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Often misunderstood pain causes back pain through the sacroiliac joint
About 90 percent of Germans know this plaguing phenomenon: back pain. But for every fifth person affected, the origins of the symptoms remain undetected, as they are not located in the back, but in the sacroiliac joint (SI). Prof. Dr. Jürgen Harms, specialist for orthopedics and trauma surgery and expert for spine surgery in Heidelberg, clarifies the most important questions around the often underestimated joint.
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- What tasks does the ISG fulfill??
- Why does the ISG often remain unrecognized as a pain trigger??
- What are the most common causes of ISG complaints??
- Are there people who are particularly vulnerable to ISG syndrome??
- How can an ISG syndrome be detected??
- How to treat pain in the ISG?
- What are the chances of a normal everyday life after surgery??
What tasks does the ISG fulfill??
The sacroiliac joint connects the crura with the ilium and forms a kind of bridge between the spine and the leg axis. It forms the interface between the transmission of power between the upper and lower body and thus contributes significantly to the stability of the body.
Pain on the edge of the pelvic bucket. Cross iliac joints. Picture: Henrie Why does the ISG often remain unrecognized as a pain trigger??
Patients and physicians usually suspect a herniated disc in lower back pain. Its symptoms are very similar to an ISG block, so it often comes to wrong diagnoses and subsequently to incorrect treatments.
What are the most common causes of ISG complaints??
Strains, deformities, missteps or falls on the buttocks are among the most common triggers. Such an inattention brings the sturdy corset of ligaments, tendons and muscles out of balance. As a result, the joint canted and blocked painful. Also, pelvic deformities can lead to long-term problems.
Are there people who are particularly vulnerable to ISG syndrome??
People with slight malpositions in the hips or different leg lengths burden the ISG with each movement. In particular stress, for example during sports, the articular surfaces suddenly shift and cause pain. In addition, pregnant women represent a risk group. During and after pregnancy certain hormones cause a loosening of the ligamentous apparatus, which can also cause a blockade of the two joint plates. In addition, older people are considered to be particularly at risk because age-related signs of wear and tear, for example osteoarthritis, have a negative impact on the ISG.
How can an ISG syndrome be detected??
There are many potential causes of pulling low back pain. If the symptoms increase, as soon as those affected bend over or sit cross-legged, the ISG comes into question as a source. Later, even the simplest movements, such as climbing stairs or putting on shoes, become more and more difficult. However, patients only receive a correct diagnosis from the doctor. This patient performs a thorough medical history and can identify the cause by means of so-called provocation tests and pain medication directly into the joint.
How to treat pain in the ISG?
First, conservative therapies are used. Should mild painkillers, heat treatments or infiltration therapy in combination with physiotherapy for muscle building cause any improvement, radiofrequency thermocoagulation is used. This destroys permanently stressed nerves. Only when these methods are exhausted, today's physicians resort to modern triangular implants. The so-called iFuse implants give the joint new hold.
What are the chances of a normal everyday life after surgery??
In the past, doctors used special screwing systems to stabilize the sacroiliac joint. However, as this method has been unsuccessful in many cases, modern medicine uses the triangular iFuse implants. Thanks to a special porous surface coating, they grow into the surrounding bone within three to six weeks. Patients already experience first successes immediately after the procedure and soon return to their everyday lives without complications. Both statutory and private health insurance companies cover the costs of this treatment. (Sb / pm)