The Many Roads to Sacroiliac Joint Dysfunction and Low Back Pain

When it comes to the culprits behind low back pain, which affects up to 85% of people at some point in their lives, some are fairly well known, such as herniated disc, pulled muscle, and sciatica.

Then there’s sacroiliac (SI) joint dysfunction, which isn’t as well-known, yet it’s likely responsible for 15% to 30% of low back pain cases.

As spine and neurosurgery specialists, Dr. Ali H. Mesiwala and our team are well aware of this fact and the often hidden role that SI joint dysfunction plays in the overall low back pain burden. Here, we take a look at that role because knowing what you’re up against in the battle to find relief from low back pain is an important step.

SI joints and your back

From a skeletal perspective, your back is formed by a column of vertebrae that stretch from the base of your skull to your pelvis. At the base, just above your tailbone and below your lumbar spine, is a triangular-shaped bone called the sacrum, which is really five vertebral segments that are fused together as one.

Your sacrum forms the junction point between your back and your hips, and the connection is made on either side of the sacrum through SI joints. These two joints attach your sacrum to the iliac crests of your pelvis.

When the SI joints aren’t working well

Under ideal circumstances, your SI  joints provide stability in your lower back and transfer loads easily from your low back to your hips. When there’s SI joint dysfunction, one of two problems arise:

1. The joint is too loose, or hypermobile
2. The joint is too tight, or hypomobile

Either of these scenarios can lead to low back pain that can feel an awful lot like some of the more common back issues, such as sciatica and herniated discs.

There are many reasons why your SI joints can become impaired, such as:

• Trauma, such as a fall on your backside
• Repeated lifting
• Degenerative changes and arthritis
• Pregnancy 
• Scoliosis
• Previous spine surgery

When it comes to this last one, we’re referring to lumbar spinal fusion procedures — SI joint dysfunction is a common complication because the fusion places new and added pressure on your SI joints.

Getting the right back pain diagnosis and treatment

As you might imagine, one of the first steps in getting relief for your back pain is to make sure we’re targeting the right problem. All too often, we see SI issues being overlooked, which can mean that people aren’t getting the right treatment.

With our patients, we first spend a good deal of time reviewing symptoms and looking over digital images of the structures in your low back. Then, Dr. Mesiwala puts patients through certain movements that can accurately identify whether the SI joints are involved.

If Dr. Mesiwala identifies SI joint dysfunction, we can then tailor your treatment to this issue. Dr. Mesiwala is a leading expert in the field of SI joint dysfunction, and he has pioneered a minimally invasive fixation procedure that returns stability to the joints so that they better support your back.

So, if you’re dealing with low back pain, and you’ve yet to find answers, look no further than our practice. For expert diagnosis and treatment of back pain issues of all kinds, you can contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to schedule a consultation with Dr. Mesiwala.