Sacroiliac Joint Dysfunction and How It Leads to Lower Back Pain

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Of the nearly 620 million people worldwide who have lower back pain, sacroiliac joint dysfunction accounts for more than its fair share. Here’s a look at this common condition and how we can help.

Nearly 620 million people worldwide report lower back pain, making it the leading cause of disability around the globe. More alarming, this number is expected to increase to 843 million by 2050.

There are many different paths to lower back pain, and the first step toward relief is identifying the root cause behind your discomfort. Among the more common culprits is sacroiliac (SI) joint dysfunction, which is responsible for 15% to 30% of lower back pain cases. Specifically atypical low back pain. 

As a board-certified specialist in spine surgery, Dr. Ali H. Mesiwala is well-versed in the many conditions that can lead to lower back pain, including SI joint dysfunction. In fact, Dr. Mesiwala has performed more than 600 minimally invasive SI joint surgeries, making him one of the pioneers and leaders in his field.

Given this experience, you’ve come to the right place if you want to learn more about SI joint dysfunction, which we review below.

The important role of your sacroiliac joints 

We consider joints like your hips, knees, and shoulders to be major joints, but there's a good case to be made for adding your sacroiliac joints to this list. Your SI joints play an incredibly important role in joining your upper body to your lower body.

More specifically, your SI joints are found in your sacrum, which is located just below your lumbar spine and above your coccyx (tailbone). This triangular bone is what connects your spine to your pelvis, and your SI joints create this connection. Where the iliac crests in your hips and your sacrum meet, you have an SI joint on each side that acts as a shock absorber between your upper and lower body.


SI joint dysfunction explained


When you have SI joint dysfunction, this usually means one of the two things: either there’s too much movement (friction) in your SI joints or your SI joints are too stiff.

Women are more prone to SI joint dysfunction thanks to pregnancy and childbirth. During these events, the ligaments supporting the SI joints loosen and can create instability in the joints.

Other roads to SI joint dysfunction include:

  • An uneven gait
  • Previous spine or hip surgery
  • Prolonged sitting or standing
  • Acute injury

Whatever is behind the SI joint issue, patients often report feeling pain in their lower back (specifically near the midline) and deep in your groin and  (deep) hips — usually on one side. SI joint dysfunction can also mimic sciatica in that the pain can travel down one side of your buttocks and into the top of your leg.

Addressing your SI joint dysfunction

Our first order of business is to conduct a comprehensive evaluation to determine whether your SI joints are responsible for your discomfort. Evaluation involves a history, physical examination, including diagnostic maneuvers, and review of imaging. Additionally, a diagnostic injection is performed by a pain management physician.  If we do find this to be the case, we prefer to start with conservative steps, such as rest, injections, and physical therapy. 

If these prove ineffective, Dr. Mesiwala can perform a minimally invasive surgery in which he stabilizes your SI joint(s). He only needs to make a small incision to do the work and, in most cases, Dr. Mesiwala completes the stabilization procedure in about half an hour in the outpatient setting. Typically, you’re free to return home the same day, walking on your own power, and without the need of a brace. This means that patients recover faster (due to reduction in pain), and with the assistance of physical therapy, are able to resume the activities they enjoy on a daily basis. 

Dr. Mesiwala has been a pioneer in the field of minimally invasive sacroiliac joint fusion surgery serving as faculty for other surgeons and actively participates in national/international research efforts regarding SIJ surgery. 

Before we get too far ahead of ourselves, the first step is to come see Dr. Ali H. Mesiwala for an evaluation. To get started, please contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to schedule an appointment.