ISG Syndrome
The ISG syndrome is not uniformly defined. It encompasses various disorders associated with pain in the sacroiliac joint.It can thus be seen as a collective term that covers various diseases of the sacroiliac joint. In part, the term sacroiliac joint syndrome refers to diseases that lead to chronic pain.
Typical pain is back pain, especially in the area of the pelvis (also low back pain). Pain also occurs in the buttocks and lateral pelvis and in the groin area. Typical causes of an ISG syndrome are arthrosis as a sign of wear and tear, overloading and overstressing of the ligamentous apparatus, inflammation in other basic diseases (e.g. Bechterew’s disease) and by a loosening of the ligamentous apparatus in women during pregnancy and after birth.
During pregnancy, a loosening of the ligamentous apparatus is a desired and necessary procedure, since it is only possible to give birth by means of a slightly greater mobility within the sacroiliac joint. As a diagnosis, various clinical tests can be performed if ISG syndrome is suspected. Typical is the forerun phenomenon, in which the examiner palpates a bony prominence of the pelvis on both sides of the standing patient (so-called spinae iliacae posteriores superiores: these can be palpated on the back by following the iliac scoops from the top towards the buttocks).
At these points a pressure pain is also typically found in the ISG syndrome. When the patient slowly bends forward, it is assessed whether these bony protrusions move forward evenly on both sides. If this is not the case, this indicates a blockage within the sacroiliac joints.
There are several other clinical tests that involve movement within the sacroiliac joint and whose painfulness suggests ISG syndrome. In combination with typical triggers, such as unilateral posture while sitting or doing sports, the diagnosis can be made. Imaging procedures such as X-ray, CT or MRI examinations are usually not necessary.
However, they may be useful in individual cases if the course of the disease is complicated or if there is a suspicion of chronic inflammation of the ISG (sacroiliitis) as the cause of the symptoms. Therapeutically, conservative measures are initially considered in the ISG syndrome. These include pain relief with classic painkillers (e.g. ibuprofen).
In addition, physiotherapeutic measures and avoiding special stress situations can help. In severe cases, injection of the painful joint with local anesthetics and cortisone-like substances can be offered (under certain circumstances also CT-guided). Very rarely, surgical therapy with stiffening of the ISG is also considered.
