Sacroiliac joint syndrome (ISG syndrome)

As Sacroiliac joint syndrome (ISG syndrome) refers to lower back pain that occurs in the lower back. The sacroiliac joint connects the hip bones with the sacrum by means of ligaments. Sacroiliac joint syndrome can occur in both young and elderly people.

What is sacroiliac joint syndrome?

The Sacroiliac joint syndrome (ISG syndrome) is a painful condition affecting the lower back. The sacroiliac joint is not a movable joint such as B. the knee. It serves as a connection between the sacrum and the hip bones. Due to the rigid fixation with straps, the mobility of the ISG is severely restricted.

The sacrum is located between the lumbar vertebrae and the tailbone and consists of five vertebrae that are fused together. In the sacroiliac joint syndrome, the joint surfaces shift against each other. This is often associated with very severe pain and restricted mobility.

Since the lower area of ​​the spine in particular is subject to great stress, pain and degenerative changes in this area often occur. Sacroiliac joint syndrome (ISG syndrome) is one of the most common forms of back pain.

causes

The Sacroiliac joint syndrome can have many causes. Above all, bad posture and incorrect strain in sport and work often lead to signs of wear and tear and thus to lower back pain. A lack of exercise and thus underdeveloped muscles also promote the development of the sacroiliac joint syndrome.

Another cause can be illnesses. Ankylosing spondylitis, rheumatoid arthritis or osteoporosis can trigger sacroiliac joint syndrome. Bacterial infections, often e.g. B. Lyme borreliosis, can cause inflammation in the sacroiliac joint.

Sacroiliac joint syndrome often occurs during pregnancy, as the muscles and ligaments in the lower spine are stressed during this time.

In the case of lower back pain, the psychological factor must not be ignored. Stress and other psychological burdens often express themselves in the form of a sacroiliac joint syndrome.

Symptoms, ailments & signs

A possible symptom that indicates a dislocation of the sacroiliac joint is diffuse low back pain. These are usually accompanied by a sharp pain in the ISB, which can radiate into the legs, stomach and lumbar area. The feeling of limping or jamming in the hip joint is also typical, often associated with restricted mobility.

In general, the pelvis and lower back appear unstable and painful when bending forward or backward strongly. The pain mainly occurs when one has remained in one posture for a long time. After lying, standing or sitting there is persistent pain and stiffening of the muscles, which only slowly subsides.

When lying on the back, extreme pain usually occurs, which radiates from the joint to the surrounding body regions. The typical pain can affect the entire pelvic area. If the condition is not treated, serious complications can develop. If left untreated, the pain develops into a chronic condition that also occurs at night and during periods of rest.

In addition, severe inflammation can develop, which significantly restricts the mobility of the affected joints. This is usually accompanied by emotional upsets and irritability.

Diagnosis & course

The Sacroiliac joint syndrome will i. d. Usually diagnosed by an orthopedic surgeon. Here the doctor uses various examination methods. In addition to a detailed anamnesis (taking the medical history, describing the symptoms), tests are carried out both standing and lying down.

The so-called forward phenomenon and the reverse phenomenon are tested. These tests check the mobility of the sacroiliac joint. In addition to the physical exam, imaging techniques are also used. However, x-rays cannot show sacroiliac joint syndrome. X-rays, magnetic resonance imaging and CT are used to rule out other diseases and injuries to the spine and intervertebral discs.

A blood test can be used to determine whether there is any inflammation. With the help of a bone scintigram, the inflammation in the area of ​​the IS joint can be made visible. If a sacroiliac joint syndrome is diagnosed, the disease remains i. d. Usually not limited to the IS joint, but the hips and lumbar spine are also affected over time.

The course of a sacroiliac joint syndrome has to be assessed differently, since it depends on the cause as well as the treatment. Often the symptoms only appear for a short period of time and get better with the help of medication and physiotherapy. Sacroiliac joint syndrome develops into a chronic disease in around 30 percent of all those affected.

Complications

Due to the sacroiliac joint syndrome, the patient suffers from severe pain in different regions of the body. In most cases, however, the back and hips are affected. The pain often results in restricted mobility and thus in psychological complaints. Furthermore, it can lead to tension in the muscles and pain in the knees.

The everyday life of the person affected is restricted by the sacroiliac joint syndrome and many physical or sporting activities can no longer be carried out. If the pain also occurs at night in the form of pain at rest, this can lead to sleep disorders. A long-term treatment of the pain with the help of painkillers is not recommended, as these have a negative effect on the stomach.

In the case of inflammation, antibiotics and other medications can be used to stop it. There are no further complications. However, the person concerned is dependent on physiotherapy to treat the symptoms. However, this does not always lead to a positive course of the disease, so that the person affected may suffer from restrictions for his entire life. Life expectancy is not affected by sacroiliac joint syndrome.

When should you go to the doctor?

Unusual lower back, lower or buttock pain should always be examined by a family doctor or an orthopedic surgeon. If there is already a concrete suspicion of a serious illness, a quick investigation is required. Affected patients should speak to their general practitioner or visit a specialist clinic with symptoms. Since sacroiliac joint syndrome is usually chronic, close monitoring is indicated. If side effects and interactions occur during the treatment, the responsible doctor must be informed.

The same applies if the pain intensifies or new symptoms appear. Typical warning signs that have to be clarified immediately are restricted mobility or paralysis in the area of ​​the back and buttocks. People who suffer from ankylosing spondylitis or osteoporosis are particularly prone to developing sacroiliac joint syndrome. Rheumatoid arthritis or a bacterial infection can also trigger the disease. People who suffer from any of these diseases should speak to their doctor if they experience the symptoms and symptoms mentioned.

Treatment & Therapy

At a Sacroiliac joint syndrome there are different treatment options. At the beginning of the therapy plan there is physiotherapy and pain therapy. Then the cause of the symptoms must be found and treated appropriately.

If there is an infection, it is treated with antibiotics. As a secondary disease in the context of a rheumatic disease, cortisone preparations are usually administered in conjunction with painkillers, as these are the most effective.

If the pain is very severe, an anesthetic can be injected into the joint space. This relieves the discomfort and mobility is also improved, as the injection of fluid means that the joint surfaces no longer rub against each other.

Physiotherapy is used both as an immediate measure and as a long-term therapy. Stimulation current treatments, heat applications, physiotherapy and occupational therapy exercises, underwater gymnastics, etc. have proven to be particularly effective here. The aim of physiotherapy is to relieve pain, restore mobility and correct incorrect posture. Because the joint is blocked in sacroiliac joint syndrome, manual therapy can be used to attempt to release the blockage.

So-called alternative treatment methods have also proven effective for sacroiliac joint syndrome. Yoga, progressive muscle relaxation and acupuncture offer a good alternative to conventional medicine.

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Outlook & forecast

The prognosis for SI joint syndrome differs from patient to patient. Among other things, the age of the person affected as well as the severity of the disease and the selected therapeutic measures play a decisive role in the course of the disease. An ISG syndrome that has not been around for long has the best prognosis. It can usually be treated with the help of physiotherapy and targeted exercise. Spontaneous improvements are also more common in this form of ISG syndrome.

On the other hand, an ISG syndrome that has existed for a long time is difficult to treat. Despite physical activity, massages or physiotherapy, the patients suffer from constant pain. However, there are also differences here with regard to the quality and quantity of pain. While some patients only feel pain in the SI joint area when they are overexerted, others complain of pain even when they are at rest. The pain quality varies from barely noticeable to very strong.

Especially in younger patients between the ages of 15 and 40, the ISG syndrome hardly shows any improvement despite appropriate treatment. The quality of life and everyday life of those affected suffer greatly as a result. It is not uncommon for them to have to rely on pain medication for life to cope with their everyday lives. In some cases, however, the usual pain medication for SIJ syndrome is very weak, so patients have to learn to live with the pain.

prevention

There are several ways to get one Sacroiliac joint syndrome to prevent. Exercise is a must, as is avoiding obesity. Furthermore, it makes sense to attend a so-called back school. This is offered by all health insurance companies or you can learn it from a physiotherapist.

These are special exercises for the back. With their help one learns to recognize and avoid bad posture and incorrect strain. Important: If you already have pain, you should move slightly, because the resting state can make a sacroiliac joint syndrome (ISG syndrome) even worse.

Aftercare

Follow-up care for sacroiliac joint syndrome depends on the degree of the disease and the age of the patient. With an early diagnosis, the symptoms can be alleviated quite well. The aftercare is primarily about targeted physiotherapy. With the right movements, this helps to make the joint mobile on the one hand and to stabilize it on the other.

For those affected, sporting activities are irreplaceable, also in order to avoid any overweight. Depending on the problem, the doctor may recommend attending a back school. Some of these offer health insurances, but individual physiotherapy is also helpful. With the health-promoting exercises, those affected strengthen their backs and learn the ideal posture.

A conscious handling of one's own body prevents further improper stress and has a correspondingly positive effect on the quality of life. Even if patients experience pain, they should exercise enough and not take long-term pain medication. At rest, the affected joint may get worse. For aftercare, doctors often recommend heat applications or special relaxation methods such as yoga. Gentle exercise also improves the back muscles, which in turn reduces symptoms. After an intensive introduction, the exercises are also suitable for use at home.

You can do that yourself

In the case of sacroiliac joint syndrome, the patient has various self-help options that can significantly alleviate the symptoms of this disease.

First and foremost, various heat applications have a very positive effect on the symptoms and can alleviate the pain. Relaxing exercises such as yoga or other light sports can also strengthen the back muscles and reduce symptoms. Acupuncture can also have a positive effect on the course of the sacroiliac joint syndrome. Furthermore, many patients are also dependent on physiotherapy or physiotherapy. These exercises can often be done at home so that movement is restored. The patient should also note that long-term use of pain medication is not recommended as it can damage the stomach. The use of painkillers should therefore always be coordinated with the doctor.

The symptoms of sacroiliac joint syndrome can also be limited by underwater gymnastics. These exercises are usually done in a group, but can also be done alone. However, if the pain is severe, the patient should contact a doctor, as this can be alleviated with an anesthetic. In most cases, sacroiliac joint syndrome has a positive course of disease.