Is Surgery the Only Solution for Low Back Pain Related to SI Joint Dysfunction?

Sacroiliac (SI) joint dysfunction accounts for up to 25% of cases of back pain. If you consider that around 65 million people in the United States report recent experiences with back pain, it means that millions of Americans are dealing with SI joint dysfunction.

If you have an SI joint dysfunction issue and you're wondering about next steps — specifically whether surgery is in your future — the good news is that there are plenty of other options to try first.

At our practice, Dr. Ali H. Mesiwala and his team are leading specialists in spine surgery and SI joint surgery. Even as surgical experts, we still exhaust conservative measures first, and the good news is that these measures are often highly successful. Let’s take a look.

Physical therapy can make a big difference

When you have an SI joint problem, it often boils down to one of two issues — your SI joints are too tight, causing significant stiffness, or they’re too loose, which leads to pain and hypermobility.

In either case, physical therapy (PT) is an effective, frontline treatment that can go a long way toward restoring stability and relieving pain. The PT in these cases focuses on two main objectives:

1. Stretching out inflamed and tight connective tissues around your SI joints
2. Strengthening key SI joint support muscles

These two efforts have proven to be the best way to combat SI joint dysfunction without surgery.

Hot and cold therapies

To manage symptoms and inflammation, we highly recommend using hot and cold therapies. For example, placing an ice pack around your SI joints can relieve inflammation and numb the pain. On the other end of the temperature spectrum, hot water can relax any tight tissues — and tissues often tighten or spasm when you’re in pain.

Movement is key

When you’re in pain, it’s instinct to want to rest and not move, but this can harm the SI joint dysfunction. Yes, we want you to avoid strenuous activities if you're dealing with SI joint dysfunction and steer clear of activities that can stress your SI joints, such as lifting heavy objects or riding a bike.

That said, exercise is important for healing because movement encourages better blood flow, which can help speed up healing and reduce inflammation. In fact, not moving can be detrimental because your lower back can stiffen up, which only adds to your discomfort.

So, light walking and exercise are important, even in the early stages of SI joint issues.

Interventional joint injections

If your SI joint dysfunction is causing you a good deal of pain and engaging in any exercise or PT is off the table because of it, we can look at interventional spine injections. These interventions can offer better relief than non-steroidal anti-inflammatory medications, allowing you to take more sustainable steps, such as the aforementioned PT, to address your SI joint dysfunction.

When surgery makes sense

If you try all the steps we outline above and your SI joint is still giving you trouble, then we can explore surgery. While SI joint surgery is still surgery, we assure you that Dr. Mesiwala uses only the most advanced, minimally invasive surgical techniques whenever possible.

Again, this outcome is far down the road, and we have many avenues to try to improve your SI joint function in the meantime.

To explore your nonsurgical options for SI joint dysfunction, we invite you to contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to schedule a consultation today.