An estimated 15-30% of people with lower back pain don't have a spine problem; they have sacroiliac (SI) joint dysfunction. As an expert on SI joints, Ali H. Mesiwala, MD, FAANS, provides long-lasting pain relief with SI joint surgery. Dr. Mesiwala has successfully treated SI joint problems for more than a decade. During that time, he performed more than 600 minimally invasive SI operations and pioneered many of the techniques and implants used in surgery. To schedule an appointment, use online booking or call one of the four offices in Newport Beach, Marina del Rey, Rancho Cucamonga, and San Bernardino, California.
You may need SI joint surgery — a minimally invasive SI joint fusion — to relieve the pain caused by SI joint dysfunction. The SI joints connect your hip bones to the sacrum, a triangular-shaped bone at the base of your spine.
While the other joints in your body facilitate movement, the SI joints are designed to provide stability and restrict joint movement. When you walk, jump, or run, the SI joints absorb shock and transfer the force between your upper and lower body.
You can develop pain when the joint becomes inflamed or the ligaments stretch, allowing the joint to move too much. Both problems often develop due to:
Women frequently develop SI joint pain during pregnancy when the joint's ligaments relax to prepare for delivery.
SI joint problems cause pain in your lower back and hip. Some people have groin, pelvic, or leg pain. You may also develop leg instability, changes in the way you walk, or pain when you go from sitting to standing.
Dr. Mesiwala begins with a comprehensive history and learning about the location, nature, and pattern of your pain. During your physical exam, he checks your spine and hips and performs provocation tests, physical maneuvers that detect problems in the lumbar spine and SI joint.
After your exam, Dr. Mesiwala orders diagnostic imaging such as X-rays, CT scans, and MRIs. Finally, he performs a diagnostic injection. Using real-time imaging to guide the needle, he injects a dye and local anesthetic into the SI joint.
The dye allows details of the joint to show up with X-rays. If the local anesthetic relieves your pain, then it verifies that the SI joint is the source of the problem.
The first line of treatment for SI joint pain includes physical therapy, medications, and injections. Many patients improve with conservative care, but if you don't, then surgery is the next step.
During SI joint surgery, Dr. Mesiwala uses a minimally invasive procedure to fuse the joint. After giving you general anesthesia, he makes a one-inch incision in the side of your buttocks, then implants pins that stabilize the joint by connecting the two bones.
Your surgery takes less than one hour, and most patients can go home within a few hours afterward.
The first 48-72 hours are the most uncomfortable due to swelling, but ice packs help. It takes 1-2 weeks for the incision to heal, and 2-6 weeks for most of the pain to disappear.
You can let your post-op pain guide your activities. Once your pain resolves, you can participate in any activity you can tolerate.
If you have ongoing lower back or SI joint pain, call Ali H. Mesiwala, MD, FAANS, or book an appointment online today.