Sacroiliac Joint Dysfunction

Overview

Sacroiliac joint dysfunction occurs when one or both sacroiliac (SI) joints become inflamed or irritated. These joints connect the sacrum, the triangular bone at the base of the spine, to the iliac bones of the pelvis.

The SI joints support much of the body’s weight and help transfer forces between the upper body and legs. They normally move only slightly and are supported by strong ligaments.

When the joint becomes inflamed or damaged, it can cause lower back and pelvic pain. This condition is sometimes called sacroiliitis.

Urban Spine and Joint

Symptoms

Symptoms of sacroiliac joint dysfunction may include:

  1. Dull, aching pain in the lower back
  2. Pain in the buttocks, hips, or groin
  3. Pain that may travel down the leg, similar to sciatica
  4. Stiffness in the lower back, pelvis, or hips
  5. Pain that worsens with standing, running, or climbing stairs
  6. Pain that increases with weight-bearing activities

Pain is often felt on one side of the lower back but may occur on both sides.

Diagnosis

Diagnosis begins with a medical history and physical examination. A doctor will check for tenderness around the SI joints and perform specific movements that may reproduce pain.

Because SI joint pain can mimic other spine conditions, imaging tests may be used to rule out other causes. These may include:

  1. X-rays to evaluate the spine and pelvis
  2. MRI scans to detect inflammation or other structural problems
  3. CT scans for detailed images of the joint

In some cases, doctors may perform a diagnostic SI joint injection. If pain improves after the joint is injected with a local anesthetic, the SI joint is likely the source of symptoms.

Treatment Options

Treatment typically begins with conservative care to reduce inflammation and improve stability.

Common treatment options include:

  1. Nonsteroidal anti-inflammatory medications (NSAIDs)
  2. Physical therapy and strengthening exercises
  3. Stretching programs, yoga, or Pilates
  4. Activity modification to reduce stress on the joint

If pain persists, sacroiliac joint injections with corticosteroids may be used to reduce inflammation and relieve pain.

Surgery, such as SI joint fusion, is rarely needed and is usually considered only after other treatments fail.

When to Seek Evaluation

Persistent lower back pain, neck pain, or radiating nerve pain should not be ignored. Early evaluation allows for proper diagnosis and targeted treatment, helping prevent progression and long-term complications.