Sacroiliac joint dysfunction, also known as sacroiliitis, is the inflammation of one or both of the sacroiliac joints, the joints that link the pelvis and lower spine by connecting the sacrum to the iliac bones. Sacroiliac joint dysfunction may be caused by injury, pregnancy, osteoarthritis, degeneration of cartilage, or inflammatory joint disease. At times, a structural abnormality, such as legs of differing lengths or severe pronation, may put increased stress on the joint, resulting in this problem. Patients with sacroiliac joint dysfunction typically experience pain in the buttocks and lower back that worsens when running or standing. While a traumatic injury may cause this problem, it more often develops gradually over a long period.
The most common symptom of sacroiliac joint dysfunction is pain, either in one side of the lower back or in the hip. Pain usually increases when the patient bends, stands after a long period of sitting or reclining, or climbs stairs, and decreases when the patient lies down. Sacroiliac joint dysfunction is diagnosed through physical examination, during which the physician moves the patient's legs and hips into varying positions, and through imaging tests like X-rays or a CT scan. Anesthetic injections may also be used as a diagnostic tool.
Conservative treatment methods are usually sufficient to treat sacroiliac joint dysfunction. The most important of these, when acute pain is present, is rest. Patients are instructed to restrict activity, particularly activity that increases pain levels. Other techniques to reduce pain include application of ice for 20 to 30 minutes two to three times a day and intermittent application of heat to help loosen tight muscles. Massage, physical therapy, or chiropractic treatment may also be helpful. Over-the-counter pain medication is usually prescribed and sometimes corticosteroid injections are administered as well. Surgery is normally not considered to treat this condition.
Complex Regional Pain Syndrome
Complex regional pain syndrome, also known as reflex sympathetic dystrophy, is a form of chronic pain that often develops after an injury. The pain experienced is often long-term and intense, and tends to get worse over time instead of getting better. This condition often affects the arms, legs, hands or feet and can spread to nearby areas as it progresses. In addition to pain, patients may also experience swelling, redness and skin sensitivity. The exact cause of complex regional pain syndrome is unknown however it may be linked to emotional stress and a sympathetic nervous system.
In addition to chronic and severe pain, the symptoms of complex regional pain syndrome may also include:
- Throbbing in the affected area
- Tenderness and sensitivity
- Changes in skin color
- Change in skin texture
- Joint stiffness and swelling
While the exact cause of complex regional pain syndrome is unknown, one theory suggests that it may be due to problems in the central and peripheral nervous systems. It is also believed to be caused by an inappropriate inflammatory response in the body. People with complex regional pain syndrome, may have pain or an injury that triggers an immune response, which leads to the characteristic inflammatory symptoms of redness, warmth, and swelling in the affected area. Emotional stress may also increase the symptoms.
Complex regional pain syndrome is often diagnosed by ruling out other medical or underlying conditions. After a full physical examination is performed, the following diagnostic tests may also be administered:
- Bone scan
- MRI scan
- Blood tests
While there is no cure for this condition, there are several treatment options that may be used to relieve symptoms. The goal of most treatments is to reduce swelling and pain. Types of medication may include:
Additional treatment methods may include physical therapy, topical analgesics,spinal cord stimulation and a sympathetic nerve block. Patients may be prescribed a combination of these treatments in order to achieve effective pain relief.