Often misunderstood causes of pain: back pain caused by the sacroiliac joint

Undetected pain trigger: Seven questions about the sacroiliac joint
Around 90 percent of Germans are familiar with this troublesome phenomenon: back pain. However, in every fifth affected person the origins of the complaints go undetected, since these are not in the back but in the sacroiliac joint (ISG). Prof. Dr. J├╝rgen Harms, specialist in orthopedics and trauma surgery and an expert in spinal surgery in Heidelberg, clarifies the most important questions about the often underestimated joint.

What are the tasks of the ISG?

The sacroiliac joint connects the sacral and intestinal bones and represents a kind of bridge between the spine and the leg axis. It forms the interface in the transmission of power between the upper and lower body and thus contributes significantly to the stability of the body.

Why is the ISG often not recognized as a pain trigger?

Patients and doctors usually suspect a herniated disc in the case of pain in the lower back. Its symptoms are very similar to an ISG blockage, which is why incorrect diagnoses often result and incorrect treatments as a result.

What are the most common causes of ISG complaints?

Strains, dislocations, missteps or falls on the buttocks are among the most common triggers. Such inattention brings the stable corset of ligaments, tendons and muscles out of balance. As a result, the joint tilts and painfully blocks. Misaligned pelvis can also cause problems in the long term.

Are there people who are particularly susceptible to ISG syndrome?

People with slight misalignments in the hips or different leg lengths strain the ISG with every movement. With special stress, for example during sports, the articular surfaces suddenly shift and trigger pain. In addition, pregnant women represent a risk group. During and after pregnancy, certain hormones loosen the ligaments, which can also block the two joint plates. In addition, older people are also particularly at risk because age-related signs of wear, such as arthrosis, have a negative impact on the ISG.

How can an ISG syndrome be diagnosed?

There are many potential causes of pulling pain in the lower back. If the complaints increase as soon as those affected bend forward or sit cross-legged, the ISG is the source. Later, even the simplest movements such as climbing stairs or putting on shoes are becoming increasingly difficult. However, patients can only get a correct diagnosis from the doctor. The doctor carries out a thorough medical history and can identify the cause using so-called provocation tests and an analgesic injection directly into the joint.

How can pain in the ISG be treated?

First, conservative therapies are used. If light painkillers, heat applications or infiltration therapy in combination with physiotherapy to build muscle do not produce any improvement, radio frequency thermocoagulation is used. This destroys nerves that are under constant wear. Nowadays, only when these methods have been exhausted do medical practitioners resort to modern triangular implants. The so-called iFuse implants give the joint new hold.

What are the chances of normal everyday life after the operation?

In the past, doctors used special screw systems to stabilize the sacroiliac joint. However, since this method was unsuccessful in many cases, modern medicine uses the triangular iFuse implants. Thanks to a special porous surface coating, they grow together with the surrounding bone within three to six weeks. Patients notice the first successes immediately after the procedure and soon return to their everyday life without symptoms. Both statutory and private health insurance companies cover the costs of this treatment. (Sb / pm)

Author and source information

Video: Low Back Pain u0026 The Sacroiliac Joint - Patient Seminar (August 2020).