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Physical Therapy for SI Joint Pain, Part 2

Last week, we explored the various causes of SI joint pain. This week, we will discuss common symptoms, diagnosis methods, and finally, treatment options for this painful condition.

 

Symptoms

Each person experiences symptoms of SI joint disorders somewhat differently. Common symptoms include:

  • lower back pain

  • feeling like your legs may buckle and not support your body

  • groin pain

  • increased pain when standing up from a sitting position

  • numbness

  • pain in the buttocks, hips, and pelvis

  • pain limited to just one of the SI joints

  • pain radiating down into the thighs and upper legs

  • stiffness or a burning sensation in the pelvis

  • weakness

 

Diagnosis

SI joint problems can be difficult to diagnose. The joints are located deep in the body, making it difficult for doctors to examine or test their motion. Often, damage to the joints doesn’t show up on imaging tests such as X-rays, MRIs, or CT scans. And the symptoms are very similar to conditions like sciatica, bulging disks, and arthritis of the hip.

Your doctor may take the following steps in order to diagnose SI joint problems:

  • An examination during which they ask you to move and stretch in specific ways. This can help them pinpoint the source of your pain.

  • Injecting a numbing drug, such as lidocaine, into the SI joint. If the pain goes away after a short period of time, this indicates that you most likely have an SI joint problem.

  • Imaging tests, such as X-rays, MRIs, and CT scans.

 

Treatment Options

  • Therapy, exercise, and self-care - Physical therapy, low-impact exercise like yoga, and massage can help stabilize and strengthen the SI joints and ease pain.

Another tip is to use cold packs to alleviate the pain. When the pain is more manageable, apply heat with a heating pad or heat wrap, or a soak in a warm bath.

You can also wear a sacroiliac belt to help support the SI joint, which may help ease your pain.

  • Medication and nonsurgical therapies - If your SI joint pain can’t be managed with physical therapy, exercise, and self-care, or if it’s caused by a chronic condition like AS, your doctor may recommend medication and nonsurgical therapies. These can include:Surgery - Surgery is the considered the last resort. With sacroiliac joint fusion surgery, small plates and screws hold the bones in the SI joint together so the bones fuse, or grow together. Your doctor may suggest this surgery if the pain is chronic and the combination of physical therapy, medications, or minimally invasive interventions hasn’t been effective.
    • anti-inflammatory medications, including nonsteroidal, anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen

    • muscle relaxants

    • oral steroids, for short-term use only

    • tumor necrosis factor inhibitors (TNF inhibitors) to treat AS

    • corticosteroid injections into the joint

    • radiofrequency ablation, which uses energy to deactivate the nerves that are causing your pain

If you are suspect you have SI joint pain, visit Excel Rehabilitation Services on Burnside Ave. in Gonzales, Louisiana. You will receive one-on-one professional diagnosis and care from an experienced physical therapist!

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