Do I have sacroiliac joint pain or a herniated disc?

Sacroiliac joint pain and a herniated disc are two conditions with overlapping symptoms. Mr Amarjit Anand, a leading spinal surgeon, clarifies the symptoms of each condition, how a diagnosis is made and the treatment available.

Where is the sacroiliac joint?

The sacroiliac joint connects the sacrum (lower part of the spine) to the iliac crest (part of the pelvis).

What does sacroiliac pain feel like?

Pain from the sacroiliac joint presents with low back pain and buttock pain. Patients may feel a ‘clunk’ in their low back and can have difficulty sitting, running, sleeping on one side and turning over in bed.

This is sometimes seen in patients that have sustained previous trauma to their low back and pelvis. It is also seen in patients with hypermobility, patients with inflammatory arthritis, post-pregnancy and after previous lumbar fusion surgery.

What does a herniated disc feel like?

People with a herniated disc will feel low back pain with radicular pain (sciatica) that radiates down into the buttock and leg.

This may be associated with sensory disturbance:

• Tingling/paraesthesia
• Numbness
• A feeling of burning down the leg

And/or motor deficits:

• Leg weakness
• Loss of power
• Giving way
• Drop foot
• Buckling at the knees

Can a herniated disc cause sacroiliac pain?

Herniated disc and sacroiliac pain infrequently co-exist, but are separate spinal pathologies. However, any spinal pathology that causes pain can have an impact on spinal biomechanics and loading, resulting in an overload of other joints and structures.

How is a diagnosis made?

A thorough history and clinical examination is the key to a correct diagnosis. We correlate the clinical findings with imaging results, such as from a spine MRI scan and/or occasionally a SPECT (single-photon emission computerized tomography) scan. This allows for a precise diagnosis that we can base future treatments on.

What treatments are available for sacroiliac pain?

There are a variety of options.

Non-operative:

• Chiropractic and osteopathic treatments
• Physiotherapy for muscle strengthening (core strengthening and pelvic stabilisers)
• Sacroiliac joint belt
• Medications, such as analgesia (pain relief) and NSAIDs

Operative:

• Sacroiliac joint injections (with a steroid or PRP)
• Prolotherapy
• Radiofrequency denervation (Rhizolysis)
• MIS Sacroiliac joint fusion (with iFuse)

What treatments are available for a herniated disc?

There are several treatments for a herniated disc.

• Physiotherapy
• Medications, such as analgesia (pain relief) & NSAIDs
• Steroid injections (to help reduce inflammation and to speed up recovery)
• Surgery, such as a microdiscectomy, might be an option if non-operative measures fail to alleviate pain.

No matter your spinal condition, we are here to help to provide you with the optimal treatment plan.

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