SI joint sciatica

[espplayer7]

Hey guys I was wondering if and injury to the SI joint alone can cause sciatica. Can the joint itself cause sciatica or is it always the piriformis that gets irritated from it cause it.

[Justin]

Hey guys I was wondering if and injury to the SI joint alone can cause sciatica. Can the joint itself cause sciatica or is it always the piriformis that gets irritated from it cause it.

Hi espplayer7,

I must have missed your post...sorry for the late reply.

Sacroiliac joint dysfunction can cause referred pain down one's leg. "True" sciatica is discogenic, meaning that the intervertebral disc itself is causing sciatica (neuralgia along the sciatic nerve). When a disc is herniated (the term "bulging" is also often used), it can compress surrounding structures namely nerve roots. The L4, L5, S1, S2 and S3 spinal nerve roots join to form the sciatic nerve in the leg.

The greater sciatic foramen (foramen = opening) in the pelvis is where the sciatic nerve runs. The piriformis muscle originates on the anterior (front side) of the sacrum and runs out through the greater sciatic foramen, ultimately attaches to the greater trochanter (a unique part) of the femur (the "big bone" in your thigh). The sciatic nerve exits the greater sciatic foramen in very close relation to the piriformis muscle (there is variation in where the sciatic nerve exits the foramen and some individuals [some studies state up to 15% of the population] actually have the sciatic nerve pierce [or run through] the piriformis muscle).

Thus, with the close proximity of the sciatic nerve and the piriformis muscle, many patients can experience what is called "piriformis syndrome." Essentially, the sciatic nerve is compressed and/or irritated by the piriformis muscle.

Note: "true" sciatica is not caused by sacroiliac joint dysfunction.

I hope this helps.

[espplayer7]

thanks for the reply. That is what I am wondering myself. I had a fall that slightly displaced my SI Joint. I get pain all the way down to my foot. My back completely fine from my MRI. Is it the piriformis then that is probably causing the foot nerve pain? So the SI Joint itself cannot cause sciatica? I am seriously considering getting the piriformis release but of course I dont want to come to find out that the SI Joint itself alone is causing the pain. Thanks

[Justin]

thanks for the reply. That is what I am wondering myself. I had a fall that slightly displaced my SI Joint. I get pain all the way down to my foot. My back completely fine from my MRI. Is it the piriformis then that is probably causing the foot nerve pain? So the SI Joint itself cannot cause sciatica? I am seriously considering getting the piriformis release but of course I dont want to come to find out that the SI Joint itself alone is causing the pain. Thanks

espplayer, I would wait and not jump into surgery. You truly need to diagnose what's going on before you start operating on hunches, especially since your MRI is OK.

One way to help reveal what is causing the foot pain is to have a formal physical exam that can evaluate your sacroiliac joints and inspect piriformis movement (external rotation of the thigh).

The SI joint does not cause sciatic--however, it can cause referred pain down one's leg that can mimic sciatica. I would completely exhaust ALL conservative care with your SI joint (physical therapy, osteopathic and/or chiropractic adjustments)--there's no need to jump into surgery at this point.

Good luck!

[espplayer7]

Well Im not jumping into surgery per say. I have been in PT for a few months and do my exercises at home daily. I have been adjusted by a chiropractor about 12 times (max my insurance will cover for a year) and have had ART. It has SLIGHTLY calmed things down but by no means to a point of being active again (jogging, training of any sort etc...). I am kind of at a loss on what to do.

[Justin]

Well Im not jumping into surgery per say. I have been in PT for a few months and do my exercises at home daily. I have been adjusted by a chiropractor about 12 times (max my insurance will cover for a year) and have had ART. It has SLIGHTLY calmed things down but by no means to a point of being active again (jogging, training of any sort etc...). I am kind of at a loss on what to do.

Where are you located? I would look for a Doctor of Osteopathic Medicine (DO) that specifically practices Osteopathic Manipulative Medicine (OMM, which is a specialty. Note: not all DOs practice OMM).

Here's a link to locate a physician: Search the AOA's Physician Database. Make sure to check the box "Osteo Manipulative Treatment."

I wish you the very best.

[Cindylou]

Fyi, Justin, I couldn't get this link to operate. Just wanted to let you know. CL

[Justin]

Fyi, Justin, I couldn't get this link to operate. Just wanted to let you know. CL

The website was down for maintenance and it's now back up and running.