Chronic sacroiliac pain can become a real problem for patients, since it causes immense suffering, limits physical functionality and generally disrupts life. Chronic SIJ symptoms will often linger until successfully treated, since there is often a causative process that will not resolve without targeted care. Chronic pain has become a horrific burden to modern society virtually all over the developed world. However, since chronic pain is far less of a burden in third world and developing countries, there seems to be something amiss in the theories used to explain it. As scholars of pain for our entire professional careers, we have many thoughts on why chronic pain has found such an entrenched foothold in modern society. We happily share these thoughts in this very essay.
This discussion examines chronic SI joint pain syndromes, including the causes and treatments offered. We will also provide alternative theories on why chronic pain has become such a serious and widespread problem that was virtually unheard of only a few decades ago.
Chronic Sacroiliac Pain Causes
From a purely anatomical point of view, there are many justifiable reasons why chronic pain might occur in the sacroiliac joint. Some of the most logical and verified reasons of these long-term pain syndromes include all of the following scenarios:
Several noted autoimmune diseases can attack the SI joint, including ankylosing spondylitis, rheumatoid arthritis, Crohn’s Disease and colitis. These are all known to be treatment-resistant, chronic concerns that endure long-term.
Severe injury to the SI joint might cause fracture, ligament laxity or tension problems, or even dislocation of the joint which might require an extended recovery time or professional medical intervention to resolve.
Functional issues, such as muscular imbalances and ligament tension or laxity problems, might last until they are rectified using proper exercise, stretching or other care methods.
Post-pregnancy SI joint problems are likely to last for extended timelines and some might not resolve, despite several attempts at conservative care using seemingly appropriate therapies.
Chronic Sacroiliac Pain Treatments
Chronic pain is usually the harbinger of dangerous and possibly invasive treatments compared to short-duration acute pain. Most SIJ concerns are originally managed using the most conservative methods possible, including exercise, stretching, ice, heat and mild pharmaceutical products, such as OTC drugs. However, as time passes and the pain becomes chronic, escalation of care is commonplace.
Patients are often given prescriptions for more powerful drugs, including those which are the most dangerous (opioid pain relievers). Injections are also commonly offered and might provide excellent relief, but only for transient periods of time ranging from a few days to several months.
If pain persists despite the passage of more than 6 to 12 months, it is common for surgery to be offered or even recommended, since statistics show that the symptoms will probably not ameliorate without more concerted treatment efforts. Sacroiliac joint fusion is the most common for of surgical therapy, a though less invasive ligament-targeting treatments are also available for some diagnoses.
Alternative Chronic Sacroiliac Pain Explanations
Chronic pain is a growing problem not because we as a species are becoming less physically capable, but instead because the ever-advancing nature of our psychoemotional selves. The mind influences all pain conditions in both potentially positive and negative ways. However, it seems that negative influences are fostered by today’s medical establishment, while positive influences are reserved for people who believe in and actively cultivate true mindbody health.
In some patients, pain is actually created by the mind and has no structural basis (psychogenic sacroiliac pain syndromes). In others, there is some variable degree of structural plausibility or causative logic due to degeneration, injury or disease, but the pain is worsened, perpetuated or explained in symptomatic scope through the psychosomatic process of the mind.
It is obvious that our unconscious and subconscious selves are suffering more emotional sensitivity than ever before in human history. Combine this fact with the continually present nocebo effect that surrounds us due to our expectation to suffer negative consequences from virtually everything we do and the perfect circumstances for chronic pain already exist in our day-to-day lives.
Our thoughts on this fascinating topic are kept simple and minimal here, due to topical constraints. However, we highly recommend learning more about how the mind influences SIJ pain problems by reading all of the focused essays in our psychosomatic sacroiliac joint pain resource section. Remember, all mindbody pain syndromes are 100% real and experienced completely in the body. They are not generally imagined or exaggerated. The only differences between them and structurally-based pain are the origin of symptoms and the reasons why the symptoms exist.
If you need help managing chronic pain while searching for a cure, we highly recommend the resources available at The Chronic Pain Coach for a holistic approach to care.