Very often it is difficult to identify the source of the back pain. Lower back pain is caused by sacroiliac joint problems about 15% of the time. Diagnosing it is difficult and involves making sure that nothing else is the cause of the problem. There are some physical examination tests which can implicate the sacroiliac joint as the cause of your pain. Most of the time it is off to one side, is around the size of the little dimple on either side of your lower back.
If your sacroiliac joint is suspected to be the cause of your lower back pain, we can treated with local physical therapy, the sacral belt, and possibly an injection of steroid medication into the sacroiliac joint. If your pain keeps coming back and is unmanageable, you may wish to consider surgical treatment.
Minimally invasive sacroiliac joint fusion needed as indicated by ALL of the following:
- Significant sacroiliac joint pain (pain rating of at least 5 on a 0-10 numeric scale) and/or significant activity limitations due to sacroiliac joint pain
- Unilateral pain localized over the sacroiliac joint
- Sacroiliac joint pain confirmed with response (pain) to three or more provocative examination maneuvers that stress the sacroiliac joint (e.g., FABER test, thigh thrust, pelvic gapping test, pelvic compression or Gaenslen test)
- Confirmation of diagnosis of sacroiliac disease via pain relief of at least 75 percent (i.e., on visual analogue scale) due to fluoroscopy-guided needle injection of local anesthetic into sacroiliac joint (expected time frame of pain relief depends on anesthetic chosen, dose and concentration)
- Failure to respond to at least six months of alternative treatments consisting of analgesics (g., nonsteroidal anti-inflammatory medication) and one or more of the following:
o Physical therapy
o Sacroiliac joint steroid injection
o Radiofrequency rhizotomy
- Alternative or contributing diagnoses absent (e.g., hip osteoarthritis, L5-S1 spine degeneration, tumor, infection or fracture)
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- BCBS Association – Diagnosis and Treatment of Sacroiliac Joint Pain (6.01.023). January 1, 2018. https://app.evidencestreet.com/