By Dr. Magdalena Kerschner
Sacroiliac (SI) joint pain can significantly impact daily life, affecting up to 25% of individuals with chronic lower back pain.
This often-overlooked source of discomfort occurs where the sacrum meets the iliac bones of the pelvis, creating a crucial junction that bears and transfers weight between the upper body and legs during movement.
The SI joint can become painful due to various factors, including pregnancy, childbirth, trauma, arthritis, or biomechanical irregularities. Age-related changes and repetitive stress can also contribute to joint dysfunction. Common symptoms include pain in the lower back, buttocks, and groin, which typically worsens with prolonged sitting, standing, or certain movements like climbing stairs or getting out of a car.
Diagnosis of SI joint pain requires a comprehensive medical evaluation, as symptoms can mimic other conditions like herniated discs or sciatica. Healthcare providers typically perform specific physical tests, including pain provocation maneuvers, to isolate the SI joint as the pain source. Imaging studies such as X-rays, CT scans, or MRI may be necessary to rule out other conditions and confirm SI joint involvement.
Initial treatment typically begins with conservative approaches. Physical therapy plays a crucial role, focusing on strengthening core muscles, improving flexibility, and correcting postural abnormalities. Therapeutic exercises may include pelvic tilts, bridges, and gentle stretches to stabilize the joint and reduce stress on surrounding structures. Additionally, patients may benefit from manual therapy techniques, including joint mobilization and soft tissue work.
For those who don’t find adequate relief through conservative measures, SI joint injections represent an effective intermediate treatment option. These injections typically contain a combination of local anesthetic and corticosteroid medication, delivered precisely into the joint under fluoroscopic or ultrasound guidance. The anesthetic provides immediate pain relief, while the steroid reduces inflammation, offering longer-lasting benefits that can extend from weeks to months.
The injection procedure is typically performed on an outpatient basis and takes approximately 30 minutes. Patients remain awake but may receive light sedation for comfort. Using real-time imaging guidance ensures accurate placement of the medication, maximizing therapeutic benefit while minimizing risks. Most patients can return to normal activities within 24-48 hours, though they’re advised to avoid strenuous exercise for a short period.
While SI joint injections can provide significant relief, they work best as part of a comprehensive treatment approach. Combining injections with physical therapy, activity modification, and proper body mechanics often yields the best outcomes. Some patients may benefit from wearing a sacroiliac belt temporarily to provide joint stability and reduce pain during activities.
For those experiencing persistent pain despite conservative treatment and injections, additional interventional options exist. Radiofrequency ablation of the nerve supply to the SI joint can provide longer-lasting pain relief, typically 6-12 months or more. In severe cases unresponsive to other treatments, minimally invasive SI joint fusion surgery may be considered to permanently stabilize the joint.
Prevention remains essential for long-term management. This includes maintaining a healthy weight, practicing proper lifting techniques, and engaging in regular exercise to support joint stability. Ergonomic modifications at work and home can also help reduce stress on the SI joint during daily activities.
With proper diagnosis and a tailored treatment approach incorporating various therapeutic options, including injections when appropriate, most individuals with SI joint pain can achieve significant improvement in their symptoms and quality of life.
Dr. Kerschner
Dr. Magdalene Kerschner, a graduate of Wayne State University School of Medicine, completed her Anesthesiology residency at The University of Kentucky. Her experience in spine surgery anesthesia led to her specialization in chronic pain management. As a Board Certified Interventional Pain Physician, Dr. Kerschner believes that while pain is undeniable, suffering is optional. She aims to help patients reclaim their joy through interventional techniques and complementary therapies.
Dr. Kerschner stays involved with professional societies to keep up with medical advancements. She served as Vice President of Ohio Interventional Pain Physicians Society and is an active member of Ohio Medical Association’s Substance Abuse Committee. She contributed to the development of Ohio’s HB 93, known as “The Pill Mill Bill,” which led to the closure of illegal pain clinics.
Her compassionate work extends internationally. Dr. Kerschner has participated in medical missions with World Medical Mission in Kenya, worked alongside Mother Teresa in Calcutta, and served in Brazil, the Philippines, and Belize. She received a Humanitarian Award from the Philippine government for her contributions.
Dr. Kerschner’s Scotty Dog Foundation has awarded numerous high school scholarships in Southwest Ohio and surrounding areas.
In her practice, Dr. Kerschner emphasizes individualized treatment plans, recognizing that each patient has unique needs. She believes in using good judgment to determine the most beneficial procedures, medications, and therapies for each patient. Dr. Kerschner and her staff prioritize spending ample time with patients during consultations, ensuring they have opportunities to ask questions and fully understand their treatment options.
When your pain is under control you can get back to living the way you are used to. Exercise, eat healthy, and enjoy life to the fullest. At Advanced Pain & Spine Institute we are more than just a doctor’s office, we are friends that are ready to help you get your life back.
Advanced Pain & Spine Institute Naples
239.307.7087
www.apsiwellnessnaples.com
9975 Tamiami TR N # 1, Naples, FL 34108