Orthopaedic Associates Articles

Recent Articles

Commonly Overlooked, SI Joint Dysfunction May Be the Cause of Your Back Pain

March 18, 2021

Are you experiencing pain, numbness, tingling, or weakness in your lower back, pelvis, or hips? Leg instability? Disturbed sleep or sitting patterns due to pain? Or pain going from sitting to standing, and have not been able to find a solution? Sacroiliac (SI) joint dysfunction is a commonly overlooked source of pain for many individuals.

What is Sacroiliac Joint Dysfunction?

The SI joint is located in the pelvis, linking the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone). The joint is an essential component for shock absorption to prevent impact forces from reaching your spine.

Like any joint in the body, the SI joint can be injured or become degenerative. SI joint dysfunction can cause back pain that may either be localized in your lower back or radiate all the way down through your buttocks and legs. This pain can range from mild to severe and often shows up while lifting, running, walking, or even sleeping on the involved side.

Clinical publications have identified the SI joint as a pain generator in 15-30% of chronic lower back pain patients. In addition, the SI joint is a pain generator in up to 43% of patients with continued or new onset lower back pain after a lumbar fusion.

There are several causes of SI joint dysfunction, so it can be difficult to pinpoint the primary issue. However, most common causes include injury due to an accident, triggering of pregnancy hormones, degenerative diseases such as osteoarthritis, and an inflammatory arthritis that primarily affects the spine called ankylosing spondylitis.

Making a Diagnosis

According to scientific data, it’s common for pain from the SI joint to feel like disc or lower back pain. For this reason, SI joint disorders should always be considered in lower back pain diagnosis.

A variety of tests performed during a physical examination may help reveal the SI joint as the cause of your symptoms. Sometimes, X-rays, CT-scan or MRI may also be helpful in the diagnosis of SI joint-related problems.

The most relied upon method to accurately determine whether the SI joint is the cause of lower back pain symptoms is to inject the SI joint with a local anesthetic. The injection will be delivered under either X-ray or CT guidance to verify accurate placement of the needle in the SI joint. If symptoms are decreased by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to the lower back pain.

Treatment

Once the SI joint is confirmed as the cause of symptoms, treatment can begin. Some patients respond to physical therapy, use of oral medications, or injection therapy. These treatments are often performed repetitively. If symptom improvement using these therapies only lasts temporarily, your surgeon may consider other options, including minimally invasive surgery.

If an SI joint fusion surgery is chosen as the next best course of action, Neurosurgeon Dr. Matthew T. Davies, MD is trained in the latest minimally invasive surgical technique, the iFuse Implant System from SI-Bone, Inc., which is proven to improve pain, patient function, and quality of life.

Join us on March 23 from 6-7 p.m. for a free patient educational webinar where Dr. Davies will discuss and review SI joint dysfunction. Click Here to Register

Expert Tips on Avoiding Winter Sports-Related Injury

February 22, 2021

While the winter blues may cause less motivation to get up and work out, it is important for both your physical and mental health to make sure you are exercising multiple times a week. This body movement may take the form of playing an organized sport, doing online videos in your home, and every option in between. Whichever activity you decide is best for your lifestyle and schedule, it is important to do so safely to avoid injury.  

While the winter season brings us some great opportunities to be active (hockey, Nordic skiing, downhill skiing, and fat tire biking just to name a few), it also brings opportunity for sports related injuries. 

We all look forward to a Northland favorite, hockey. Our area boasts some talented organized teams as well as provides great public outdoor and indoor rinks for community members to enjoy. In order to stay off the bench and on the ice, it is important to know about the common injuries that come along with the game. Hockey injuries primarily occur due to contact to the upper and lower body, which can result in shoulder separations or dislocations as well as knee ligament injuries. 

Another winter favorite includes downhill skiing, which takes place at high speeds and therefore the injuries occur with more “energy”. This can result in head injuries, concussions, knee ligament injuries, and fractured tibias or wrists. 

Now, we are definitely not recommending that you stop participating in these activities out of fear of injury. There are numerous ways to prevent these injuries. 

First, make sure you are wearing appropriate protective equipment for your sport or activity. Some of these items include helmets, mouth guards, and wrist guards. It is also important to understand the conditions of the terrain and snow you are skiing, biking, skating, etc. on. Ski, bike, and skate in control and always be aware of your surroundings so that you do not injure others or so that obstacles such as sticks or poles do not result in severe lacerations. 

Being active in colder weather can also make you more prone to injury. Outdoor activities and sports during the winter months require more time to warm-up our muscles before starting an activity. Remember to always stretch prior to working out or playing your sport. If you do not have time to stretch or warm-up, then try to ease into your activity and increase intensity gradually as your body warms up. 

Bumps, bruises, and minor injuries are common in any sport, but make sure to observe the following things that require medical attention: 

1.    Deformity of your limbs -- this may mean something is broken.
2.    Inability to move a joint or extremity -- this may mean something is dislocated. 
3.    Significant joint swelling -- this may mean a ligament has been torn. 
4.    Loss of consciousness – this may mean head trauma. 
5.    Abdominal pain -- this may mean you have bleeding from your spleen or liver. 

If you are experiencing any of these symptoms, it is time to see a professional.
 

The Sports Medicine team at Orthopaedic Associates of Duluth is here to treat any injuries and get you back in the action. Our board-certified surgeons specialize in sports medicine and work with patients from diagnosis to recovery for both surgical and non-surgical treatments. We also have a great team of physical therapists, occupational therapists, and athletic trainers who are dedicated to working with you until you are back to playing your sport. 

We are often able to schedule appointments for the same day as you first contact us by calling 218-722-5513.

Our goal is to provide you with the tools you need in order to avoid injury altogether. However, in the moments when a larger issue or injury does occur that impacts your ability to remain active or play your sport, know we are here with options to keep you enjoying a great active winter in the Northland.