The sacroiliac (SI) joints connect the spine to the pelvis, providing stability and absorbing shock. When these joints become dysfunctional due to injury, arthritis, or instability, patients can experience chronic pain in the lower back, buttocks, and legs. For some, conservative treatments provide relief. However, when all else fails, having the sacroiliac joint fused may be the best solution for achieving long-term relief from chronic pain, allowing patients to regain mobility and function. When you have fused sacroiliac joints your joints are stabilized to reduce friction, inflammation, and pain.
Understanding Sacroiliac Joint Dysfunction
The SI joints bear weight and help with movement, but they can also become a source of pain due to:
- Arthritis – Degeneration of the joint cartilage can lead to inflammation and discomfort.
- Injury or Trauma – Falls, car accidents, or repetitive stress can damage the SI joint.
- Pregnancy-Related Changes – Hormonal shifts and increased load can cause instability in the SI joints.
- Previous Lumbar Fusion – Altered biomechanics can place extra stress on the SI joints, leading to pain.
- Inflammatory Conditions – Diseases like ankylosing spondylitis can cause chronic inflammation in the SI joints.
The Conservative Approach: First Steps Before Fusion
Before considering surgery, physicians explore non-surgical treatments to relieve sacroiliac joint pain. These treatments include:
Physical Therapy
A structured physical therapy program focuses on strengthening the muscles around the SI joints, improving stability, and reducing pain. Common exercises target the glutes, core, and pelvic muscles to minimize excessive joint movement. Examples include:
- Bridge exercises to strengthen the glutes and lower back.
- Clamshell exercises to stabilize the pelvis.
- Pelvic tilts to improve core engagement and reduce SI joint stress.
- Hip flexor stretches to alleviate tightness contributing to misalignment.
Medications
Medications play a key role in managing SI joint pain. Common options include:
- Anti-inflammatory drugs (NSAIDs) to reduce swelling and discomfort.
- Muscle relaxants to ease muscle spasms around the SI joint.
- Neuropathic pain medications like gabapentin or duloxetine for nerve-related pain.
- Corticosteroids in pill form for temporary relief of inflammation.
Sacroiliac Joint Injections
If therapy and medications are not enough, sacroiliac joint injections may provide relief. These injections contain a combination of corticosteroids and anesthetic to reduce inflammation and confirm that the SI joint is the pain source.
- Diagnostic SI joint injections help determine if pain relief is significant enough to warrant further treatment.
- Therapeutic SI joint injections may provide longer-lasting relief, helping patients avoid surgery.
- Radiofrequency ablation (RFA) may be used to burn pain-causing nerves around the SI joint, offering months of relief.
When Is Sacroiliac Joint Fusion Necessary?
For patients who experience persistent pain despite conservative treatment, sacroiliac joint fusion may be the next step. This procedure involves placing small implants or bone grafts to permanently stabilize the joint and eliminate movement that causes pain.
Signs that a sacroiliac joint fusion may be beneficial include:
- Pain relief from SI joint injections, but only temporarily.
- Ongoing difficulty walking, standing, or sitting for long periods.
- No significant improvement despite months of therapy and medications.
- Severe SI joint instability or arthritis confirmed through imaging studies.
The Sacroiliac Joint Fusion Procedure
Sacroiliac joint fusion is a minimally invasive surgery that typically involves:
- A small incision over the SI joint.
- Insertion of implants or bone grafts to promote fusion.
- Stabilization of the joint to eliminate painful movement.
- A recovery period that includes a gradual return to activity with physical therapy.
Recovery After Sacroiliac Joint Fusion
Patients who have fused sacroiliac joints often report significant reductions in pain and improved quality of life within a few months. Additionally, having fused sacroiliac joints can prevent further degeneration and reduce dependency on pain medications. A successful sacroiliac joint fused procedure can lead to lasting stability and restored function.
Recovery from a sacroiliac joint fusion varies by patient but generally follows this timeline:
- Week 1-2: Patients use assistive devices (e.g., crutches or a walker) to limit weight-bearing.
- Week 3-6: Gradual increase in movement and physical therapy begins.
- Month 2-3: Pain continues to subside as fusion progresses, and normal daily activities resume.
- Month 3-6: Full recovery is expected, with most patients experiencing significant pain relief.
Many patients can return to light work duties within 4 to 6 weeks, while those with physically demanding jobs may require up to 3 months before resuming full activity. Over time, a sacroiliac joint fused can contribute to long-term pain relief and enhanced mobility.
Potential Risks of Sacroiliac Joint Fusion
As with any surgery, sacroiliac joint fusion has potential risks, including:
- Infection at the surgical site, though this occurs in less than 2% of cases.
- Failure of the joint to properly fuse, which happens in a small percentage of patients.
- Nerve irritation or damage, which is rare but possible.
- Continued or new pain due to altered biomechanics.
- Blood clots due to limited mobility post-surgery.
To mitigate these risks, surgeons use minimally invasive techniques, prescribe appropriate post-surgical medications, and encourage early movement to prevent complications.
Is Sacroiliac Joint Fusion Right for You?
If you’ve struggled with sacroiliac joint pain despite trying therapy, medications, and injections, SI joint fusion could be an option. At Red Butte Pain Solutions, we specialize in evaluating and treating SI joint dysfunction to help our patients regain their quality of life.
Contact us today at 602-633-4334 or schedule an appointment to learn more about your options.