Ask a doctor on the topic of Orthopedics

Acute sharp pain in the area of the sacroiliac joint

March 7, 2010 | 10,00 EUR | answered by Dr. med. Olaf Stephan

Hello,

I have a general question regarding back pain.

In the year 2000, I had a spinal examination, and the following results were found:

Spinal misalignment. Slight residues of a past M. Scheuermann. Lumbar rib pair (variance).

I have a sedentary job, but I do sports 3-4 times a week to keep my musculoskeletal system somewhat fit.

Unfortunately, I have been experiencing "acute" pain in the lumbar region for years. More specifically, I feel the acute stabbing pain at the sacroiliac joint. It feels as if the pain is medial in both joints, radiating cranially but not beyond the hip, just around the joint.

I feel the pain very strongly after physical activity (tennis). I'm not sure if this is related. Often, the pain combines with groin pain "only" on the left side after sports. A few times, I experienced a kind of cramp-like state in the early morning. I could barely stand - my legs shook, and my joints hurt acutely. A warm shower helped temporarily.

The pain is relieved when I sleep if I bring my legs closer to my body (lying on my back). I also notice that I feel pain while standing when I sneeze, for example.

I have been to a masseur (cupping) several times.

It only provided temporary relief.

Even with training at the fitness center targeting the lower back, I am only temporarily pain-free.

Since I have had these pains for a long time and they are disabling, I would like to have them treated.

What could be the causes here, and which doctor should I consider?

Thanks in advance

Best regards

Markus

Dr. med. Olaf Stephan

Dear Inquirer,

Without a thorough clinical examination and possibly further X-ray diagnostics, the cause of the complaints you are experiencing is difficult to determine. One could initially think of a problem in the hip joint area, where conventional X-rays usually help to further diagnose. The pain in the area of the sacroiliac joints could also indicate inflammation, as often seen in conditions such as ankylosing spondylitis or other rheumatic diseases. In this case, a pelvic overview X-ray would be taken first, and in case of doubt, an MRI examination would be recommended, as it does not involve radiation exposure. If there is suspicion of a rheumatic disease, some specific blood tests may also be necessary. However, a degenerative spinal disease or postural abnormalities could also be an explanation for your symptoms. I would recommend that you consult a specialist in orthopedics or rheumatology to establish an accurate diagnosis.

Best regards,
O. Stephan