Sacroiliac Joint (SIJ) Pain

Have you been told your only option for low back pain is steroid injections or surgery? Minimally invasive regenerative alternatives offer pain relief and can help you get your lifestyle back on track

The sacroiliac joint is sometimes referred to as the SI joint. In fact, you have two sacroiliac joints in the lower back, and they sit either side of the spine. They connect your spine to the hips on either side just below your waist. They are important in helping to cushion the impact when you move or lift anything heavy. Sacroiliac joint pain can be a dull aching pain or a sharp pain that can also be felt in the upper back, buttocks, groin and thighs.

What treatments does The Regenerative Clinic offer?

Our renowned medical team provides a range of treatments, from the traditional to the innovative:

This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Depending on the root of the back pain, PRP can be injected into the discs (intradiscal), facet joints and paraspinal muscle. Patients usually see their symptoms improve within six weeks of having the injections. Read more clinical evidence supporting PRP here.

In a recent study, 91% of patients with chronic low back pain reported a significant reduction in pain, six months after PRGF treatment. This treatment involves applying plasma rich in growth factors (PRGF- Endoret) using intradiscal injections to repair tissue in the low back.

This day case treatment is exclusively offered to our patients. It uses pioneering technology using your body’s own adipose (fat) cells to treat pain and inflammation with MFAT Injections. Injections using MFAT Injections are minimally invasive and are carried out under ultrasound guidance. Altogether the procedure takes about an hour to perform with a minimal recovery time. As well as being a potential alternative to surgery, MFAT Injections can also aid post-surgery recovery.

Bone Marrow Aspirate Concentrate (BMAC) is a non-surgical, minimally invasive, regenerative treatment that harnesses the natural ability to heal the body through the assistance of biological growth factors. BMAC utilises the regenerative stem cells collected from bone marrow to aid in the acceleration of healing moderate to severe osteoarthritis and tendon injuries. Read more here.

What causes sacroiliac joint pain?

Compared to many other joints, the SIJ doesn’t move much during normal everyday activity. They’re supported by strong ligaments and muscles, with cartilage sandwiched between the bones to protect them. If the ligaments harden or the cartilage wears down, often due to arthritis, the bones can rub together painfully.

Sacroiliac joint pain occurs when the joint becomes inflamed through:

Arthritis is the inflammation of one or more of your joints. People typically tend to suffer from osteoarthritis or rheumatoid arthritis.

Osteoarthritis is more common and is caused by the cartilage wearing away.
Rheumatoid arthritis is a chronic disease that causes the joint lining to swell and leads to pain and stiffness in the joint.

What are the symptoms of sacroiliac joint pain?

You feel SIJ pain first in your lower back and buttocks, and it may travel outwards into your hip, groin or thigh. Your leg may tingle or feel numb as well. Either one or both sides of your body may be affected. Sitting, standing, walking, lying down or using stairs can all make the symptoms feel worse.

Symptoms of sacroiliac joint pain vary depending on the cause, but symptoms typically include:

How is sacroiliac joint pain diagnosed?

Sacroiliac joint pain is difficult to diagnose as the joints are situated deep in the body. If you are experiencing pain in the lower back particularly in the pelvic area, a doctor will examine you applying pressure to different areas to see where it hurts.

In some cases, the doctor may refer you to have an:

Your doctor may also inject a numbing drug into the sacroiliac joint to see if this eases the pain. If it does, you know for certain you have a sacroiliac joint problem.

What are the non-surgical options for sacroiliac joint pain?

Treatment for sacroiliac joint pain aims to relieve symptoms and improve the function of the lower back.

Initial treatment may include medications such as analgesics which help reduce the pain, non-steroidal anti-inflammatory drugs – NSAIDS – which reduce the pain and inflammation and steroid injections which reduce inflammation and provide short-term relief.

Your doctor may recommend applying ice packs to the area for a few days and then switching to heat packs for another couple of days. If you do this, it’s important to place a cloth between the ice and your skin to prevent you getting an ice-burn.

You may also be referred to a physiotherapist who will show you various exercises to improve strength and flexibility. Low-impact exercises such as yoga can also improve symptoms of sacroiliac joint pain.

A sacroiliac belt can also be worn to provide support to the hip and pelvic area.

Our expert team specialises in treating sacroiliac joint pain using advanced non-surgical techniques including stem cell therapy, AMPP® Activated Mesenchymal Pericyte Plasma (using Lipogems® technology) and Platelet Rich Plasma (PRP) therapy.

What are the surgical options for sacroiliac joint pain?

Surgery is rarely needed for sacroiliac joint pain, but if your symptoms don’t improve using non-surgical options, surgery may be recommended. If surgery is needed, your doctor may recommend sacroiliac joint fusion surgery. Small plates and screws are used to hold the sacroiliac joint together, so the bones fuse permanently.

Why have a consultation at the Regenerative Clinic?

Our experienced consultants will undertake a thorough examination exploring non-surgical and surgical treatments. They’ll also discuss your suitability for our state-of-the-art biological therapies.

Who will my consultation be with?

Your consultation will be with one of our spine specialists, Mr. Shahid KhanProfessor Mohammed Al-Jumaily or Dr. Stefano Palmisini and will last approximately 30 minutes. On the day, or the day before you will be asked to attend for an MRI scan.

As well as undertaking an examination, our specialists will take details of your medical history and discuss your symptoms. They will also detail all your treatment options and cover their potential benefits and risks.

Our expert team comprises of highly experienced surgeons, sports medicine doctors and physiotherapists who are committed to delivering a high level of care and the correct treatment option so you can quickly get back to moving around.

The first step is to book a consultation for a thorough assessment. Click here to make an appointment.

What is the autologous biological approach and when should it be considered?

Autologous translates as ‘from the same person.’ In brief, it involves using your own cells to encourage healing. The major benefits are that there is no chance of rejection, infection or contamination as you are using cells from your own body rather than a donor.

We offer a range of therapies based on this principle which can be considered if traditional treatments including surgery aren’t relieving your pain.

Clinical evidence

Biological treatments are pioneering procedures and we’re continuously monitoring and recording its effectiveness. Patients undertaking these treatments are asked to complete pre-operative and post-operative questionnaires.

The information obtained from these questionnaires allows us to monitor your progress and it also contributes to our evidence-based database and other global studies on biological treatments. All information gathered is anonymised.

Intradiscal and intra-articular facet infiltrations with ‘Endoret’ plasma rich in growth factors reduce pain in patients with chronic low back pain. Read full paper.

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