Sacroiliac Joint Pain: Causes and Treatments

The most common causes of pain in the SI joints is inflammation (caused by degenerative conditions like osteoarthritis and ankylosing spondylitis) and trauma to the joints². 

SI joint pain can be caused by prior surgery, injury, pregnancy, childbirth, and having an abnormal gait when walking³. Some people experience pain in the SI joints due to general wear and tear associated with aging. 

People who have uneven leg lengths often have a shuffling or uneven gait that causes strain on the SI joints and connecting ligaments. Over time, this can lead to inflammation, discomfort and radiating pain. If you have one leg that is shorter than the other, it’s important to talk to your doctor about correcting your gait so you can avoid future pain in the SI joints.

Pain in the buttocks, hips and lower back can have several causes. If your doctor suspects your pain is being caused by sacroiliac joint dysfunction, he or she will use a variety of information and tests to make a diagnosis. These include: an overview of your symptoms, physical maneuver testing, x-ray imaging and SI joint injections⁴. 

X-rays of your pelvis can reveal damage to the sacroiliac joints. An MRI may also be recommended if your doctor is concerned about ankylosing spondylitis. 

Anesthetic SI joint injections are also used to determine the source of hip and pelvic pain. If anesthetic injections into your sacroiliac joint provide relief, your pain is most likely being caused by the sacroiliac joints. 

If you suffer from chronic pain caused by the SI joints, you have several options for treatment. 

• Rest - A rest period of up to 48 hours may be necessary to reduce the strain and inflammation in your sacroiliac joints. 
• Physical Therapy - Many individuals with sacroiliac joint pain notice improvement in their symptoms with physical therapy. Manual manipulation, ice and heat and certain exercises can help reduce muscle tension and improve range of motion in the SI joint.
• NSAIDs - Non-steroidal anti-inflammatory drugs are the first-line treatment for sacroiliac joint pain that doesn’t get better with rest. These over-the-counter medications help relieve pain by reducing inflammation in the SI joints.
• Muscle Relaxants - Muscle relaxant medications can help control muscle spasms associated with acute sacroiliac joint pain. 
• Sacroiliac Joint Injections - If you’ve found pain relief with a diagnostic SI joint injection, your doctor may recommend an injection for longer lasting pain relief. An SI joint injection is a minimally invasive procedure that can provide pain relief for several weeks or even months. 
• Sacroiliac Joint Fusion - For SI joint pain that is unresponsive to other treatment methods, surgical treatment is a final option. SI joint fusion places implants in the SI joints in the pelvis to help improve stability and increase weight bearing ability. Complications from SI joint fusion are low, and most patients experience clinically significant improvements in pain and disability following the surgery^5.