What is joint pain?
As people get older, joint pain becomes increasingly more common. This happens because the sacroiliac joint (SI joint) – which is a weight-bearing joint – begins to fuse, which can cause arthritis and pain.
What causes joint pain?
Many different conditions can lead to joint pain, including osteoarthritis, rheumatoid arthritis, bursitis, gout, strains, sprains, and other injuries. While knee, shoulder, and hip pain are the most common complaints, joint pain can affect any part of your body, from your ankles and feet to your shoulders and hands.
SI pain usually feels like low back and buttock type pain. Usually the pain doesn’t radiate below the knee, but in rare occasions it can. Something that is very common is pain on the side of the legs, which is called bursitis. Whenever a person has pain the body moves just a little bit differently than if they didn’t have pain which is usually the cause of bursitis. This pain can be very severe and radiate from the front or back of the hips and legs.
SI joint injection
The most common treatment is a diagnostic block, or an SI joint injection. We put a needle directly into the joint and watch the medicine spread into that area and check after a short time to see if the pain feels better. For many people, this will give significant relief. Other treatments are physical therapy and active release techniques.
Medial + lateral branch blocks
Medial branch blocks and lateral branch blocks allow us to numb the small joints in the lumbar spine and down to the SI joint. Sometimes we do this a few times (called a double diagnostic block) and see if a patient feels relief. If the patient feels significant relief, then we can cauterize the nerves, which we test before cauterizing to make sure we are in the right area. If we cauterize the nerves, the average pain relief is about a year.
SI pain can be difficult to treat sometimes because 2/3 of the nerves come from the back of the joint and 1/3 comes from the front. Pain doctors can only inject nerves in the back section, which is most common for pain. If a patient’s pain is from the front nerves then there are other options such as a spinal cord stimulator, exercise, or stretching. Surgeons can actually fuse the joint in rare cases that don’t respond to any other joint pain treatment.
Joint pain treatments can greatly improve your comfort level and give you significant relief. As joint pain doctors, we try to get patients out of pain, whether it be through injection or some other treatment, and then into therapy.