Sacroiliac Joint Dysfunction

Sacroiliac Joint Dysfunction: Treatment in Palm Beach

The sacroiliac (SI) joint connects the sacrum at the base of the spine to the ilium of the pelvis. SI joint dysfunction is a frequently overlooked but significant cause of low back, buttock, and leg pain. It is estimated to account for up to 25% of chronic low back pain cases.

At Palm Beach Regenerative, image-guided SI joint treatment is an integral part of the lumbar spine care approach, with precise injection targeting the joint and surrounding ligaments. Reach out to our practice to schedule an appointment today.

What Is Sacroiliac Joint Dysfunction?

The SI joint is heavily reinforced by ligaments and normally has very limited movement. Dysfunction arises from either too little movement (from arthritis or fusion) or too much movement (from ligament laxity), both of which can produce pain in the buttock, low back, and into the hip or thigh.

SI joint dysfunction is particularly common in women following pregnancy and delivery, in athletes with pelvic asymmetry, and in patients following lumbar fusion surgery.

Signs and Symptoms

• Pain in the low back, buttock, and sacral region, typically one-sided
• Pain that worsens with prolonged standing, walking, or transitions such as getting up from a chair
• Radiating pain into the hip, groin, or back of the thigh
• Pain with single-leg weight-bearing or stair climbing
• Tenderness directly over the SI joint
• Worse with prolonged sitting

Common Causes and Risk Factors

• Ligament laxity from pregnancy or hormonal changes
• Trauma or fall directly onto the sacrum
• Arthritis or inflammatory conditions affecting the SI joint
• Altered gait mechanics from hip or lumbar pathology
• Post-lumbar fusion syndrome where forces transfer to the SI joint

How It Is Diagnosed

Clinical examination with specific SI joint provocative tests (FABER, thigh thrust, Gaenslen's test) is the starting point. A fluoroscopic or ultrasound-guided diagnostic injection into the SI joint that relieves pain is the most reliable confirmation of the SI joint as the pain source.

Dr. Ghattas incorporates diagnostic injection as part of his evaluation when SI joint involvement is suspected.

Conventional Treatment Options

• Physical therapy for pelvic stabilization and SI joint muscle support
• SI joint belts for temporary stabilization
• SI joint steroid injections for inflammatory cases
• Prolotherapy for ligament laxity
• Radiofrequency ablation of SI joint nerves
• Surgical SI joint fusion for severe refractory cases

The Palm Beach Regenerative Approach

Dr. Ghattas offers image-guided orthobiologic injection into the SI joint using fluoroscopic guidance to confirm accurate placement. For patients with SI joint ligament laxity, prolotherapy or platelet injection targeting the posterior SI ligaments provides a stabilizing biological stimulus to support ligament tightening.

The choice between intra-articular joint treatment and peri-ligamentous treatment is guided by the specific findings of your clinical and diagnostic evaluation, reflecting the individualized approach at Palm Beach Regenerative.

The BioMod Advantage: MLS Robotic Laser Therapy applied to the sacral and SI joint region reduces local inflammation and supports the ligament structures surrounding the joint. Xymogen collagen support and anti-inflammatory protocols create a systemic environment that complements the targeted injection treatment and supports SI joint stabilization.

Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery or other interventions may be more appropriate.