The sacroiliac joint (SI pain)

One of the most common causes of low back pain that we see in our office is the pain caused by the sacroiliac joint (SI).

Typically a patient will come in after visiting a physician who prescribed NSAIDS or provided a cortisone injection. They may have also visited a chiropractor, a physical therapist,and a massage therapist. All obviously with limited results.

Those who come with an MRI will usually provide a film showing a herniation between the L5 and S1 vertebrae and a prognosis of impending surgery.

But is it the joint itself causing the pain?

“The sacroiliac joint has been shown to be a source of pain in 10% to 27% of suspected patients with chronic low back pain utilizing controlled comparative local anesthetic blocks.” (1)

If it is not the discs what is it? Many times it is the ligaments and tendons.

The sacrum, is a triangular shaped bone at the bottom of your spine. It fuses between the iliac bones, your “right and left hips,” to complete the pelvis. Holding this boney structure together is a network of ligaments and tendons. When these ligaments and tendons become weakened or lax, one of the most common causes of low back pain occurs.

Subluxation or a slipping of the sacroiliac (SI) joint.
Ligaments and tendons are weakened by age, overuse syndrome, or injury. In the sacroiliac joint, because it supports the torso and has large nerves running through it all the way to the feet, these injuries to the sacroiliac ligaments can mimic other injuries such as disc herniation and lead to an incorrect diagnosis which could lead to an unnecessary lower back surgery.

Prolotherapy works be strengthening the connective tissue that holds the pelvic, groin, hip region together. Typically a few injections are needed during a few visits to stabilize the area and bring pain relief through healing.

“This descriptive study of prolotherapy in private practice has shown positive clinical outcomes for the 76% of patients who attended the 3 months and 12 months’ follow up visits…” (2)

“Intra-articular prolotherapy provided significant relief of sacroiliac joint pain, and its effects lasted longer than those of steroid injections.” (3)

Watch a treatment to the lower back

http://www.prolotherapyinstitute.com/prolotherapy-to-the-lower-back.htm

1. Pain Physician. 2009 Mar-Apr;12(2):399-418.
Evaluation of sacroiliac joint interventions: a systematic appraisal of the literature.
Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP.

2.Cusi M; Saunders J; Hungerford B; Wisbey-Roth T; Lucas P; Wilson S. The use of prolotherapy in the sacroiliac joint. Br J Sports Med 2010;44: 100-104.

3.Kim WM, Lee HG, Jeong CW, Kim CM, Yoon MH. J Altern Complement Med. 2010 Dec;16(12):1285-90.A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain.