What is Sacroiliac Joint Dysfunction?
The sacroiliac joint, or SI joint, straddles the two main bones in the pelvic area — the sacrum and the ilium — and connects the spine to the pelvis. Shaped like a triangle, the large sacrum bone sits at the base of the spine, while the ilium is the uppermost part of the hip bone.
SI joint dysfunction occurs when this joint becomes unstable or inflamed, causing back, pelvic, groin, and hip pain. The condition typically results from inflammation (sacroiliitis) due to aging, or too much or too little movement. Pain may be particularly acute when you stand up after sitting, walk up a hill or stairs, or twist your body in bed.
How is SI Joint Dysfunction Diagnosed?
To identify whether SI joint dysfunction is the source of back pain, a combination of physical and imaging tests are used. The physical exam entails putting pressure on the sacrum or hips; if the pain worsens or goes away temporarily, then SI dysfunction may be at the root of the discomfort.
Since SI joint dysfunction isn’t typically spotted on an X-ray or MRI, an orthopedic specialist can diagnose the condition by injecting a local anesthetic into the lower back or buttocks. If the pain subsides significantly, then the ache was most likely caused by a compromised SI joint.
What is Sacroiliac Joint Fusion?
If sacroiliac joint pain does not respond to physical therapy or medication, the next step may be sacroiliac joint fusion surgery. To begin this minimally invasive procedure, the surgeon makes a small incision in the side of the buttocks. This opening allows the surgeon access to the hip bone.
After drilling a hole into the sacrum and ilium, the surgeon stabilizes the sacroiliac joint with either an implant, a bone graft, or both. For a bone graft, bone shavings from the ilium are collected to fill the space after the cartilage and soft tissue are removed from the joint. Both methods are intended to promote bone growth and strengthen the joint as the implant or grafted fragments fuse with the bones.
Recovery Time for Sacroiliac Joint Fusion
Full recovery from sacroiliac joint fusion surgery typically takes up to six months. For four weeks following the procedure, patients may be advised to use a cane or walker. Your doctor may also recommend wearing a pelvic brace to relieve pressure on the joint and ensure it fuses properly.
A physical therapy program of stretching and strengthening exercises can build up your range of motion as well as increase strength in the core muscles, lower back, and legs. Aerobic activities such as swimming, walking on an elliptical machine, or pedaling a stationary bike may be incorporated into your fitness regimen later.
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