The lowest spinal region is often overlooked, but also prone to pain
Jun 30 2011
SI joints connect the spine to the pelvis. MedicineNet.com explains that these joints' mobility is relatively low since most of the motion in that area occurs at the hips and the lumbar spine (lower back). However, SI joints support the weight of the upper body when a person stands upright, and as such these structures are subject to significant pressure and stress. This makes the cartilage vulnerable to wear-and-tear over time, which may result in conditions such as arthritis or acute inflammation.
In addition to people who are older or obese, women of childbearing age are at a higher risk for the SI joint problems. This is due to weight gain and altered gait associated with pregnancy as well as the release of a hormone that causes ligaments to relax in preparation for childbirth. Since this allows for increased motion in the joints, it can result in greater stress on the joints and abnormal wear, the news site further states.
When lower back pain symptoms as a result of SI joint dysfunction first arise, conservative treatments with physical therapy or medications should be tried first. Pain management techniques like ablation or neurostimulation may also provide some relief.
In addition, a recent study presented at the 2011 European League Against Rheumatism Annual Congress demonstrated the safety of biologic agents that block the tumor necrosis factor for the treatment of inflammation of the SI joint, known as ankylosing spondylitis.
However, if these non-invasive approaches fail to bring lasting results, patients have several surgery options, including endoscopic procedures, which are growing in popularity across the board.
Recently, Becker's Orthopedic, Spine and Pain Management Review devoted an article to the discussion of proper diagnosis of SI joint problems and treatments involving minimally invasive surgery.
In order to distinguish SI dysfunction from other conditions that may have similar symptoms - such as sciatica - doctors can inject a local anesthetic to the area of the joints to see if the patient obtains pain relief, the news source reported.
Among the different surgical options, it singled out a novel procedure whereby the orthopedic surgeon inserts an implant through a small incision to stabilize the joint.
This is a significant improvement over the older approach that relied on a bigger opening, which caused more trauma to the surrounding soft tissue and resulted in a longer recovery time.
"I thought the traditional sacroiliac joint fusion was too invasive and I used to refer these patients to interventional pain management," said Richard Kube, MD, an Illinois-based spine surgeon, quoted by The Review.
However, he added that "now that there's a less invasive way for surgeons to provide a permanent solution to these patients, this procedure could help improve the outcomes for a large portion of the population."
According to some statistics, between 15 and 38 percent of the general population are affected by SI joint disorders.