedures
- Injections: Injecting a steroid medication, such as cortisone, directly into the joint can quickly reduce inflammation and pain. However, this is not always possible.
- Radiofrequency ablation: This uses a special needle to damage the nerve that carries pain signals from the joint to the brain, eliminating pain.
- SI joint fusion: If no other treatment is successful, a very rare surgical procedure is performed to fuse the two bones of the joint together, stopping the movement of the joint.
What things can you do at home?
Along with medical treatment, you can also get relief from these things. But remember, it's very important to talk to your doctor before doing these things.
- Alternating hot and cold applications to the painful area.
- Rest and avoid activities that increase pain.
- Engaging in light exercises like yoga.
- Maintaining correct posture (when standing, sitting).
- Using a special SI belt (Sacroiliac belt) worn around the hips.
Take-Home Message
- SI joint pain is a common cause of pain in the lower back, hips, and buttocks.
- This condition can occur due to various reasons, such as falls, pregnancy, and arthritis.
- The main symptom is that the pain increases when standing up from a sitting position or climbing stairs.
- If you have symptoms like these, be sure to see a doctor and get a proper diagnosis.
- There are various treatment options, such as physical therapy, medications, and injections, and your doctor will determine the treatment that is best for you.
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