Diagnosing SI joint pain
Up to 85% of people will experience low back pain at some point in their life.1 As one of the leading causes of hospital visits, it’s important to address back pain with your patients as soon as possible. However, if the pain is stemming from the SI joint, it can be difficult to diagnose, as its symptoms mimic other types of back pain.
The SI joints are the source of chronic lower back pain in 22.5% of patients.2
Here are a few common symptoms that may indicate your patient is suffering from SI joint pain:
- Dull ache below L5, often unilateral at PSIS
Pain radiates to buttocks, groin, back of thigh, and sometimes calf
Pain when sitting or lying on affected side
Pain when climbing stairs
Patient history and risk factors
If a patient has specific underlying conditions or a history of certain medical events, this may indicate they have a greater likelihood of suffering from SI joint dysfunction.
Risk factors include:
Injury: a fall, misstep, lifting accident, etc.
Postpartum: hormone-induced ligamental laxity, lordosis changes, weight gain
Biomechanical: Female sex, previous lumbar fusion, anatomic abnormalities
Diagnostic algorithm
Suspicious complaints and subjective history
Negative general back exam, positive SI joint provocation
Relief with at least two fluoroscopic-guided SI joint blocks
Sacroiliac joint dysfunction is the source of LBP
1Spoor AB, Oner FC (2013) Minimally Invasive Spine Surgery in Chronic Low Back Pain Patients. J Neurosurg Sci; Sep;57(3):203-18
2Bernard et al. Recognizing specific characteristics of non-specific low back pain. Clinical Orthopedics and Related Research. April 1987; 217: 266-280