General

The sacroiliac joint (SI joint) connects the lower part of the spine with the pelvis. ISG pain therefore occurs in the lower area of ​​the back, but can also radiate.

For pain in the Sacroiliac joint (ISG, sacrum-iliac joint) are widespread complaints that can have individually different causes. The sacroiliac joint is a joint in the pool is localized and that Sacrum with the Iliac bone connects. It connects so that pool with the lower part of the Spine and is therefore essential for a variety of movements.
It is through one tighten ligaments secured and is therefore relatively stable.The functionality of the joint is essential for painless movement, especially when walking and bending.
For complaints that are triggered by the ISG, a Sacroiliac joint syndrome or one Sacroiliac joint blockage spoken, which can take on different forms and forms. The diseases are not dangerous and can be treated well to a certain extent.
When diagnosing a Herniated disc of the lumbar spine be excluded as a trigger for the pain. The individual complaints can be very different and can vary in localization, radiation and intensity.
What is the underlying cause of the pain in the sacroiliac joint or whether it is a ISG syndrome is best assessed by an orthopedic surgeon.

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Symptoms

If pain comes from the sacroiliac joint, it can differ in some points depending on the cause and the severity of the disease. In the case of pain in the sacroiliac joint, pain duration, pain quality, pain localization and radiation as well as pain intensity vary.
Typical for SI joint pain is a radiation in the buttocks or the strip as well as in the Thigh. The pain is often one-sided. The symptoms are typically alleviated somewhat through movements and exercises, although they tend to get worse if you have a sedentary lifestyle and especially if you sit for longer periods of time. warmth also usually has a pleasant effect.
The characteristics of the pain described can give the attending physician an indication of which cause is responsible for the development of SI joint pain and which therapy is individually suitable.

Pain when walking

Since the sacroiliac joint is the essential connection between the pelvis and the spine, it is not surprising that the symptoms also occur, especially in the Go and running occur. The pain when walking can be felt in the move or at the hip occur and in the thigh, buttocks, or groin radiate.
However, typical pain in the SI joint is one improvement the pain while walking. Therefore, if pain occurs mainly when walking and becomes worse with additional duration of movement, another cause should be looked for if necessary. After a precise description of the pain, the attending physician can in many cases find the cause of the pain using additional modern diagnostic methods and initiate appropriate therapy. If pain occurs when walking, the cause can also be a herniated disc, which is why a visit to a doctor is recommended, especially in the case of very severe pain and additional paralysis of the leg or foot.

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Appointment with a back specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

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Pain in the leg

ISG pain usually occurs on the lower back and shine in some cases up in the leg out. This often leads to punctual pain certain movements or at Sit in a specific position.
If the pain is down to that lower leg or the foot radiate, however, another disease is more likely to be the cause of the symptoms. Especially when next to the radiating pain Sensory disturbances and Signs of paralysis occur, the ISG is more likely to be the cause unlikely. In the case of pain that radiates into the leg, a doctor should be consulted in order to rule out a serious illness.

Pain when sitting

Typical for SI joint pain is the appearance or worsening of existing pain when sitting. So if the symptoms mainly occur while sitting or if they worsen significantly while sitting, the ISG is likely to be the cause. Often, pain in the sacroiliac joint also occurs in people who, due to their professional activity, often sit and accordingly tend to muscular instability in the pelvic area. The same applies to elderly people who have weak pelvic muscles due to a lack of exercise and a lot of sitting.
Whether the ISG can actually be held responsible for the complaints can only be confirmed with certainty after an extensive physical examination by the attending physician.

What might also interest you: Sacrum pain

Pain in the abdomen

If you experience lower abdominal pain, it suggests that internal organs represent the cause of the pain. So it happens that patients who Sacroiliac joint causes discomfort in the abdomen, usually having to live with the pain for a long time without a diagnosis being able to be found. If internal organs and diseases have been ruled out, a visit to an orthopedic surgeon can still help to find the cause of the pain.
By muscular tension, which is triggered by a blockade of the ISG, as well as by irritation of certain annoy there may be pain in the lower abdomen originally caused by the joint.
The treating orthopedic surgeon can use movement tests and a comprehensive medical history to find the cause and put together a suitable therapy option.

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Read more on this topic at: Pain in the abdomen

causes

The causes of SI joint pain can be very different. In addition to a Wear and tear of the joint, the arthrosis, it can too Inflammation, Muscle stiffening, Joint blockages or Weaknesses of the ligamentous apparatus come.
Arthrosis of the SI joint is particularly popular very common in old agebut usually does not cause pain. However, osteoarthritis of the joint may be the cause of the symptoms.
Often there is one blockade of the joint to blame for the discomfort. Here it comes to a Restriction of movement in the joint. This can go through unfavorable movement patterns but also through free pieces of cartilage or Signs of wear of the joint. A blockage is often triggered by acute stress on the joint.

Please also read: SI joint osteoarthritis

Through the Changes in hormone levels during the pregnancy it comes to one Loosening of the ligamentous apparatuswhich otherwise ensures the necessary stability of the joints. ISG pain during pregnancy is therefore a common ailment that can be temporarily improved through muscle building training. After pregnancy, the normalization of the hormone balance should also improve the symptoms.

Inflammation in the SI joint can occur there in different ways. For example, inflammatory rheumatic diseases such as Bechterew's disease can lead to such an inflammation in the joint. Reactive arthritis can also trigger an inflammation of the sacroiliac joint as a result of infection with certain pathogens. Here structures of the joint are attacked by the immune system even though there is no primary infection of the joint, it is an autoimmune disease.

Also try our self-test on ISG blockade.

Intestines

In rare cases, the intestine or certain Bowel disease be the cause of the pain in the SI joint. Chronic inflammatory diseases of the intestine in particular can cause problems in the joints. Inflammatory rheumatic Related diseases such as ankylosing spondylitis, which in many cases lead to complaints of the sacroiliac joint, are also often associated Changes of the Intestinal lining hand in hand. The entire range of rheumatic diseases is often associated with one Inflammation of the joints such as a bowel problem socialized.
In the case of problems of the ISG as well as recurring problems of the intestine, a connection between these symptoms should be considered, which should be examined by a treating doctor under certain circumstances. In addition to stool samples and the examination of the blood Rheumatoid factors and other abnormal values ​​is also one in some cases Colonoscopy indexed. Changes in the intestinal mucosa found at the same time as well as sacroiliac joint problems should always be examined for a connection.
Ultimately, the standard therapy for joint pain can also lead to intestinal problems. So-called NSAIDs prescribed which as pain relievers as well Anti-inflammatories can relieve the discomfort. However, since these can also cause problems in the gastrointestinal tract, a should especially with long-term treatment Proton pump inhibitors ("Acid blockers") can also be taken. This can usually prevent serious complications of therapy with NSAIDs.

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diagnosis

Since sacroiliac joint pain can be caused by a number of different causes, the attending physician should conduct a comprehensive diagnosis. In addition to the necessary specialist knowledge, orthopedic surgeons usually have access to the necessary medical imaging equipment.
First there is a comprehensive anamnese in the foreground. During this conversation the pain should be described in all its qualities. The radiation and the precise localization of the pain are particularly important for the attending physician. This is followed by a physical exam. By palpating the affected region and performing certain movement tests, the examining doctor can assess which structures are causing the pain. It is also important to find out whether the sensitivity is restricted in certain areas and whether paralysis occurs.
In some cases, diagnostic imaging must follow in order to determine the individual reason for the complaints. In order to be able to assess ligaments, cartilage and nerve structures in addition to bony structures, in most cases a Magnetic resonance imaging carried out.
It may also be necessary to examine different blood values, especially if autoimmune diseases or other systemic diseases are the cause. In particular, an increase in the inflammation values ​​can provide an indication of the cause of the disease.

treatment

Above all, it is important to know the individual cause of the symptoms in order to initiate an appropriate therapy. In most cases, "acute therapy" can result physical exercises and physical therapy, one Heat treatment as well as by the administration of Painkillers the problem is well handled. However, a recurring problem is typical. To prevent these relapses, the exercises recommended by the doctor or physiotherapist should be performed regularly and targeted muscle building in the region should be aimed for.
In addition to oral pain relievers and anti-inflammatory drugs, a Infiltration therapy are used in which the attending physician puts the drug in liquid form directly into the The source of the complaints is splashing. Due to the freedom from pain, the muscles relax and after the medication has subsided, the patient is pain-free even without treatment.
In rare cases, surgery may be necessary to remove loose pieces of cartilage.

forecast

The prognosis for pain in the SI joint is very good in many cases. So can help of exercises and modern therapy options a pain relief can be achieved successfully. In many cases, there is also a spontaneous improvement in the symptoms. Generally have chronic pain of the sacroiliac joint significantly worse disease course as acute pain that usually improves within a few days.
The cause responsible for the pain also has an impact on the individual prognosis. Pain during pregnancy in the ISG is not uncommon and improves at the latest when the hormonal balance is normalized, while pain caused by a rheumatic disease is much more difficult to treat and therefore has a poorer prognosis.

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