The sacroiliac (SI) joints are the source pain in approximately 10 – 20 percent of people with chronic low back pain. The spine sits on top of the sacrum, which is part of the pelvis. The sacroiliac joints are located in the pelvis between the sacrum and the iliac bones. There are two sacroiliac joints, one on each side. People often experience pain in the lower back, posterior hip and sometimes pain radiating down their leg, usually to the calf. They often have tenderness in the back of the hip.

In this picture the left sacroiliac join is red indication inflammation or arthritis in the joint, which results in pain.

Diagnostic imaging studies such as x-rays, CT scans and MRI scans may show degenerative changes in the SI joints. However even normal appearing joints can be painful. The best way to determine if the sacroiliac joint is the source of a persons low back or posterior hip pain is to inject local anesthetic into the joint. These are called diagnostic blocks. This procedure usually provides immediate pain relief and confirms that the joint is the source of the persons pain. The relief will last for a few hours. Injecting cortisone into the joint can provide longer pain relief, sometimes for weeks or months. Rarely people will get permanent pain relief from a cortisone injection.

This picture shows an electrode in position between the openings in the sacrum and the SI joint.. Each of the yellow circles is a lesion created by passing an electric current that cauterizes the nerves, which are shown in red. Making a series of electric lesions removes the nerve supply to the sacroiliac joint and eliminates the pain.

Sacroiliac joint rhizotomies usually provide pain relief for a year or more and sometimes permanently. If the pain recurs the procedure can be repeated usually with equal or better results than the original procedure. The goal of performing rhizotomies is to eliminate pain and allow the person to return to a more active quality of life. People can usually decrease or eliminate their use of pain medication.

Sacroiliac joint blocks and rhizotomies can be performed at the Welcome Back Clinic. For more information or to book an appointment with a pain specialist call 250-828-6740