ISG Syndrome


The ISG Syndrome (Sacroiliac joint syndrome) describes a disease of the lower spine and pelvis. The sacroiliac joint connects the spine to the pelvis. Wear, mishaps or accidents can be the cause of an ISG syndrome and cause pain. Read more about signs and treatment of ISG syndrome here.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. M54ArtikelübersichtISG syndrome

  • description
  • symptoms
  • Causes and risk factors
  • Examinations and diagnosis
  • treatment
  • Disease course and prognosis

ISG syndrome: description

The sacroiliac joint (sacrum-iliac joint) connects the lower spine (Os sacrum) with the pelvis (Os ilium). It is only slightly mobile, is backed by a strong ligament and can not be actively moved. Physicians call such a joint as amphiarthrosis.

If the joint surfaces tilt, the ISG syndrome develops. Frequently, joint strain causes ISG syndrome, and it is more common during pregnancy, causing ISG pain.

Degenerative changes in the sacroiliac joint are common with increasing age, but usually do not cause pain.

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ISG syndrome: symptoms

Patients with ISG syndrome mainly have pain in the sacroiliac joint. The ISG pain usually occurs as an attack and when bending or turning the trunk on. Even when walking, after a long physical effort or prolonged sitting in a certain position, sufferers suffer from the typical symptoms.

In the process, the articular surfaces of the joint tilt, resulting in a so-called ISG blockage. The ISG blockage causes ISG pain on the affected side as well as pain that can radiate from the lower back to the buttocks, the back thigh along the knee. These radiating ISG pains are similar to discomfort that can occur with herniated discs. The doctor will take this into account when making his diagnosis.

Some patients report pain in the lower abdomen and groin caused by tension in the lumbar iliac muscle (iliopsoas muscle).

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ISG syndrome: causes and risk factors

ISG syndrome: bad stress and the activation of pain receptors

Tens or compressive loads on the ligamentous apparatus of the sacroiliac joint are often responsible for ISG syndrome. These arise, for example, by poor posture, heavy lifting or overweight. Inflammatory reactions triggered by this cause pain and transmit this information to the brain via the spinal cord via pain receptors (nociceptors). The pain receptors of the sacroiliac joint are particularly active in ISG syndrome.

In the ISG syndrome, the therapist will correct both the causes, such as abnormal stress, and reduce the activity of the nociceptors.

ISG syndrome: diseases as a trigger

In the case of ankylosing spondylitis, a chronic inflammatory disease of the spine and the pelvis, processes of remodeling occur on the spine and inflammatory processes occur. This can trigger an ISG syndrome and cause discomfort.

ISG syndrome in pregnancy

Due to the hormonal change in pregnancy, the ligaments relax and can trigger an ISG syndrome. Because the ligamentous apparatus loses stability and the sacroiliac joint less well withstands pressure, the back muscles take on a stabilizing function. This tenses the muscles and hurts.

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ISG syndrome: examinations and diagnosis

Anyone who has pain in the sacroiliac joint should consult a doctor. First, many patients can be treated by the family doctor, later they are usually referred to an orthopedic surgeon. For pain in the sacroiliac joint, your doctor will first ask you the following questions, among other things, to inform yourself about your medical history (anamnesis):

  • When did the pain first appear?
  • Where exactly is the pain?
  • Does the pain radiate, for example into the leg?
  • How does the pain feel? Like a burning or stinging for example?
  • Which pre-existing conditions do you suffer from?
  • Are hereditary diseases known in your family?
  • Did you fall?
  • Do you have fever?

ISG Syndrome: Physical Examination

Subsequently, your doctor will examine you physically. In doing so, he performs, among other things, the following examinations:

  • Knock Pain Test: Your doctor will grope and tap the spinous processes of the spine in turn. Pain can indicate a vertebral fracture. In ISG syndrome, the spine usually does not hurt. Pain is more likely to occur laterally to the spine on the lower back.
  • Leading phenomenon: They stand with their backs to the doctor, who puts his thumbs on the two sacroiliac joints. Then bend forward. In the event of ISG irritation, the thumb on the affected side is pulled into flexion earlier.
  • Mennell sign: They lie on their stomach and the doctor fixes the sacroiliac joint with one hand. With the other hand he raises your leg. If you feel pain in the joint, the Mennell sign is positive and indicates an ISG syndrome.
  • Quad (Patrick test): They are on their backs. Now bring the right hoe to the left knee and drop the bent right leg to the right side. If you look at your legs from above, they form the number four. Subsequently, the test is carried out on the opposite side. In pain or limited mobility, this indicates involvement of the hip or sacroiliac joint.

ISG syndrome: further diagnostics

Usually, no blood tests are necessary. For chronic low back pain, before the age of 45, the doctor may take you blood to have it checked for signs of ankylosing spondylitis in the laboratory.

In addition to an X-ray examination, computed tomography (CT) can detect possible vertebral fractures or dislocations.