The sacroiliac joints are located where the base of the spine meets the pelvis on each side. These joints support the weight of the upper body and absorb impact during movement. When they become irritated or dysfunctional, they can cause significant pain.
SI joint dysfunction is a common but often overlooked cause of lower back pain. The pain pattern can mimic other conditions such as sciatica or hip problems, which sometimes leads to delayed diagnosis.
Symptoms of Sacroiliac Joint Dysfunction
Pain from SI joint dysfunction is typically felt in the lower back and buttock, often on one side. It may radiate into the groin, hip, or upper thigh but rarely extends below the knee.
Symptoms often worsen with prolonged sitting, standing from a seated position, climbing stairs, or lying on the affected side. Some patients notice increased pain when shifting weight from one leg to the other. The pain may be sharp with certain movements or a dull ache at rest.
What Causes Sacroiliac Joint Dysfunction?
SI joint dysfunction can result from too much or too little movement in the joint. Hypermobility may develop during pregnancy or after trauma, while reduced mobility often results from arthritis or joint degeneration.
Other causes include leg length discrepancy, altered gait patterns, prior lumbar spine surgery, and repetitive stress from activities like running or heavy lifting. Inflammatory conditions such as ankylosing spondylitis can also affect the SI joints.
Our Diagnosis Approach to Sacroiliac Joint Dysfunction
Diagnosis involves a physical examination with specific tests that stress the SI joint. A cluster of positive findings on these tests suggests the SI joint as a likely pain source. Your symptom pattern and history also provide important information.
Because imaging studies often appear normal even when the joint is painful, diagnostic injections are the most reliable way to confirm SI joint dysfunction. A significant reduction in pain following an injection into the joint confirms the diagnosis.
Evidence-Based Treatments
Physical therapy focused on stabilizing the pelvis and correcting muscle imbalances is often the first step. A sacroiliac belt may provide support during activities. Anti inflammatory medications can help manage symptoms.
SI joint injections deliver corticosteroid medication directly into the joint to reduce inflammation and pain. For patients with confirmed SI joint pain who respond well to injections but experience limited duration of relief, radiofrequency ablation of the nerves supplying the joint may provide longer lasting results.
When to Seek Care
Consider evaluation if you have persistent lower back or buttock pain that has not responded to general treatments, particularly if the pain worsens with transitional movements like standing from sitting or walking up stairs.
Seek prompt evaluation if pain is severe, accompanied by fever, or associated with new weakness or numbness in the legs. These symptoms may indicate a condition other than SI joint dysfunction.
