Treatment Options for Lower Back Pain

Low back pain is one of the most common health problems affecting an estimated 85% of the western population. The sacroiliac joint is a common source of low back pain, accounting for about 30% of all cases. Latest evidence shows sacroiliac joint (SIJ) dysfunction is seen in 1 in 3 patients with chronic low back pain and has been misdiagnosed for years.

What is the sacroiliac joint and how do symptoms of dysfunction present themselves?
The sacroiliac joints (SIJ) sit on the left and right sides of your spine between the sacrum and the ilium bones of the pelvis. Their primary roles are to provide stability for the pelvis and bear the upper body’s load when you stand or walk and shift that load to your legs. They are an essential component for energy transfer (or shock absorption) between the legs and the torso.

The pain starts when your SI joint becomes inflamed. There are several reasons in could happen, but hypermobility (too much movement, the joint is too loose) and hypomobility (too little movement) are the root of the problem. This can occur as the result of a fall, work injury, car accident, pregnancy and childbirth, or hip/spine surgery (laminectomy, lumbar fusion, etcetera). Another factor contributing to SIJ dysfunction could be age. As we age our bones become arthritic and ligaments stiffen. When the cartilage wears down, the bones may rub together causing pain.

Patients who may be experiencing SIJ Pain report symptoms such as…
Pain in the lower back
Pain in the buttocks, hips and pelvis
Increased pain when standing up from a seated position
Inability to sit for long periods of time (i.e. long car rides, working at a desk)
Inability to perform daily functions such as vacuuming or loading the dishwasher.
Have continuous low back pain despite other therapeutic treatments such as spinal cord stimulation or spinal fusion.

This sounds like me; what are my treatment options?
SI joint disorders require appropriate interpretation of your history, clinical exam results and imaging studies. Often, hip pathology and or lumbar pathology can coexist with SI joint pathology. Excel Pain and Spine physicians are trained in the diagnosis and treatment to help diagnose your condition accurately and get you on the path for lasting relief.
SI dysfunction treatment options could include:
4-8 weeks of physical therapy
SI diagnostic and therapeutic joint injections
Radiofrequency ablation of the nerves in the
SI joint
SI joint stabilization procedure utilizing
SI joint stabilization

SI joint stabilization allows for stabilization of the SI joint in eligible patients where other treatment has failed. This procedure is minimally invasive in nature and is typically performed at an outpatient surgical center. Patients can expect a fast recovery time and, in some cases, immediate relief.

Some of the benefits of this system include:
Drill-less
Non-metal implant (LinQ is made from cadaveric bone)
Low risk of infection or complications
Long-term relief from SI joint pain

The LinQ implant is about the size of an almond and is inserted in between the sacrum and ilium to help anatomically restore the joint space and re-stabilize the joint. While patients are encouraged to return to normal activity as soon as they feel they are able to, they should limit bending, lifting, and twisting for about 6 weeks post operation. This time will allow the soft tissues around the incision site to heal properly.

Frequently Asked Questions
Does SI Stabilization require an overnight hospital stay?
No, this is a same-day, outpatient procedure.

Is it covered by Medicare?
Yes, and private insurance too.

If I’ve had a prior fusion or laminectomy, am I still a candidate?
Yes, many patients have SI dysfunction even after other fusion and laminectomy surgeries.

What about other procedures (SCS, RFA, or injections)?
Yes, the same as above.

Can I still have MRIs and CT scans?
Yes, this is NOT a contraindication against MRIs or CTs.

Will I get immediate pain relief?
In many cases, yes, however, some soreness can be expected after surgery.

What if I have pain on both sides?
Each patient is different. Once we conduct several tests to determine the diagnosis of the pain, we can make a plan specific to each individual. If there is bi-lateral SI pain, treating both sides are an option.

I think I could be a candidate for this procedure. What are the next steps?
Make an appointment with a physician at Excel Pain and Spine to be evaluated for SI joint dysfunction. From there, you will discuss personalized treatment options to address your diagnosis and fit your lifestyle.

EXCEL Pain ans Spine
(P) 813.701.5804
(F) 813.291.7615
excelpainandspine.com

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