Treatment for work-related SI joint dysfunction is designed to return the worker to work. Acetaminophen can be used to treat the pain, but it will not control the inflammation. Anti-inflammatory medications, such as ibuprofen and naproxen, are commonly used to treat the pain and inflammation.
Limiting activities helps decrease inflammation and calm muscle spasm. Some patients benefit from wearing a special brace called a sacroiliac belt which wraps around the hips to hold the sacroiliac joint tightly together, possibly easing pain.
Physical therapy is often tried to improve the strength and control of the back and abdominal muscles. Some therapists are trained in massage and manipulative techniques that attempt to treat the pain in this manner. A patient will be instructed in home exercises to adjust the SI joint and ease the symptoms. A chiropractor can provide this treatment.
Injections may be used for two purposes. First, injections are used primarily to confirm that the pain is coming from the SI joint. Secondly, a series of cortisone injections may be recommended to try to reduce the inflammation in and around the SI joint. Cortisone is a powerful anti-inflammatory medication that is commonly used to control pain from arthritis and inflammation. Injections are viewed as temporary and are expected to last several months at the most.
Another procedure is called radiofrequency ablation in which the small nerves that provide sensation to the joint can be “burned” with a special needle called a radiofrequency probe. In theory, this destroys any sensation coming from the joint, making the joint essentially numb. This procedure is not always successful. It is temporary but can last for up to two years and can be repeated if needed.
If other treatments fail, surgical fusion of SI joint dysfunction may be considered. Basically, the two bones that form the SI joint, the sacrum and the iliac bone, are glued together so they don’t articulate or move against each other anymore. In most people, the SI joint fuses as we age, but this advances the process, theoretically eliminating the pain from the joint.
After surgery, physical therapy using treatments such as heat or ice, electrical stimulation, massage, and ultrasound will help calm the pain and muscle spasm. A patient will learn how to move safely with the least strain on the healing area. Any physical limitations or permanent work restrictions will have to be decided by the doctor.
In Wisconsin, McCormick Law Office attorneys get the same best results in worker’s compensation claims whether the permanent work restrictions come from herniated disc surgery or SI joint surgery. The keys are the work-related restrictions and the trusted strength of the causation tie to the work accident or job duties.
