The SI Joint: It Might Be Causing Your Postpartum Low Back Pain
Is Low Back Pain Normal?
Low back pain during pregnancy is fairly common. About 50% of women experience some kind of lower back pain while they are pregnant.
What you might be surprised to learn is that even after the baby is born, about 25% of women continue to have pain in the lower back, buttocks, groin, and even the legs.
Many things could be causing this kind of persistent pain, called postpartum pelvic girdle pain. The important thing to note is that it might be due to the SI joint.
What Is the SI Joint?
The sacroiliac (SI) joints are located in the back of the pelvis. They link the iliac bones (the pelvis) to the sacrum (the lowest part of your spine above the tailbone).
The SI joints provide stability for the pelvis and to bear and transfer load from the upper body to the legs.
The SI joint is the source of pain for about 75% of women with persistent postpartum pelvic girdle pain.
What are the symptoms of SI joint dysfunction?
SI joint pain symptoms may include:
- Pain in the lower back, buttocks, and/or hip and groin area
- Pain radiating down the back of the leg
- The area directly over the SI joint may be sensitive to touch or pressure
- Sensation of lower extremity pain, numbness, tingling, weakness
- Difficulty sleeping due to pain, frequently caused by rolling over in bed
- Feeling of leg instability, like buckling or giving way
- Unable to sit for long periods or sitting on one side to avoid the pain
- Pain going from sitting to standing Both men and women can experience SI joint dysfunction due to a variety of causes, not only pregnancy. Your doctor will likely ask you to point to where it hurts, to describe any history of injury and when the pain started, and to talk about any problems with standing or sleeping. You’ll also be asked to stand, sit, and move in varying directions. Non-surgical and surgical treatment options are available. Non-surgical treatment options may include:
What are my treatment options for SI joint dysfunction?
Your doctor may recommend a diagnostic injection into the joint with a local anesthetic to confirm the diagnosis.
How will my doctor know if my pain is coming from my SI joint?
- Oral pain medications (NSAIDs, opioids, etc.)
- Activity modification
- Physical therapy
- SI belting (a non-elastic strap placed temporarily around the pelvic joints)
- Therapeutic SI joint injections (injections that may temporarily reduce the pain)
If a patient experiences ongoing or recurrent pain after 6 months or more of appropriate non-surgical treatment, the doctor may recommend minimally invasive surgery to fuse the SI joint.
Studies have shown that patients with SI joint pain that began during or just after pregnancy who received the iFuse Procedure, a minimally invasive SI joint fusion available since 2009, showed significant long-term reduction in pain and marked improvement in physical function and in quality of life.
There are not many other procedures, if any, where my patients do as well as they do as quickly as they do as with an iFuse SI joint fusion.
Is your SI joint the cause of your low back pain? Take the short SI pain quiz to find out.
For a complete listing of the references used to create this article, click here.
Dr. Lucien Miranne is a Board Certified Neurosurgeon at Southern Brain and Spine in Metairie, LA. He operates at Touro Infirmary in New Orleans and Crescent City Surgical in Metairie. He attended LSU Medical School in New Orleans and did his residency in neurosurgery at Vanderbilt University Medical Center in Nashville, TN before returning back to Metairie to start his practice.