Sacroiliac Joint Pain

Sacroiliac (SI) joint pain is a common cause of pain in the lower back, buttocks, or thighs. It’s caused by injury or inflammation in one or both sacroiliac joints.

The SI joints are two of the largest joints in the body. They connect the bone just above your tailbone (the sacrum) to your hip bones (the ilium).

Their job is to reduce strain on the spine by distributing weight to your lower body and acting as a shock absorber.

Symptoms of SI Joint Breakdown

SI joint pain can be challenging to diagnose because many other conditions, like sciatica, can cause pain in the same places. Typical symptoms are:

Pain
- In the lower back, hips, pelvis, and thighs
- That radiates to the buttocks and thigh
- That is worse when standing up
- On one or both sides of the body
- May be worse in the morning

Numbness or tingling in the legs or feet
Weakness
Instability in the legs
Difficulty sitting for long periods

Causes of SI Joint Pain

Inflammation is the most common cause of SI joint pain. Common causes include:

Injury to the joints or surrounding ligaments
Regular stress on the joints (like jogging)
Conditions that change your normal walking pattern
Degenerative arthritis (osteoarthritis)
Inflammatory conditions like ankylosing spondylitis
Pregnancy, as it changes the gait and loosens the joints
Overuse
Aging
Chronic illness

Diagnosing SI Joint Pain

Diagnosis can be difficult because many conditions cause the same symptoms. It can also be difficult to examine the joints. Plus, damage to joints doesn’t always show up on imaging tests.

To diagnose the source of your pain, you may have:

A physical exam with movement tests designed to pinpoint the source of your pain.
Blood tests to look for signs of inflammation.
Imaging tests, like X-ray, MRI, or CT scan, to look for signs of an injury or changes to the joints.
An injection of a numbing agent into the joint to determine if the pain goes away. If it does, your doctor can conclude you have an issue with your SI joint.

Treatment of SI Joint Pain

Treatment depends on individual factors, like how intense your pain is and how it affects your life. At-home treatments like cold packs, stretching, and pain relievers may be the first line of treatment.

Cold/heat – Alternating between cold packs and heat may reduce the pain and inflammation.
Pain relievers – Over-the-counter pain relievers like ibuprofen (Advil) or naproxen (Aleve) may reduce pain and swelling.
Exercise – Stretching, strength-building exercises, and gentle aerobic activities like walking can help.
Physical therapy – A physical therapist can lead you through exercises to improve flexibility and strengthen the muscles around the joint.
Aquatic therapy – Aquatic therapy is a gentle, low-impact option that takes weight off your joints while you exercise, relieving pain while strengthening the muscles around your joints.
Joint injections – Anti-inflammatory or steroid medications with a pain reliever can provide some relief.
Nerve ablation – Also called a nerve block, ablation is a minimally invasive procedure that uses radio waves to disable the nerve fibers that deliver pain signals from the lower back to the brain.
Surgery – If non-surgical treatments don’t relieve your pain, surgery to fuse one or both SI joints together may be an option. The procedure is minimally invasive, takes about an hour, and most patients go home the same or the next day.

SI joint pain can be a chronic problem that interferes with your activities and interrupts your sleep. With treatment, most people will find relief from the pain and regain their lost mobility.

If you think you may have pain from your SI joint, schedule a consultation appointment today!