Dr. Steven Beer

Dr. Steven Beer, Wyoming Spine and Neurosurgery Associates

Up to 85% of all people have lower back pain at some point in their life. Lower back pain is second only to the common cold as a reason for a physician office visit. Despite a lot of attention being given to lower back pain, a major contributor is often overlooked.

Up to 30% of chronic low back symptoms are related to the sacroiliac joint. Unfortunately, this cause is often discounted or overlooked.

Where is the sacroiliac joint?

The sacroiliac (SI) joint forms the lowest segment of the spine and is located on either side of the sacrum in the lower back and pelvic areas. The two SI joints connect the sacrum with the left and right ilium bones (the wing bones) of the pelvis.

What causes SI joint pain?

Strong ligaments surround each joint, allowing approximately two to four degrees of movement during weight-bearing activity. The SI joints are essential for supporting the upper body and effectively transferring loads between the spine and legs. Like other joints, the SI joints can become damaged from acute or repetitive trauma, causing disruption and degeneration. This damage can result in SI joint dysfunction, which may cause pain in the buttocks, lower back/spine, pelvis/groin and legs.

Why is a diagnosis of SI joint dysfunction often missed?

SI joint dysfunction is often overlooked, as abnormalities often do not show up on a medical image, and symptoms often present in a pattern similar to lumbar spine and/or hip conditions. This could potentially lead to the wrong diagnosis and treatment that may not address the appropriate cause of the pain. Patients who present with lower back, buttock, thigh or groin pain should have their lumbar spine, SI joints and hips carefully evaluated to determine all possible sources of pain.

What are common complaints from patients with SI joint dysfunction?

  • Some of the most common symptoms of SI joint dysfunction include the following:
  • Lower back pain (below L5, or the fifth lumbar spine vertebrae)
  • Sensation of lower extremity pain, numbness, tingling, weakness and/or instability
  • Pelvis/buttock pain
  • Hip/groin pain
  • Disturbed sleep and sitting patterns due to pain
  • Pain when going from sitting to standing

How is a diagnosis of SI joint dysfunction confirmed?

A physician will want to perform several diagnostic tests to determine if the SI joint is contributing in whole or in part to symptoms. These tests may include provocative manipulation and injecting the SI joint with numbing medicine.

What treatments are available for SI joint dysfunction?

Nonsurgical treatment may include medication, physical therapy and/or SI joint steroid injections to manage the pain. For patients who are no longer responding to conservative care, the iFuse Implant System offers a minimally invasive surgical option to stabilize and fuse the SI joint.

Typically, three small triangular titanium implants are placed across the joint, and the triangular shape and strength of the implants resist movement and rotation of the joint. iFuse is the only device for treatment of SI joint dysfunction that is backed by significant published clinical evidence.

How can someone learn more about the SI joint as a potential cause of their chronic lower back pain?

As a board-certified neurosurgeon treating a wide array of complex conditions, I’m happy to evaluate you.

Dr. Steven J. Beer, FAANS, is a board-certified neurosurgeon specializing in the conservative and operative management of brain and spinal disorders. As a founding member of Wyoming Spine and Neurosurgery Associates, his goal is to offer treatments to get patients back to normal in the shortest time possible.

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