SI Joint Pain SI joint Infection

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Is Infection to Blame for Your SI Joint Pain?

Infection is historically the least common cause of pain in the the SI (sacroiliac) joints. Given the variety of causes of lower back pain, infection is seldom the first diagnosis. It is discovered after other causes are ruled out. Infection can lead to serious SI joint dysfunction. Antibiotic therapy produces the best clinical outcomes.

Understanding Infection as a Cause of SI Joint Pain

In order to understand how infection can impact the SI joints, it is useful to take a look at where the joints are and how they are designed to perform. The sacroiliac joints form at the points where the sacrum region of the spine and the two ilium (hip) bones meet, one on the left and one on the right side of the spine. The two ilium bones are the major structures of the pelvis. The SI joints play a major role in supporting the upper body and helping to transmit motion through the hips and legs. There are several components to the SI joints, each of which is subject to pressures that can cause friction, inflammation, and long term wear and tear.

The SI joints are basically opposing bony surfaces covered by cartilage and bound together by extremely strong ligaments. By design, SI joints have a narrow range of movement. But they need to be fluid enough to allow the hips and legs to move smoothly while at the same time supporting the spine and upper body. SI joint infections can upset this balance of function, damage the joints, and lead to long term SI joint dysfunction.

IS joint infection is typically attributed to bacteria that already exists in the body, and is spread to either one of the SI joints or both. The ligaments of the SI joints contain a large amount of blood vessels, particularly on the anterior (front) side of the pelvis. This creates optimal conditions for blood borne bacteria to reach and suffuse the area. Infection will inflame the joints which can generate tenderness and pain. The most frequently reported bacterium to infect the SI joints is Staphylococcus aureus. A variety of other organisms have also been reported to induce SI joint infection, including Streptococcus, Bacillus, Escherichia coli, Salmonella, and Mycobacterium tuberculosis.

While SI joint infection can happen to anyone, the majority of cases seem to occur in children and young adults. Symptoms that help lead to a diagnosis of SI joint infection include fever, tenderness on the posterior of the SI joints, compression of the posterior pelvis, and orthopedic mobility tests of the legs and hips.

SI joint pain can be divided into two main categories — hypo-mobility and hyper-mobility. Hypo-mobility simply means low movement. The ligaments that hold the SI joints together tighten and lose elasticity. Cartilage of the SI joints can erode, bone spurs can develop, and the joints can freeze or lock up. The result is limited motion and chronic pain. Hyper-mobility means high movement. The ligaments stretch out and become more elastic. This can cause undue friction within the joint, misalignment of the bones, uneven wear, and subsequent pain. There are also many nerves in proximity to the SI joints that can become irritated and inflamed. The range of pain can vary from dull to acute.

SI joint pain can express itself on either the left or right side of the lower back. SI joint dysfunction can produce pain in the buttocks, groin, and thighs as well.

Infection is just one of the many ways the SI joints can suffer undue stress. Such stress inflames the joint, damages cartilage, increases wear and tear, and adds to the overall deterioration of mobility. If you are experiencing symptoms of pain related to an infection, get in touch with a medical expert in spine health. Early diagnosis and treatment of SI joint dysfunction can slow progression of the disease, relieve low back pain, and help to restore healthy joint function.

Sources:

http://www.medscape.com/viewarticle/410460_3

http://www.ncbi.nlm.nih.gov/pmc/articlesPMC2485062

Tips for Preventing and Managing SI Joint Pain at Home

  • Regular stretching and exercise can help prevent and ease low back pain.
  • When lifting heavy objects, use your legs for leverage, not your back.
  • Walk cautiously and wear shoes with good traction when walking on slippery surfaces.
  • When carrying something, be sure to distribute its weight evenly, not favoring one side.
  • Consult a spine specialist for severe low back pain that hasn’t resolved with conservative methods in a few weeks.

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