1. Ice, Heat, and Rest
Ice packs help with acute pain and should be applied to the area of inflammation for 15-20 minutes at a time. Ice packs can be continued intermittently for two weeks to allow inflammation to subside. At that point, heat can help soothe the area. But, in general, heat can increase inflammation in the acute phases.
NSAIDs reduce pain and swelling, Acetominophen is useful for pain and does not have the GI upset that NSAIDs have.
3. Chiropractic Manipulations
It can be effective when the SI joint is fixated or "stuck." It may be irritating if the SI joint is hypermobile. Specific manoeuvres are side-posture manipulation, drop technique, blocking techniques, and instrument guided methods.
4. Supports or Braces
If the SI joint is loose, a brace or belt can be wrapped around the waist to stabilize the area.
5. Physical Therapy and Exercise
Physical therapy, low impact aerobics, water exercises may be helpful to strengthen the muscles in cases of hypermobility and increase the range of motion in cases of fixation.
6. Sacroiliac Joint Injections
Injecting lidocaine and steroids into the joint are also therapeutic besides being diagnostic. Due to the relief of pain, the patient with SI joint dysfunction can start physical therapy and require fewer pain medications. Radiofrequency ablation may help relieve chronic pain, and fixation surgery is reserved for severe joint instability.
7. Stem Cell Regeneration
Stem cell regeneration
is an experimental and non-invasive treatment for a damaged and painful Sacroiliac joint. For many years patients have achieved promising results from targeted stem cell treatments of the hip and knee joints, and in the SI joint this is also possible. During the treatment, stem cells are carefully injected either paraspinally or into the SI joint and surrounding ligaments. Usually CT imaging guidance will be used by an orthopaedic specialist. The cells respond to inflammatory signals from the inflamed joint and start working to repair and regenerate the joint. This can be assisted with shockwave therapy and other supportive therapies.
8. Sacroiliac Joint Fusion Surgery
Due to advancements in technology and technique, an SI fusion can be a minimally invasive procedure involving one or two small incisions right above the buttock(s) below the waistline, on either side of the spine. Instead of a lateral approach, this posterior approach minimizes injury to surrounding tissue, such as muscle. A synthetic bone matrix is introduced to help strengthen the fusion, along with threaded screws to fixate the bone during this time. Our team includes highly experienced surgeons in this technique, and you can find further information on SIJ Fusion Surgery here