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SI Joint Pain

Understanding Sacroiliac Joint Pain, Symptoms, Causes, and Treatment

Sacroiliac (SI) joint pain is a common source of pain in the lower back, buttocks, pelvis, and sometimes the hip or upper leg. The SI joints connect the sacrum at the base of the spine with the pelvis and help transfer forces between the upper body and legs.

When an SI joint becomes irritated, inflamed, arthritic, or unstable, it can cause pain that may interfere with walking, sitting, standing, exercising, sleeping, and other everyday activities.

At Kansas Pain Management, our pain specialists evaluate the potential source of your pain and develop an individualized treatment plan based on your symptoms, examination, medical history, and diagnostic findings.

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What Is the SI Joint?

The sacroiliac joints are located on both sides of the lower spine, where the sacrum meets the pelvis. These joints provide stability and help absorb and transfer forces between the spine and lower body. Although the SI joints normally have limited movement, irritation or changes affecting the joint can contribute to pain. SI joint pain may occur on one side or both sides of the body.

What Does SI Joint Pain Feel Like?

SI joint pain can vary from person to person. Common symptoms may include:

  • Pain in the lower back
  • Pain in the buttocks
  • Pain around the back of the hip or pelvis
  • Pain that may extend into the groin or upper leg
  • Pain when standing for long periods
  • Discomfort when walking or climbing stairs
  • Pain when getting up from a chair
  • Pain when turning in bed
  • Increased pain with certain movements or positions
  • Stiffness around the lower back or pelvis

 

SI joint pain does not always feel the same as pain caused by the lumbar spine or hip. Because several conditions can produce similar symptoms, proper evaluation is important.

What Causes SI Joint Pain?

Several factors can contribute to SI joint pain or dysfunction.

Arthritis and Degenerative Changes

Wear and tear affecting the SI joint may cause inflammation, stiffness, and pain.

Injury or Trauma

A fall, automobile accident, sports injury, or other trauma can affect the SI joint and surrounding structures.

Repetitive Stress

Repeated movements or activities that place stress on the pelvis and SI joint may contribute to irritation or pain.

Pregnancy and Pelvic Changes

Hormonal and physical changes during pregnancy can affect the ligaments and mechanics around the pelvis and SI joints. Some people may experience SI joint-related pain during or after pregnancy.

Previous Spinal Surgery

Changes in the biomechanics of the spine and pelvis following certain spinal procedures, particularly lumbar fusion, may increase stress on the SI joint in some patients.

Abnormal Movement or Instability

Changes in how the SI joint moves can contribute to irritation and pain.

In some cases, there may be more than one contributing factor.

Where Is SI Joint Pain Located?

SI joint pain is commonly experienced around the lower back and buttocks, often on one side.

Some patients may also experience discomfort around the hip, groin, pelvis, or upper leg.

The location of pain alone cannot determine whether the SI joint is responsible. Your physician may use your medical history, physical examination, and diagnostic testing to determine the most likely source of your symptoms.

SI Joint Pain Treatment

Treatment depends on the cause and severity of your symptoms, how long you have experienced pain, your overall health, and how you have responded to previous treatments.

Treatment may begin with conservative approaches and progress to interventional procedures when appropriate.

 

Physical Therapy

A structured physical therapy program may help improve strength, flexibility, stability, and movement patterns involving the lower back, hips, pelvis, and core.

 

Activity Modification

Modifying activities that aggravate symptoms may help reduce stress on the SI joint while allowing the area to recover.

 

Medications

Depending on your medical history, your physician may recommend medications to help manage pain or inflammation.

 

SI Joint Injection

A fluoroscopy-guided SI joint injection may be used for both diagnostic and therapeutic purposes.

The injection may contain a local anesthetic and corticosteroid. The diagnostic component can help determine whether the SI joint is contributing to your pain, while the therapeutic component may provide pain relief for some patients.

Learn more about SI Joint Injections →

 

Other Interventional Treatments

Depending on the source of pain and your individual diagnosis, other minimally invasive pain-management treatments may be considered.

Your physician will determine whether another procedure is appropriate based on your specific condition.

 

SI Joint Fusion

For carefully selected patients with chronic SI joint pain who have not obtained adequate relief from conservative and less-invasive treatments, minimally invasive SI joint fusion may be considered.

SI joint fusion uses specialized implants to stabilize the affected joint and promote fusion.

Fusion is not necessary for everyone with SI joint pain and is considered only after an appropriate diagnostic evaluation.

Learn more about SI Joint Fusion →

Diagnostic SI Joint Injection

A fluoroscopy-guided SI joint injection may be used to help determine whether the SI joint is a significant source of pain.

A meaningful temporary reduction in your typical pain following a diagnostic injection can support the SI joint as an important pain generator. Your physician will interpret the response along with your other clinical findings.

When Should You See a Pain Specialist?

Consider speaking with a pain specialist if SI joint or lower-back pain:

  • Continues despite home care or conservative treatment
  • Interferes with work or daily activities
  • Makes walking, sitting, or standing difficult
  • Prevents you from exercising or participating in activities you enjoy
  • Frequently disrupts your sleep
  • Keeps returning after temporary improvement
  • Has not been adequately explained by previous evaluations

Early evaluation can help identify potential sources of pain and determine appropriate treatment options.

FAQs

There is no single cause. SI joint pain may be associated with arthritis or degeneration, injury, repetitive stress, pregnancy-related pelvic changes, altered biomechanics, or other factors.
Common symptoms include pain around the lower back, buttocks, pelvis, or hip area. Some people may also experience discomfort extending toward the groin or upper leg. Symptoms vary between individuals.
Yes. SI joint-related pain can sometimes extend into the leg. However, pain traveling down the leg can also be caused by conditions such as lumbar nerve irritation or sciatica. An appropriate evaluation can help distinguish between potential causes.
Your physician may use your medical history, physical examination, specific SI joint provocative maneuvers, imaging when appropriate, and a diagnostic SI joint injection to evaluate whether the SI joint is contributing to your pain.
A diagnostic SI joint injection can provide useful information about whether the SI joint is a significant source of pain. A significant temporary improvement in the patient's typical pain can support the diagnosis, but the response is interpreted together with the overall clinical evaluation.
The duration varies. Some episodes improve with conservative treatment, while others can become persistent or recurrent. The appropriate treatment depends on the underlying cause and individual circumstances.
Some cases may improve with activity modification, physical therapy, and other conservative measures. Persistent or recurrent pain should be evaluated to determine whether the SI joint or another structure is contributing to the symptoms.
Not necessarily. The SI joint can be one source of pain in the lower-back and buttock region, but lumbar spine conditions, hip problems, and other conditions can cause similar symptoms.
An SI joint injection involves injecting medication into the joint and may be used for diagnosis and pain relief. SI joint fusion is a minimally invasive surgical procedure designed to stabilize the joint and promote fusion. Fusion is generally considered only for appropriately selected patients with persistent SI joint pain.
Yes. Depending on the cause and severity of symptoms, treatment may include physical therapy, activity modification, medications, injections, and other non-surgical approaches. Surgery is not necessary for everyone with SI joint pain.

Why Choose Kansas Pain Management?

At Kansas Pain Management, our physicians take an individualized approach to diagnosing and treating chronic pain.

Rather than assuming that every case of lower-back or buttock pain comes from the SI joint, our team evaluates your symptoms and clinical findings to identify the most likely source of your pain.

When SI joint pain is suspected, we can discuss appropriate diagnostic and treatment options, ranging from conservative care and injections to advanced minimally invasive procedures for appropriately selected patients.

Our goal is to help you understand your condition and make an informed decision about your treatment.

Take the Next Step for SI Joint Pain

You do not have to ignore persistent lower-back, buttock, or pelvic pain.

If you have ongoing symptoms that may be related to the sacroiliac joint, Kansas Pain Management can evaluate your condition and discuss appropriate treatment options.

Schedule an appointment with Kansas Pain Management to learn more about SI joint pain and available treatment options.

Call Kansas Pain Management to schedule an evaluation.