SI Joint Pain Prior to Lumbar Fusion Surgery

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Is Prior Lumbar Fusion Surgery to Blame for Your SI Joint Pain?

Surgery to fuse lumbar vertebrae in the lower back is a procedure that is not used lightly. While it does a superb job of helping to support a seriously compromised spine, it frequently results in chronic pain in the SI (sacroiliac) joints. Statistics show that nearly 75% of people who have had lumbar vertebrae surgery will develop SI joint dysfunction within five years.

Understanding Prior Lumbar Fusion Surgery as a Cause of SI Joint Pain

In order to understand how prior lumbar fusion surgery 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 a narrow range of motion does not mean zero motion. Surgical fixation of the lumbar spine immobilizes the section which is fused. Such close proximity to the sacral spine puts undue pressure on the ligaments of the SI joints. This can compromise the integrity of the entire joint.

Lumbar fusion surgery may be necessary for a number of conditions that reduce spinal stability. Vertebrae may be broken. Disks are susceptible to herniation. Severe arthritis can weaken the spine and add to chronic low back pain. Lumbar fusion will eliminate all movement between the vertebrae that are fused. The surgery is designed to mimic the normal healing process of broken bones. While the gain of lumbar fusion is increased support, the loss is spinal flexibility.

For SI joints, prior lumbar fusion surgery can create both hypo-mobility and hyper-mobility of the joint. Hypo-mobility simply means low movement. The ligaments that hold the SI joints together tighten and lose elasticity. With the extra mechanical load caused by the fused lumbar spine above it, 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. However, since lumbar spine fusion also results in greater motion at the SI joints, hyper-mobility is also a possibility. 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. Whether the ligaments are lax or locked, the many nerves in proximity to the SI joints can become irritated and painful as well. 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.

Prior lumbar fusion surgery is just one of the many ways the SI joints can suffer undue stress. Such stress increases wear and tear on the joints, inflammation, cartilage damage, and overall deterioration of mobility. If you are experiencing symptoms of pain related to prior lumbar fusion surgery, 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.ncbi.nlm.nih.gov/pmc/articles/PMC3459112 Sacroiliac

 

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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