Pain is often felt in the lower back just to the side of the midline at the level of the buttocks. This pain can radiate down the back of the thigh to the knee and rarely to the side of the calf. Occasionally pain can be felt in the groin also. Pain can be aggravated by standing on that leg alone or going up and down stairs.
The sacroiliac joint is a large joint between the sacrum (spine) and the pelvis, it is a joint and can therefore be irritated by arthritis or abnormal movements here.
Your consultant will take a history of the pain and examine you using special provocative tests to elicit the symptoms. Xrays and occasionally bone scans and MRI scans are requested also to help pin point the problem and help exclude other joints that can mimic the pain.
Initially an injection into the Sacroilliac joint is recommended for 2 reasons:
Physio therapy is offered those mild cases with girdle weakness, if this fails in the long term or the condition is more severe then we would consider fusion.
This new system offered is a day case procedure done through a keyhole approach. Under X-ray guidance and regional anaesthesia up to 3 triangular shaped titanium rods are passed across the troublesome joint. These rods are rough and grip onto the bone either side of the joint, this renders the joint unable to move at all. In the long term the bone grows onto the rods incorporating them and fusing the joint. This minimally invasive approach drastically reduces the risks of bleeding, infection and pain compared to the more traditional methods of fusion allowing earlier weight bearing and discharge from hospital on the day of surgery.
Every surgical procedure carries risks, the risks using this approach to joint fusion are dramatically reduced.
Depending on the kind of work you do, you may need up to six weeks off work. However, you will be advised about this as everyone is different and your rate of recovery may be different from other people’s. We normally recommend that you don’t work at all for the first two weeks, gradually returning to normal after four to six weeks (if your job mainly involves sitting down). Commuting during rush hour is not recommended for at least six weeks after fusion surgery. Manual workers may need up to three months to return to normal.
The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you are confident walking without crutches and can get into your car without help, which is usually around six weeks after surgery. Vehicle insurance companies also usually suggest a six-week period off driving, although you should always check with your car insurance company first.