In order to understand what Sacroiliac Joint Dysfunction is, you must first know what the SI joint is and the location of the joint.
At the lower aspect of the spine, just below the lumbar vertebrae, lies the sacrum. The sacrum is a triangular shaped bone built by several fused vertebrae. The ilium bones are the uppermost and largest bones of the pelvis. The two ilium bones join the sacrum medially to make the SI joint. Ligaments and muscles attach to the joint for support and strength. These muscles and ligaments can also be a source of SI pain and dysfunction. Most importantly, the function of the SI joint is to transfer the weight of the upper body to the lower extremities.
Dysfunction generally occurs when there is pain in the joint. Inflammation can ensue and cause a debilitating injury. The typical and most common pattern of injury occurs by two main forces, vertical compression and rotational movements. Examples of this type of mechanical strain include; carrying a heavy object and twisting, and falling onto the backside. Common symptoms include low back pain, buttock pain, sciatic pain, numbness/tingling, and groin or hip pain. The symptoms can be exacerbated with the vertical compressive and rotational movements that also help practitioners diagnose the condition. Prolonged positions (such as standing, lying, and sitting), increased activity, bending forward, stair climbing, hill climbing, and rising from a seated position can irritate the SI joint.
Diagnosis of SI Dysfunction is made by a detailed history and physical and diagnostic injections. Once SI dysfunction is suspected, an injection can be introduced into the joint containing both a local anesthetic and a steroid. This procedure is both diagnostic and therapeutic, meaning, if the suspicion is correct, the pain should subside immediately. This tells the practitioner that this is the correct pain generator. The patient will feel instant relief if the diagnosis is correct. The steroid will slowly begin to work by an anti-inflammatory process. In the majority of patients, the injection mixed with some physical therapy, is enough to kick the inflammation and resolve the SI dysfunction. Ideally this is preferred treatment being that other invasive procedures can be avoided.
My name is Nancy. I am 66 years old. I do not like taking medicine because of side effects and addiction and being allergic. I am afraid of doctors because of past experiences but I was in so much pain I had to go see one. I picked Dr. Kube. My first visit to see him, I thought he would be just like the other doctors. I just kind of looked at him and kept shaking my head no to surgery because your back is a very important part of your body.
Dr. Kube wanted to give me joint injections after x-raying me but I needed a preop exam. My family doctor did not want to get involved because it was my workmen’s comp. I relayed this to Dr. Kube and he was very upset because just because it was workmen’s comp, my own doctor would not get involved.
Dr. Kube made one statement that I could not get out of my head. “Just because it is workmen’s comp and there is a lot of red tape and time involved, it is the patient that is important.”
I started looking at Dr. Kube in a different way. This doctor cares. It is not all about the money and red tape. It is what is going to help ME. There are not many doctors that feel that way anymore. I think they forgot their oaths. Dr. Kube answered all of my questions and I am sure some of them were ridiculous but like I said before, I panic when it comes to doctors. He explained everything to me in words I could understand. He took the time to CARE. He renewed my faith in a doctor. I decided to take the joint injection. He was very gentle and considerate of my fears. I was without pain for the first time in five months. It only lasted six days but it gave him the answers he needed about my back. He referred me to another doctor that would continue to help with pain management. I would recommend Dr. Kube and his staff very highly to anyone and everyone. They are all about the patient.
About The Author: Derek N. Morrow, PA-C is a physician assistant with Prairie Spine and Pain Institute. Derek works in the clinic setting as a health care provider seeing patients. He is also utilized in the operating room as a first assist in surgery. In the clinic setting, his key function is to diagnose new patients and conduct their initial treatment. He works directly with patients to establish customized treatment programs and to monitor their progress. He also conducts history and physical evaluations for many patients. He performs many office procedures including trigger point injections, large joint injections, and bursa injections, all with the help of ultrasound guidance. He is radiologically trained, and uses his knowledge of X-ray, Ultrasound, MRI, CT, and EMG-Nerve Conduction Studies to establish a diagnosis and determine the appropriate treatment. Derek is surgically trained and plays a vital role in the procedures we perform at Prairie Spine and Pain Institute.