Sacroiliac Joint Dysfunction
(SI Joint Pain)
Medical Author: Jason C. Eck, DO, MS
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What are the sacroiliac (SI) joints?
The sacroiliac (SI) joints are formed by the connection of the sacrum and the
right and left iliac bones. The sacrum is the triangular-shaped bone in the
lower portion of the spine, below the lumbar spine. While most of the bones
(vertebrae) of the spine are mobile, the sacrum is made up of five vertebrae
that are fused together and do not move. The iliac bones are the two large bones
that make up the pelvis. As a result, the SI joints connect the spine to the
pelvis. The sacrum and the iliac bones (ileum) are held together by a collection
of strong ligaments. There is relatively little motion at the SI joints. There
are normally less than 4 degrees of rotation and 2 mm of translation at these
joints. Most of the motion in the area of the pelvis occurs either at the hips
or the lumbar spine. These joints do need to support the entire weight of the
upper body when we are erect, which places a large amount of stress across them.
This can lead to wearing of the cartilage of the SI joints and arthritis.
What is sacroiliac joint dysfunction?
There are many different terms for sacroiliac joint problems including SI
joint dysfunction, SI joint syndrome, SI joint strain, and SI joint inflammation. Each of these
terms refers to a condition that causes pain in the SI joints from a variety of
causes.
What are the causes of sacroiliac joint dysfunction?
As with most other joints in the body, the SI joints have a cartilage layer
covering the bone. The cartilage allows for some movement and acts as a shock
absorber between the bones. When this cartilage is damaged or worn away the
bones begin to rub on each other, and
degenerative arthritis
(osteoarthritis) occurs. This is the
most common cause of SI joint dysfunction. Degenerative arthritis occurs
commonly in the SI joints just like other weight bearing joints of the body.
Another common cause of SI joint dysfunction is
pregnancy. During pregnancy
hormones are released in the woman's body that allows ligaments to relax. This
prepares the body for childbirth. Relaxation of the ligaments holding the SI
joints together allows for increased motion in the joints and can lead to
increased stresses and abnormal wear. The additional weight and walking pattern
(altered gait) associated with pregnancy also places additional stress on the
SI joints.
Any condition that alters the normal walking pattern places increased stress on
the SI joints. This could include a leg length discrepancy (one leg longer than
the other), or pain in the hip,
knee, ankle or foot. Patients with severe pain in the lower extremity often
develop problems with either the lower back (lumbar spine) or SI joints. In most
cases if the underlying problem is treated the associated lumbar spine or SI
joint dysfunction will also improve.
There are many disorders that affect the joints of the body that can also
cause inflammation in the SI joints. These include gout, rheumatoid arthritis,
psoriasis, and ankylosing spondylitis. These are all various forms of arthritis
that can affect all joints.
Next: What are the symptoms of sacroiliac joint dysfunction? »
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