Finding Relief with Dr. Lo: What is the Treatment for Sacroiliac Joint Pain?

Are you among the many who suffer from persistent lower back, buttock, or hip pain, wondering what could possibly be causing your discomfort? You're not alone. Often, this type of pain is mistakenly attributed to common issues like a herniated disc or sciatica, when the true culprit might be a condition known as sacroiliac (SI) joint dysfunction.

At Pain Specialists of America, we understand this frustration. For every pain, we have a plan, and our commitment to finding effective solutions is unwavering. Today, we're delving into the world of treating SI joint pain with Dr. Jason Lo, a fellowship-trained pain management physician at PSA. Dr. Lo brings a unique perspective to his practice, having personally navigated treatment and rehabilitation processes as an auto-pedestrian survivor. His insights offer a compassionate and expert view on the treatment for sacroiliac joint pain.

Understanding SI Joint Pain: More Than Just a Backache

The sacroiliac joints are located at the base of your spine, connecting your sacrum (the triangular bone above your tailbone) to your ilium (the large bones of your pelvis). These joints play a critical role in weight distribution and stability, absorbing shock between your upper body and legs. When these joints become inflamed or dysfunctional, they can cause significant pain.

SI joint pain can often be confused with other conditions, including:

• Herniated discs
• Lumbar spinal stenosis
• Sciatica
• Hip arthritis

This overlap in symptoms highlights the importance of an accurate diagnosis to ensure you receive the most effective treatment.

How is SI Joint Pain Diagnosed? Dr. Lo Explains the Expert Approach

Diagnosing SI joint pain can be challenging, but at PSA, we employ a thorough and precise approach. "The SI joint is an area that overlaps with other pathology that causes pain in the area," Dr. Lo notes.

Our diagnostic process includes:

• Detailed Patient History: We'll ask you to pinpoint exactly where your pain is located, its associated symptoms, and how it affects your daily life.
• Physical Examination: Our specialists perform specific provocative tests. As Dr. Lo describes, if your pain is reproduced during three or more of these tests, especially around the PSIS (posterior superior iliac spine) spot in your back, it strongly suggests the SI joint is the culprit. Physical examination also helps us identify other possible pain generators.
• Imaging: While imaging alone isn't always definitive, it's an important part of the overall assessment.
• Diagnostic Injections: A local anesthetic, often combined with a steroid to reduce inflammation, is precisely injected into the SI joint, guided by imaging for accuracy. "If the patient experiences significant relief from the SI joint injections, the SI joint is most likely the main pain generator" per Dr. Lo.

What is the Treatment for Sacroiliac Joint Pain? A Stepped Approach to Relief

At PSA, we don't believe in one-size-fits-all solutions. We design personalized sacroiliac joint pain treatment plans, combining multidisciplinary approaches to help you regain function and improve your quality of life. Our comprehensive approach to treating sacroiliac joint pain follows a progressive pathway, starting with less invasive options:

1. Conservative Management:

We begin with medications and conservative treatments aimed at managing your pain and inflammation. This often includes:

• • Physical Therapy: To help address core muscle strengthening, proprioception, and flexibility to correct lumbopelvic and hip biomechanics.
  • Muscle Relaxers: To alleviate muscle spasms around the joint.
  • Anti-inflammatory Medications: To reduce swelling and pain.
  • Pelvic Belt: Attempt to mimic the functions of pelvic ligament to limit shear forces and provide compression/stability to the joint.

• We prioritize avoiding narcotics whenever possible.

2. Interventional Pain Management:

If initial conservative approaches like medication therapy don't provide sufficient relief, our specialists at PSA can offer more targeted interventions directly at the source of your pain. These procedures are designed to offer more significant and localized pain reduction.

• Sacroilic Joint Injections: When inflammation within the SI joint is a primary driver of your pain, a precisely guided steroid injection can be highly effective. This procedure involves delivering a powerful anti-inflammatory medication directly into the SI joint. The goal is to reduce swelling and irritation, thereby alleviating pain. Patients often experience significant relief for 3-4 months, and these injections can be repeated as needed, though not too frequently to ensure patient safety and long-term joint health.
• Ablation (Radiofrequency Denervation): For longer-lasting relief, especially if injections prove effective but temporary, radiofrequency denervation (also known as radiofrequency ablation) may be considered. This minimally invasive procedure uses heat generated by radiofrequency waves to temporarily disrupt the nerve signals that transmit pain from the SI joint to the brain. By interrupting these signals, ablation can provide sustained pain relief, allowing you to engage more fully in daily activities and physical therapy.

3. Advanced Procedures for Lasting Relief:

For patients whose chronic SI joint pain persists despite conservative and interventional treatments, advanced procedures offer durable and often life-changing solutions. These options focus on providing more permanent stability or pain signal modulation.

• SI Joint Stabilization/Fusion: This procedure addresses SI joint pain caused by excessive motion or instability. The goal is to "stabilize the joint" by fusing the sacrum and ilium bones together, eliminating the painful rubbing or movement. Dr. Lo emphasizes that this stabilization doesn't typically affect mobility, meaning it aims to resolve pain without significantly compromising overall spinal flexibility.

Peripheral Nerve Stimulators: For chronic pain that doesn't respond to other treatments, peripheral nerve stimulation offers another advanced option. This involves implanting a small device that delivers mild electrical impulses to specific peripheral nerves near the SI joint. These impulses interfere with the pain signals traveling to the brain, effectively "masking" or reducing the sensation of pain. This can be a highly effective treatment for patients seeking long-term pain management without the need for fusion.

Exciting Advancements in Fusion: A Quicker, Easier Path to Relief

The idea of "fusion" might sound daunting, but the good news is that the way we perform SI joint fusion has come a long way. This procedure aims to permanently stabilize the joint, stopping the painful rubbing that patients often experience. Think of it like gently fusing two bones together so they no longer cause irritation.

Dr. Lo is particularly excited about recent breakthroughs in this area. Historically, surgeons used a lateral approach, meaning they accessed the joint from the side of the body. However, there's now a growing preference for the posterior approach, which means accessing the joint from the back.

What makes this new method so much better?

• Less Impact: It's considered less harm and less invasive for your body.
• Faster Recovery: This means you can often get back on your feet and back to your life much more quickly.
• Quick Procedure: Dr. Lo notes that this advanced surgery can often be completed in a remarkably short 15 to 20 minutes! This incredibly brief operating time is a clear sign of how the entire process has become more efficient and beneficial.

These advancements mean that SI joint fusion is becoming a more accessible and appealing option for lasting pain relief.

The Rewarding Journey: Life Beyond Pain

For Dr. Lo, the most rewarding part of his work treating sacroiliac joint pain is seeing patients reclaim their lives and rediscover joy. He shared a powerful story of a patient with a very high BMI, who had been told by other doctors to lose weight – a difficult feat when debilitating pain limits activity.

After receiving SI joint fusion at PSA, with a personalized post-operative protocol developed by Dr. Lo and his team, she has successfully reduced her BMI significantly and "is still getting better." This story exemplifies PSA's commitment to individualized care and the profound impact of effective pain management.

 Dr. Lo's Key Advice for Newly Diagnosed Patients

If you're newly diagnosed with SI joint pain, or if you've been struggling with undiagnosed back, buttock, or hip pain, Dr. Lo offers this crucial advice:

"SI joint pain is becoming more and more recognized. Up to roughly 30% of people with back pain can be SI. If you have back pain that’s overlooked or undiagnosed, or pain in your butt or hip areas, it could very well be your SI joint."

Don't let undiagnosed pain dictate your life. The team at PSA is dedicated to finding the root cause of your pain and developing a personalized approach to helping you find lasting relief.

Take the First Step Towards Sacroiliac Joint Pain Relief with PSA

At Pain Specialists of America, our mission is to provide unprecedented access to today's most effective pain management solutions. We are dedicated to delivering high-quality, professional, and compassionate care to help you get back to living a functional and fulfilling life.

If you’re ready to explore a treatment plan for sacroiliac joint pain that’s right for you, don't hesitate. Request a New Patient Appointment with Pain Specialists of America today. For every pain, we have a plan.