Do I have sacroiliac joint pain or a herniated disc?

Written by: Mr Amarjit Anand
Published:
Edited by: Emma McLeod

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.

A person's hand on their lower back to try and relieve back pain

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.

 

Visit Mr Anand’s profile and discover how you can benefit from his first-class patient care

By Mr Amarjit Anand
Orthopaedic surgery

Mr Amarjit Anand is a highly experienced consultant spinal surgeon specialising in minimally invasive surgery, disc prolapse, spinal stenosis, sacroiliac joints, spinal injections and sciatica.

Mr Anand graduated from The Royal Free and University College London Medical School in 2005. During his trauma and orthopaedic SpR training, he was also an anatomy demonstrator and lecturer at Oxford University. Shortly after, he was elected onto the British Orthopaedic Trainee Association (BOTA), and British Association of Spinal Surgeons (BASS) Executive Committee and Specialist Training Committee (STC).

In 2015, he received his CCT in trauma and orthopaedic surgery and subsequently completed two spinal fellowships at the Royal Berkshire Hospital and a combined neurosurgical and orthopaedic spinal fellowship in the Queen's Medical Centre in Nottingham. During his training, he travelled to several centres of excellence in Spain, Germany, France & USA to improve his specialist skills.

As well as publishing widely on trauma and orthopaedic surgery, Mr Anand has performed over 50 conference presentations around the world. He also works as a journal reviewer for the Bone and Joint Journal (BJJ), an honorary clinical lecturer at Imperial College London and examiner for multiple FRCS(Tr&Orth) revision courses.

Mr Anand is highly-trained in modern spinal techniques and is an advocate for innovation, advancements in spinal surgery technology, custom-made implants, motion-preserving surgery and minimally invasive surgery.  Mr Anand has developed advanced specialist skills in laser discectomy, MIS SIJ fusion surgery and regenerative procedures such as prolotherapy, PRP and stem cells.

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