Sacroiliac (SI) Joint Pain

Sacroiliac (SI) Joint Pain

What is the Sacroiliac joint?

The sacroiliac joint is where spine and the pelvis meet. There are two SI joints, one on each side of the body. A fibrous capsule made of muscles, tendons and ligaments attaches the sacrum (the bone at the base of the lumbar vertebrae) to the ilium (the upper most part of the hip bone). This capsule adds stability and limited movement. The space between the bones contains nerve endings. So, when the joint becomes inflamed it causes pain.

The SI joint functions to support your weight during walking, running, standing, jumping and bending; and to reduce pressure on the spine and absorb shock.

What are the symptoms of SI joint dysfunction?

Symptoms of SI joint dysfunction are similar to and often confused with symptoms of a herniated disc, low back pain or a hip injury.  Sacroiliac pain is felt in the buttocks, groin, back of the thighs and pain that radiates into the lower leg and feels like sciatica. The pain may be sharp and stabbing pain or SI joint dysfunction can cause numbness and tingling that creates the sensation that the legs may buckle. The pain may increase with activity. The pain may be limited to one SI joint, and the dysfunction may cause stiffness and burning. Pain can develop spontaneously or after a traumatic event or repetitive bending and twisting motions.

Indicators of Sacroiliac (SI) Joint Pain

Painful sitting.

Painful sit-to-stand.

Painful stair climbing.



What causes SI joint pain and dysfunction?

SI joint dysfunction is caused by inflammation of the joint. Inflammation is caused by injuries to the joint, ligament tension, muscle inflammation, shearing, fractures, arthritis and infections. Dysfunction may be called sacroiliitis.

Joint dysfunction can result from a number of conditions including:|

  • gout
  • osteoarthritis
  • inflammatory arthritis
  • pregnancy
  • Scoliosis
  • leg length discrepancies

How is SI joint dysfunction diagnosed?

Diagnosis is challenging because the joints are deep inside the body. Imaging may not reveal the damage; and symptoms can mimic sciatica, a herniated disc and hip arthritis. Your Ortho Illinois orthopedic surgeon will take a detailed medical history and conduct a physical examination using specific tests to reveal the source of your pain.  Imaging tests will be ordered to rule out arthritis, a herniated disc, fractures etc.

In some cases, your doctor may recommend an injection of lidocaine into the SI joint to see if the pain is relieved. Sometimes the injection is combined with corticosteroids which may offer pain relief for up to one year.

Treatment Options

Nonsurgical treatment is the preferred approach. This will include physical therapy, yoga, massage, ice packs alternated with heat, and muscle relaxers. An SI joint belt may help to relieve the pain. Anti-inflammatory over the counter medications can help.  If your pain does not respond, your doctor may order oral steroids to reduce SI joint inflammation, steroid injections and radiofrequency ablation to deactivate the nerves that cause your pain.

When nonsurgical options fail to relieve pain, surgery may be recommended. Dr. Brian Braaksma and Dr. Tom Stanley are trained in the latest minimally invasive surgical (MIS) techniques, including use of the iFuse Implant System.

SI joint pain is widely overlooked because of the difficulty in diagnosis. This is a good reason to see an expert orthopedic surgeon at Ortho Illinois. Contact Ortho Illinois to schedule a consultation and receive the correct diagnosis and treatment so you can get back to your life.

Do you have SI Joint pain?  Take this short quiz.