Dr. Thomas Heil grew up and earned his medical degree in West Virginia. He began a residency in General Surgery at the Mayo Clinic in Rochester, Minn., but later decided his passion lay in helping patients relieve their pain. After working in pain management for 20 years in Charlotte, NC., Dr. Heil decided to take his talents to Texas, where he now works at our Keller location.
While there is a wide range of conditions he treats, 50-75% of Dr. Heil’s patients come to seek relief from lower back pain. About 20-40% of these patients coming in for lower back pain treatment will find out their pain is stemming from their sacrum, therefore, their SI (sacroiliac) joint.
“Pain in the sacrum is a lot more common than most people would think and probably a lot less frequently diagnosed than it should be.” –Thomas Heil, M.D.
The Sacrum and SI Joint
The sacroiliac (SI Joint) can be found in the pelvis, right between the ilium and sacrum. It is also the lowest part of the spine and sits right above the tailbone. This joint is very important because it transfers energy from the upper part of the body to the lower part and is an essential component for shock absorption during activities such as walking.
Symptoms of Pain in the Sacrum
Some symptoms of SI joint pain can include:
- Generalized pain in lower back/buttock region
- Sharp or stabbing pain when movement occurs
- Pain in sleeping positions and the changing of sleeping positions
- Pain or stiffness when sitting for a long period of time
Conditions Related to Pain in the Sacrum
More often than not, pain the sacrum is caused by a joint aggravation or irritation triggered by overuse. Many times, strenuous exercise activities such as cross fit can contribute to this type of pain. With age also comes the degeneration of the fluid within the joint called synovial fluid. Your joints need this because when it begins to wear, your bones rub together. In the minority of cases, pain in the sacrum is related to another generalized inflammatory arthritic syndrome such as lupus or rheumatoid arthritis.
The Treatment
There have been a lot of different ways to treat pain in the SI joint over the years.
The first step to making sure the sacrum pain is coming from the SI joint is a diagnostic block. This is where your physician will put Novocain and some contrast agent down in the joint to ensure the right target is hit.
If the joint numbs up and feels great, sometimes just a steroid injection or two will clear it up well enough. But probably about 50% of the time those steroid injections are temporary. “Some people get several months of relief at a time but others only get several weeks,” Says Dr. Heil. “You certainly don’t want to keep getting injections that often.”
In the past, very large orthopedic procedures were done. During this time, the procedure would take probably 4-5 hours and patients would be in the hospital for a couple of weeks while in recovery. Over the past decade or so, new surgical techniques have been developed that are less- aggressive and minimally invasive. The most recent treatment option being offered is an SI Joint fusion that is about a 20-30 minute procedure that involves a very small incision- no more than the size of your thumbnail. Your physician will insert a little expander device into the SI joint and take out a small piece of the joint that is irritated and replace it with a bone graph. Usually within 4-5 days patients are starting to get over the soreness of the procedure and it is very effective as a long term treatment.
If you are Suffering from Pain in the Sacrum
Dr. Thomas Heil suggests anyone suffering from pain in the sacrum just takes it easy. If this is a new concern, try to reduce whatever you’re doing that is causing the irritation. Anti-inflammatories and rest can greatly reduce the pain. If the irritation persists, the next step would be to see a pain specialist to see if there’s something that can be done to more quickly resolve the problem so it doesn’t become a long term lingering issue.
“What we really want to do is start treating these problems aggressively early on in the process so people are not placed on these narcotics and opioids that have all of the side effects of addiction with it. So the earlier the patient can come in to see us the better off they’re going to be.” Thomas Heil M.D.
Dr. Heil is located at 4364 Heritage Trace Parkway, Suite 112A Fort Worth, TX 76244. We have 35 locations in Florida, Texas, and California that consist of trained specialists. If you are experiencing pain or would like more information, call us today to schedule a consult (888) 616-5110.
