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What’s the Difference Between Sciatica and Sacroiliitis?

By October 5, 2023No Comments

Difference Between Sciatica and Sacroiliitis

So you’ve come in to see Dr. Choi at Spine Medicine & Surgery of Long Island about chronic lower back pain. Two possible culprits? Sciatica and sacroiliitis.

What is Sciatica?

Let’s start with sciatica. Sciatica is pain that radiates along your sciatic nerve, a nerve which starts from your lower back and takes the prize for being the longest nerve in your body. It branches from your lower back through your hips, buttocks, and down each of your legs.

What is Sacroiliitis?

On the other hand, sacroiliitis is not nerve pain but pain in the sacroiliac joints. Also called “SI joints,” you’ll find these joints where the spine meets the pelvis. The sacroiliac joints are the largest joints in your body.

Causes of Sciatica Pain

Sciatica pain is often from pinching or pressure on the sciatic nerve. This compression is caused by issues such as a herniated disk, spinal stenosis, bone spurs, damage from diabetes, a tumor (though rare), or pregnancy.

Causes of SI Joint Pain

Sacroiliitis has different causes than sciatica, ankylosing spondylitis being the most common. It can also stem from conditions such as:
Crohn’s disease
Psoriasis arthritis
Reactive arthritis (Reiter’s syndrome)
Ulcerative colitis
Behçet’s disease

What Does Sciatica Feel Like?

Sciatica pain can happen anywhere in your lower back, buttocks, legs, sometimes even your feet. The pain can be accompanied by leg numbness, tingling, or muscle weakness in your leg or foot. If in the leg, sciatica is typically felt in only one leg at a time. Sciatica pain varies from person to person and from one instance to the next, feeling like a mild ache all the way to a sharp, burning sensation. Some patients report their sciatica pain can feel like an electric shock. Coughing, sneezing, or sitting for too long can trigger it.

What SI Joint Dysfunction Feels Like

Similar to sciatica, SI joint pain intensity can vary and radiate from your lower back into the buttocks, hips, and thighs. The difference is that sacroiliitis sometimes comes with lower back stiffness — after sleeping or sitting in one position for too long. And unlike sciatica pain, sacroiliitis doesn’t typically move past the upper legs.

Treatment For Sciatica and Sacroiliitis

At Spine Medicine and Surgery of Long Island, we’re all about helping you say goodbye to pain and hello to mobility once again. And we approach spine treatment conservatively — recommending non-surgical or surgical options that are minimally invasive.

With sciatica, Dr. Choi will likely recommend at-home remedies at the start if your pain is mild. Try cold packs or heat pads, stretching and/or exercising, or taking over-the-counter pain medication like ibuprofen. Of course, if your sciatica doesn’t respond to at-home care, Dr. Choi may suggest:

Anti-inflammatories or muscle relaxants
Physical therapy
Chiropractic care
Epidural steroid injections
Surgery to relieve nerve compression

As for sacroiliitis, treatments also include rest, physical therapy, and chiropractics. But the difference between sciatica and sacroiliitis treatment is the addition of options like sacroiliac joint injections or wearing supportive braces. When surgery is suggested, Dr. Choi might opt for the minimally invasive option of a small bone allograft implant to stabilize the SI joint.

Pain Management for Both Sciatica and Sacroiliitis

The injections we mentioned for both sciatica and sacroiliitis can go a long way in managing pain. At Spine Medicine & Surgery of Long Island, Dr. Choi may refer you to in-house colleague Dr. Antigone Argyriou, our pain management specialist.

Dr. Argyriou is double board-certified in physical medicine and rehabilitation and pain medicine. She can help your sciatica with an epidural steroid injection around the spinal cord where the sciatic nerve roots are located. For SI joint pain, a local anesthetic and/or corticosteroid hip joint injection goes directly into the SI joint.

Freedom from Lower Back Pain With Your New York Spine Specialist

Of course, the ultimate goal is a pain-free lower back for good. If you think you might be suffering from sciatica or SI joint dysfunction, contact us at our Ronkonkoma or Garden City, NY office. Dr. Daniel Choi and Dr. Antigone Argyriou are here to help you leave lower back pain behind.

Dr. Daniel Choi

Author Dr. Daniel Choi

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