Si Arthritis
What is SI Arthritis?
Sacroiliac (SI) arthritis involves inflammation of the sacroiliac joints, which connect the lower spine to the pelvis. This can cause lower back, buttock, and sometimes leg pain.
- Pain often worsens with prolonged sitting or standing
- Inflammatory conditions like ankylosing spondylitis can affect these joints
Overview of the Condition
The SI joints transmit forces between the upper body and legs. Arthritis in these joints can result from wear and tear (osteoarthritis), inflammatory diseases, or trauma.
Symptoms
- Pain in the lower back, buttocks, or groin
- Stiffness or reduced range of motion
- Pain aggravated by climbing stairs, running, or prolonged sitting
Causes
Degenerative or inflammatory arthritis can damage the cartilage in the SI joints. Overuse, trauma, or adjacent joint problems (lumbar spine or hip) may also increase SI joint stress.
Diagnosis
Physical exam maneuvers stress the SI joints to reproduce pain. Imaging tests like X-ray or MRI can reveal inflammation or structural changes. Diagnostic injections help confirm the SI joint as the pain source.
Treatment Options
- NSAIDs or analgesics
- Physical therapy and exercises
- Joint injections with corticosteroids
- Sacroiliac belt to provide support
Conservative Management
Initial treatment often includes rest, anti-inflammatory medications, and PT exercises to improve stability and reduce joint stress.
Rehabilitation Exercises
- Pelvic tilts to mobilize the SI region
- Hip abductor and core strengthening
- Gentle stretching of the hips and lower back
When is Surgery Needed?
Surgery is rarely the first option. It may be considered for severe, persistent SI joint pain unresponsive to conservative measures.
Surgical Procedures
- SI joint fusion to stabilize and reduce painful motion
- Minimally invasive techniques to fixate the joint using small implants
Anatomy Overview
Each pelvis connects to the sacrum via the sacroiliac joint. These strong joints provide shock absorption and help transfer weight from the spine to the legs.
Affected Areas
- Sacroiliac joints on each side of the pelvis
- Surrounding ligaments and muscle attachments
Frequently Asked Questions
| Question | Answer |
|---|---|
| How do I know if my pain is from the SI joint? | A diagnostic SI joint injection can confirm if pain relief occurs. Specific clinical tests also help pinpoint the joint as the source. |
| Is SI arthritis the same as sacroiliitis? | SI arthritis is a general term for inflammation/degeneration of the SI joint. Sacroiliitis specifically indicates inflammation, often due to autoimmune conditions. |
Prevention Strategies
- Maintain a healthy weight to reduce joint stress
- Strengthen core and pelvic stabilizing muscles
- Use proper lifting techniques and ergonomics