The small but subtle difference: sacroiliac joint in gender medicine

The small but subtle difference: sacroiliac joint in gender medicine

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Gender-specific differences also in the area of ​​the sacroiliac joint

Men suffer from high blood pressure more often, but women are more sensitive to medication: Studies on the difference between the sexes have been a topic of discussion in medical research, diagnostics and therapy for years. This gender-specific difference also plays a special role in the area of ​​the sacroiliac joint (ISG), the connection between the lower spine and the pelvis. "While the ISG becomes stiffer and more inflexible for men over the years, it still has a comparatively large scope for women in old age," emphasizes Prof. Dr. Florian Stockhammer, chief physician and specialist in neurosurgery at the Dresden City Hospital. "Correspondingly different causes lead here to painful changes such as an ISG blockade."

Gender-specific forms and changes

In men, the articular surfaces of the ISG have numerous channels and elevations, so the sides mesh well and leave little room for maneuver. In contrast, flat surfaces dominate in women, which offer a lot of freedom of movement. It is not the joint itself that provides stability here, but rather the position of the sacrum in the pelvic ring on the one hand and the muscle and ligament apparatus on the other. "In female patients, pregnancy and the associated greater flexibility of the entire ligament and tendon apparatus often contribute to a shift in the sacrum and ilium," says Prof. Stockhammer. "Other, gender-non-specific triggers for painful displacements of the joint surfaces are heavy lifting, the so-called 'kicking into space' or dull falling." In all cases, sufficient exercise, for example a long walk, jogging, swimming or cycling, helps to release the ISG blockade. Special exercises by the physiotherapist complete the program.

Uniform therapy measures

In order to restore the normal gait, heat applications are available that relax the stressed muscles. If this measure does not lead to success, acupuncture helps to resolve blockages, while syringe therapy is used for increasing stiffening pain and associated inflammation. This method, also known as infiltration therapy, provides pain relief by injecting a local anesthetic or an anti-inflammatory drug directly into the joint space. If these conservative methods no longer help, surgery is carried out. In the past, doctors stiffened the corresponding area with a rigid screw system, but today a new type of implant system with so-called iFuse implants is available. "Thanks to their porous surface structure and special design, the triangular implants grow together with the surrounding bones in a short time and provide new stability," explains Prof. Stockhammer. Health insurance companies cover the full cost of the procedure.

Author and source information

Video: Diagnosis and Treatment of the Sacroiliac Joint - Charles Harvey, MD (May 2022).