CONTRIBUTED CONTENT — Sacroiliitis is a painful condition involving the sacroiliac joints in the lower spine and pelvis. Unfortunately, sacroiliitis is misdiagnosed as sciatica and can worsen if not properly treated.

Some of the most common symptoms of sacroiliac joint pain include:

• Lower back pain.
• Hip pain.
• Pain in the buttocks.
• Stiffness.
• Weakness.
• Numbness in the legs.

These symptoms can be caused by a variety of factors, including arthritis and both recent and former injuries.

What is the sacroiliac joint?

The sacroiliac joint connects the spine to the pelvis on each side of the human body. It’s where the sacrum – the triangular bone at the base of the spine – connects to the ilium, one of the large bones that is part of the pelvis.

Almost all of the weight and pressure from the upper body transmits through the sacroiliac joint, and it’s important for proper movement and stability of the pelvis, such as walking, running and even standing. If the sacroiliac joint becomes irritated or inflamed, it can cause serious pain in the lower back, buttocks and legs. This can make it difficult to perform everyday tasks and activities. If the pain persists, it can become permanent and debilitating.

What causes sacroiliac joint pain?

Permanent sacroiliac joint pain can be caused by numerous factors ranging from a recent or past traumatic fall or accident to age-related joint degeneration. Pain may also be caused by pregnancy and childbirth. In fact, statistics show that sacroiliac joint pain is more common for women than it is for men, primarily due to pregnancy and the effects it has on the sacroiliac joint and ligaments.

Sacroiliac joint pain can also be caused by previous surgery. People who have had previous low back surgery can often develop sacroiliac joint pain. This is because the surgical fusion of the low back vertebrae often results in more force and pressure being applied to the sacroiliac joint, resulting in pain.

Sacroiliac joint pain can be difficult to pinpoint. It mimics and is similar to pain that radiates from the lower back. Sacroiliac joint pain can sometimes be misdiagnosed as “back pain,” even by well-trained and experienced health care professionals. Therefore, it’s important to consult with a qualified physician, like those at Southwest Spine and Pain Center, who can accurately diagnose both low back and sacroiliac joint pain.

How is sacroiliac joint pain diagnosed?

Accurately diagnosing the sacroiliac joint as a source of pain relies upon an extensive range of tests. A series of physical manipulations specifically designed to stress the sacroiliac joint are performed. These manipulations are called provocative tests because they’re intended to “provoke” pain from the sacroiliac joint. If pain is provoked by some of these tests, then this is a good indication it is originating in the sacroiliac joint.

Diagnostic and therapeutic injections into the sacroiliac joint are also performed to accurately diagnose sacroiliac joint pain. These injections place a pain-relieving medicine into the joint. If the pain is significantly relieved by the medicine, this is another good indicator the pain is indeed originating from the sacroiliac joint. Two or more injections are often required to confirm and verify the pain originates from the sacroiliac joint.

Dr. Jon Obray, Dr. Rick Obray, Dr. Derek Frieden, Dr. Bryt Christensen and Dr. Casey Muir all perform these tests and injections in their facility at Southwest Spine and Pain Center, located at 2891 E. Mall Drive in St. George.

Once it’s suspected and/or confirmed the source of pain is indeed the sacroiliac joint, a specialist at Southwest Spine and Pain Center will prescribe a regimen of non-operative treatment called conservative care. The objective is to reduce or eliminate pain and improve the function of the sacroiliac joint without having to perform surgery.

Conservative care ranges from physical therapy to lifestyle changes including exercise and diet. Other forms of conservative care may include modifying physical activity, weight loss (if necessary), medications and bracing. Indeed, people improve and get better from conservative care. If conservative care doesn’t reduce or eliminate the sacroiliac joint pain and improve function, then it’s time to consider the next steps, one of which is surgery to fuse the sacroiliac joint.

What is a sacroiliac joint fusion, and is it right for me?

A sacroiliac joint fusion is where a titanium implant is used to temporarily connect the ilium to the sacrum across the sacroiliac joint itself. Eventually (after 6-12 months), that connection becomes permanent with new bone growing across the joint, through and around the implant to permanently fuse the joint and reduce or eliminate the sacroiliac joint pain.

The physicians at Southwest Spine and Pain Center adopted a surgical technique and approach to sacroiliac joint fusion called the Catamaran SI Joint Fusion System in 2022. The Catamaran is implanted into the sacroiliac joint and connects the ilium to the sacrum across the sacroiliac joint space.

The surgery is mostly performed on an outpatient basis, meaning you don’t spend the night in a hospital. However, when necessary, your doctor may keep you as an inpatient, staying at least one night before returning home.

“As a group, we have started using the Catamaran technology because of its safety and effectiveness over other options if a patient needs surgery,” said Dr. Jon Obray, a physician with Southwest Spine and Pain Center. “The Catamaran surgical approach is safer because of how it is implanted into the sacroiliac joint, approaching away from nerves and blood vessels. It’s also a single, robust design requiring just one implant. With other technology, we had to use two or more implants.”

Obray added that most patients go home the same day and are reporting significant pain relief within four to six weeks, sometimes sooner.

Like any surgery, there are risks to consider and clinical outcomes vary depending on age and health, among other variables.

Leading innovation for patients and communities

Obray and his colleagues at Southwest Spine and Pain Center adopted the Catamaran technique in early 2022. The group was one of the first in the United States to perform it. The reason he prefers this technique over others is because the Catamaran is designed to avoid many of the anatomical risks associated with sacroiliac joint surgery and help foster a true fusion for permanent pain relief.

When contacted for comment, Tenon Medical CEO Steven Foster said that “having creative minds like Dr. Obray who care deeply for their patients’ health is critical. The physicians’ guidance on our research and development, and their assistance in training other doctors who wish to adopt this technology, allows us to provide innovative solutions like the Catamaran SI Joint Fusion System.”

“We want to do everything in our power to fulfill our mission of helping our patients live life again,” said Dan Payne, CEO of Southwest Spine and Pain Center. “We’ve sponsored and facilitated cadaver labs throughout the state of Utah and have invited medical colleagues of other organizations to participate and partner with us.

“These cadaver labs allow innovation and practice of the latest surgical techniques to treat the spine in the most minimally invasive way,” he continued. “This improves the health of the communities we serve and drives innovation within the field of spine and pain.”

To schedule an appointment and discuss possible treatment, please contact Southwest Spine and Pain Center at 435-656-2424 or visit SouthwestSpineandPain.com.

• S P O N S O R E D  C O N T E N T • 

Resources

• Southwest Spine and Pain Center | Address: 2891 E. Mall Drive, Suite 101, St. George | Telephone 435-656-2424 | Website.
• Other locations:
  • Hurricane: 25 N. 2000 West, Suite 8 | Telephone: 435-635-0174.
  • Cedar City: 1303 N. Main St. | Telephone: 435-586-2229.

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