Sacroiliac Joint Dysfunction and Pain Management

Sacroiliac joint dysfunction is a recognised contributor to low back and pelvic pain, arising from impaired mobility or aberrant loading at the junction between the sacrum and ilium. Clinical presentation may include unilateral gluteal or groin pain, altered gait and reduced physical function. Diagnosis relies on provocative manoeuvres, diagnostic injections and imaging to exclude lumbar or hip pathology. Management spans a spectrum from targeted physiotherapy and pharmacological analgesia to interventional procedures and surgical fusion. Recent advances have refined minimally invasive fusion techniques, enhanced understanding of ligamentous biomechanics and improved patient selection through sophisticated modelling of pelvic kinematics. Despite progress, challenges remain in early identification, standardisation of outcome measures and long-term efficacy of interventions.

Research from Nature Portfolio

Recent studies have investigated the interplay between hip, sacroiliac joint and spinal degeneration in patients undergoing total hip arthroplasty. Analyses of preoperative imaging have revealed that osteoarthritic hips exhibit greater sacroiliac joint sclerosis, irregularities and pelvic obliquity than hips affected by osteonecrosis. Coexisting lumbar spondylolisthesis or degenerative scoliosis further elevates the prevalence of sacroiliac joint degeneration. These findings support a conceptual framework of hip–sacroiliac joint–spine syndrome, emphasising the need for a holistic assessment of the lumbopelvic complex when planning arthroplasty and guiding postoperative rehabilitation.

Sacroiliac Joint Dysfunction and Pain Management publication trend

The graph below shows the total number of articles in sacroiliac joint dysfunction and pain management across all publications each year (not limited to Nature Index journals).

Technical terms

Sacroiliac joint: The articulation between the sacrum and ilium that transmits load between the spine and lower limbs.

Sacroiliac joint dysfunction: A condition characterised by abnormal motion or loading of the sacroiliac joint causing pain and functional impairment.

Minimally invasive sacroiliac joint fusion: A surgical technique that stabilises the sacroiliac joint via percutaneous implants, aiming to reduce pain by restricting pathological motion.

Finite element modelling: A computational method that divides anatomical structures into discrete elements to simulate mechanical behaviour under varying loads.

References

1. The effect of minimally invasive sacroiliac joint fusion compared to sham operation: a double-blind randomized placebo-controlled trial. EClinicalMedicine (2024).
2. An Integrated Method of Biomechanics Modeling for Pelvic Bone and Surrounding Soft Tissues. Bioengineering (2023).
3. Hip-sacroiliac joint-spine syndrome in total hip arthroplasty patients. Scientific Reports (2024).
4. Biomechanical Analysis of Stress–Strain Distribution in the Lumbar Spine–Sacrum–Pelvis System with Emphasis on Sacroiliac Joint Dysfunction. Prosthesis (2024).