Sacroiliac joint pain

The human spine is formed by individual vertebrae and connective tissue discs in between. The vertebrae form the spinal canal. There are seven cervical, twelve thoracic, and five lumbar vertebrae. The intervertebral discs are the link between the individual vertebral bodies.

The little joints that link the vertebrae together are known as facet joints. They help to stabilize the spine and, together with the intervertebral discs, allow a certain degree of mobility of the spinal cord. The spinal canal should be wide enough to allow nerve roots to float freely in cerebrospinal fluid. The front border of the spinal canal is built by the vertebral bodies and intervertebral discs, the side by the intervertebral joints (facets) and back by the ligamentum flavum (yellow band) and vertebral arches. Discs consist of an outer fibrous ring (annulus fibrosus), which surrounds an inner gel-like center (nucleus pulposus). The spinal cord and nerve roots lie within the spinal canal. The spinal cord extends downwards approx. to the 1st lumbar vertebra. Below, only nerve roots are present in the spinal canal. At the level of the intervertebral disc the nerve roots pass through the neural root foramina to exit the spinal canal. The spinal cord and nerve roots conduct electric-like signals from the skin and joints to the brain, and process of movement is initiated from the brain to the muscles.

Lower back pain is one of the most common causes for people to seek medical advice. Trauma, hyper or hypomobility of the sacroiliac joints often lead to aseptic inflammation. Sacroiliac joint pain is experienced in the lower back. In young patients, sacroiliac joint pain could be an early symptoms of Ankylosing spondylitis (Bechterew's disease).

Gradually progressing inflammation and degeneration in the sacroiliac joints

Pain in the lower back. Usually the pain is strongest early in the morning and weakens while walking.. Pain in one or both legs (pseudorrahular type)

The treatment may be non-surgical or surgical.

Strengthening the back muscles

At least 2 months of conservative treatment cannot relieve pain significantly

To destroy the nerve endings that carry the pain from the facet joints

Override pain by neuromodulation

Percutaneous cryoablation

Percutaneous radiofrequency thermoablation

Endoscopic sacroiliac joint denervation

Neuromodulation

Arthrodesis (surgical joint fusion)