What can I expect to encounter at my initial doctor’s appointment?
If you suspect the SI joint is the cause of your pain, you should see a neurosurgeon, an orthopedic spine surgeon or a physiatrist (rehabilitation physician).
- The doctor will ask you about your history of back pain and you will need to pinpoint on your body where, specifically, the pain occurs.
- Be sure to tell the doctor what causes your pain and what, if anything, relieves it. Be as specific as possible.
- If possible, share a full history of previous treatments with the doctor, including whether you’ve had any prior injections and where on the body the injections occurred. Don’t forget to note your response to any previous treatments.
- The doctor will examine you, push on your low back and perform various maneuvers in order to re-create your pain and pinpoint the diagnosis.
- You will likely have an MRI of the lumbar spine and a CT scan of the SI joint to look for any pinched nerves or other spinal or neurological deficits that may be causing your pain.
If SI joint pain is suspected, you should receive an injection to confirm the diagnosis. In some cases, a steroid may be added to the injection to provide more lasting relief; this is called a therapeutic injection.
In general, from there, you will have physical therapy. Be sure to specifically request of the therapist that they focus their treatment on the SI joint as that is very different than treatment of lower back or lumbar spine pain. It doesn’t work on everyone, but if a patient can tolerate anti-inflammatory medication that can also help a great deal.
If the pain continues, injecting the SI joint with steroids or numbing medications can provide relief.
Unfortunately, many times this relief is only temporary. If a patient is compliant with a doctor’s instructions, has tried all treatments and is not satisfied with their relief, then it’s time to consider SI joint fusion to stabilize the joint.