Sacroiliac Joint Pain: Causes and Treatments

Sacroiliac Joint Pain PTCOA graphic

Every person has two sacroiliac joints (SI joints) that connect the bones of the pelvis to the lower spine and coccyx. These joints serve an important function: they absorb the impact of movement between the upper body and the hips and legs. If the sacroiliac joints are inflamed or damaged, pain can radiate into the buttocks, lower back and legs, causing limited mobility and lower quality of life. 


SI joint dysfunction is responsible for up to 30% of lower back pain1. However, many people with back pain are misdiagnosed and fail to receive effective treatment. 

Symptom of Sacroiliac Joint Pain

How do you know if your sacroiliac joints are causing your pain? 


Here are the main symptoms to look for: 

  • Pain in the lower back
  • Pain in the buttocks, hips, pelvis, and upper thighs
  • Increased pain when standing up after sitting
  • Radiating pain in the legs
  • Weakness in the legs
  • Burning or stinging in the pelvis
  • Stiffness and limited range of motion in the hips, lower back, and groin


You may also experience pain that is similar to pain caused by sciatica, including burning, stinging and stabbing pain that can radiate through the buttocks and backs of the thighs.

Causes of Sacroiliac Joint Pain

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.

Diagnosing Sacroiliac Joint Dysfunction

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. 

Pain Management for Sacroiliac Joint Dysfunction

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 surgery5.

Treatment for Sacroiliac Joint Pain at PTCOA

Pain Treatment Centers of America diagnoses and treats chronic sacroiliac joint pain. Our team of pain treatment specialists can help you find the right treatment options for your chronic pain, including SI joint injections and SI joint fusion. 


Contact us today to schedule your appointment. 

  1.  "Sacroiliac Joint Dysfunction (SI Joint Pain) - Spine-health." https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/sacroiliac-joint-dysfunction-si-joint-pain. 
  2.  "Possible Causes of Sacroiliitis and SI Joint Pain - Arthritis-health." https://www.arthritis-health.com/types/general/possible-causes-sacroiliitis-and-si-joint-pain. 
  3. "Sacroiliac (SI) Joint Pain - StatPearls - NCBI Bookshelf." 9 Jul. 2020, https://www.ncbi.nlm.nih.gov/books/NBK470299/. 
  4.  "Sacroiliac Joint Dysfunction in Patients With Low Back Pain." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707638/.
  5.  "Minimally Invasive Sacroiliac Joint Fusion: The Current ... - NCBI." 10 Feb. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041666/.
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