Sacroilliac Joint Dysfunction/Pain
What you need to know
The sacroiliac joint connects the end of the spine to the pelvis. It is located in the posterior region of the pelvis and helps stabilize the lower end of the sacrum which is the pillar of the spine. Ligaments cover the joint, which help stabilize the joint. The ligaments may be disrupted from injury or degenerate with age, allowing the joint to have excessive motion which can disrupt the joint and surrounding nerves. As it degenerates, the cartilage within the joint wears away and nerve endings in the joints can become inflamed to cause pain in the lower back region. Up to 30% of all chronic low back pain is due to SI joint dysfunction. Patients usually complain of pain getting in and out of a seated position and changing positions. The patients can also complain of pain shooting down the leg, from the arthritis irritating the sciatic nerve.
Causes of sacroiliac joint pain can be traumatic, biomechanical (prior lumbar fusion), hormonal (pregnancy), inflammatory (sacroiliitis), and degenerative.
Despite performing a physical examination to reproduce the painful symptoms, a fluoroscopically guided injection into the joint that decreases the pain significantly confirms the diagnosis. Imaging studies such as x-rays, CT scans and MRI’s can also be utilized to demonstrate the degeneration of the joint.
Conservative treatment with physical therapy, non-steroidal medications and pelvic belts can be used. If all conservative treatment has been exhausted, surgery can be the next best step, which consists of a minimally invasive fusion.
Minimally Invasive Fusion
Patrick J. Horan, MD, MBA, FACS
Patrick J. Horan is an orthopaedic surgeon and sports medicine specialist with two decades of experience. He is board-certified in orthopaedic surgery and sports medicine. After receiving his undergraduate degree from Duke University in Durham, N.C., Dr. Horan earned his medical degree from Tufts University School of Medicine in Boston. Residency and Internship were both completed at Walter Reed Army Medical Center in Washington, D.C. He also received an MBA from Auburn University in Auburn, Ala.
Dr. Horan served 10 years on active duty in the US Army as an orthopaedic surgeon before entering into private practice. Dr. Horan is the founder of the Westchase Orthopaedic and Rehabilitation and the official surgeon of the Tampa Bay Rowdies. He maintains professional memberships with the American Academy of Orthopaedic Surgeons, the American Academy of Orthopaedic Sports Medicine and the Arthroscopy Association of North America.
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