Do I Need Surgery for SI Joint Pain?

Americans are no strangers to lower back pain — up to 80% of the population experiences the problem at some point during their lives. While there are many issues that can lead to lower back pain, we’re going to focus on one, in particular, here — sacroiliac (SI) joint dysfunction.

As an international expert in sacroiliac joint and spine surgery, Dr. Ali H. Mesiwala and his team have extensive experience helping our patients to overcome the pain and disability that often accompanies lower back pain, and we feel confident we can do the same for your SI dysfunction.

If you’re wondering whether you might be a good candidate for SI surgery, read on.

Often overlooked joints

There’s quite a bit that can go wrong in your lower back — from lumbar herniated discs to muscle strains. Often overlooked are two small joints located inside your pelvis that connect your hips to your sacrum. They’re called your SI joints, and it’s estimated that these joints may be responsible for 15-30% of lower back pain cases.

One of the reasons why SI joint dysfunction has been historically difficult to identify is that the problem causes many of the same symptoms as other issues, such as lumbar disc herniation, including symptoms in your lower back, as we well as symptoms that radiate down your leg, such as pain, numbness, and tingling.

What causes SI joint dysfunction

The two primary problems that can occur in your SI joints is when they:

• Provide too much movement (instability)
• Provide too little movement (fixation)

As a result of either of these issues, you can be left with pain in your lower back, hip, pelvis, groin, and down into your legs. In addition to the pain, you may feel stiffness due to inflammation in these joints or instability in your pelvis and hips.

Treating SI joint dysfunction

If we find that you have SI joint dysfunction, we prefer not to jump immediately to surgery. First, we recommend that you try resting, physical therapy, and icing the joints to reduce inflammation and restore pain-free movement.

If these measures prove unsuccessful, we may next recommend SI joint injections — a combination of a local anesthetic and a steroid that addresses pain and reduces inflammation.

If your SI joints still don’t respond favorably and you’re experiencing any of the following, it may be time to look at surgery:

• Considerable lower back, hip, groin, or leg that doesn’t respond to conservative treatments
• Instability in your pelvis and/or lower back
• Limits on your ability to move your lower back, hips, groin, and/or legs 
• Pain that flares after staying in one position for long periods

At our practice, Dr. Mesiwala is well-versed in a procedure called SI joint fusion. Using minimally invasive surgical techniques, Dr. Mesiwala makes a small incision through which he places titanium implants that stabilize the joint.

When we perform an SI joint fusion, it generally takes us under an hour, and you’re free to go home afterward (with complete aftercare instructions).

If you’d like to learn more about SI fusion surgery and whether this may be your best road to relief, contact one of our offices in Newport Beach, Marina del Rey, Rancho Cucamonga, or San Bernardino, California, to set up an appointment.