Sacroiliac Joint Dysfunction

Relief for pelvic and lower back pain originating from the SI joint

The sacroiliac (SI) joints connect the spine to the pelvis and play a critical role in transferring forces between the upper body and lower extremities. Although these joints allow only minimal movement, irritation or instability can produce significant pain and functional limitation.

Sacroiliac joint dysfunction occurs when inflammation, abnormal movement, or degenerative changes affect the SI joint, leading to pain that may mimic disc herniation, radiculopathy, or hip pathology.

At Resolution Spine & Joint, we specialize in accurately identifying SI joint pain and providing targeted treatments that restore stability, reduce inflammation, and improve function.

Common Symptoms

SI joint dysfunction often presents as:

• Low back pain localized below the belt line

• Buttock pain (often one-sided)

• Pain radiating into the groin, hip, or posterior thigh

• Pain worsened with prolonged sitting, standing, or transitional movements

• Discomfort with walking, climbing stairs, or rolling in bed

• A sense of pelvic instability or asymmetry

Unlike classic nerve pain, SI joint symptoms typically do not follow a clear dermatomal pattern.

Why the SI Joint Hurts

The SI joint functions as a stabilizing joint designed for force transmission rather than large movement. Pain may occur when:

• Inflammation develops within the joint

• Ligaments become strained or lax

• Movement becomes restricted or excessively mobile

• Adjacent spine pathology alters biomechanics

Even small mechanical changes can significantly increase ligament tension and muscle guarding, leading to persistent pain.

Common Causes and Risk Factors

SI joint dysfunction may develop due to:

• Degenerative arthritis

• Prior lumbar fusion altering load distribution

• Pregnancy and postpartum ligamentous laxity

• Trauma or falls

• Leg length discrepancy

• Repetitive strain or prolonged asymmetrical loading

• Inflammatory conditions

Patients with prior lumbar surgery are particularly susceptible because altered spinal mechanics increase stress across the SI joints.

Diagnosis

Diagnosis is primarily clinical and often requires confirmation with targeted intervention.

Evaluation may include:

• Detailed history and physical examination

• Provocative SI joint maneuvers

• Imaging to exclude alternative pain sources

• Diagnostic SI joint injection to confirm the joint as the pain generator

Imaging alone cannot reliably diagnose SI joint dysfunction, response to diagnostic injection is often the most informative test.

Treatment Options at Resolution Spine & Joint

Treatment focuses on reducing inflammation while restoring pelvic stability.

Conservative Management

• Physical therapy emphasizing pelvic stabilization

• Core strengthening and movement retraining

• Activity modification

• Anti-inflammatory strategies when appropriate

Interventional Treatments

• Image-guided SI joint injections to reduce inflammation

• Lateral branch nerve blocks for diagnostic and therapeutic relief

• Radiofrequency ablation for longer-lasting pain control

• Consideration of minimally invasive stabilization when symptoms are refractory

Targeted injections often provide meaningful relief by calming joint inflammation and interrupting the pain cycle.

Potential Consequences if Untreated

• Chronic low back and buttock pain

• Altered gait and movement patterns

• Muscle compensation and fatigue

• Reduced activity tolerance

• Secondary spine or hip pain

Because the SI joint influences global biomechanics, persistent dysfunction can affect multiple regions over time.

When to Seek Evaluation

Evaluation is recommended when:

• Pain persists despite conservative care

• Symptoms worsen with standing, walking, or transitional movements

• Pain location is below the belt line and localized to the buttock or posterior pelvis

• Prior lumbar treatments have not fully relieved symptoms

SI joint dysfunction is frequently overlooked, making accurate diagnosis particularly valuable.

Why Choose Resolution Spine & Joint

• Expertise in diagnosing complex mechanical low back pain

• Advanced image-guided SI joint and nerve-targeted procedures

• Rapid access to diagnostic injections for clarity and relief

• Individualized treatment plans focused on restoring stability and function

• Compassionate care recognizing the often frustrating nature of SI joint pain

Patients with SI dysfunction often feel unheard because imaging may appear “normal.” Your clinic’s diagnostic precision offers validation as well as relief.

Frequently Asked Questions

Is SI joint pain the same as sciatica?
No. SI joint pain can mimic sciatica but typically does not follow a true nerve distribution.

Can SI joint dysfunction resolve on its own?
Some cases improve with therapy and stabilization, though persistent inflammation may require targeted treatment.

Do SI joint injections hurt?
Most patients tolerate them well, and they often provide both diagnostic clarity and therapeutic relief.

Can SI joint dysfunction return?
Yes, particularly if underlying biomechanical factors are not addressed.

References

• North American Spine Society (NASS)

• American Society of Interventional Pain Physicians (ASIPP)

• International Spine Intervention Society (ISIS)