Sacroiliac Joint Pain: Causes and Treatment

Sacroiliac (SI) joint pain is a common but often overlooked cause of lower back, buttock, and pelvic discomfort. These joints form the connection between your spine and pelvis and play a crucial role in stabilizing your body during movement. Dysfunction in the SI joints can lead to inflammation, misalignment, and significant pain.

At Sobel Spine & Sports in Phoenix, Dr. Jerry Sobel offers expert evaluation and non-surgical treatment options tailored to relieve SI joint pain and restore mobility.

What Is the Sacroiliac Joint?

The SI joints are two strong, low-motion joints connecting the sacrum (base of the spine) to the iliac bones (pelvis). These joints provide stability while allowing just enough movement to absorb shock between the upper and lower body. When they become inflamed or move abnormally, pain and stiffness can develop.

Medical illustration showing the location of the sacroiliac joints between the sacrum and ilium

Medical illustration showing the location of the sacroiliac joints between the sacrum and ilium

Common Symptoms

  • Pain on one or both sides of the lower back

  • Pain radiating into the buttocks, groin, or thigh

  • Discomfort when standing from a seated position

  • Increased pain with prolonged standing or stair climbing

  • Stiffness, especially in the morning

This pain is often mistaken for lumbar disc problems or hip issues, which is why accurate diagnosis is essential.

Common Symptoms

  • Pain on one or both sides of the lower back

  • Pain radiating into the buttocks, groin, or thigh

  • Discomfort when standing from a seated position

  • Increased pain with prolonged standing or stair climbing

  • Stiffness, especially in the morning

This pain is often mistaken for lumbar disc problems or hip issues, which is why accurate diagnosis is essential.

Person with lower back pain placing a hand over the sacroiliac joint area

Causes and Risk Factors

  • Repetitive stress or injury

  • Pregnancy-related changes

  • Leg length discrepancy

  • Prior lumbar fusion

  • Inflammatory conditions like ankylosing spondylitis

  • Age-related degeneration

How SI Joint Pain Is Diagnosed

Dr. Sobel conducts a thorough evaluation to differentiate SI joint pain from other causes of back or leg discomfort.

Diagnostic steps may include:

  • Detailed history and physical exam

  • SI joint stress tests (FABER, Gaenslen's, compression tests)

  • Imaging studies of the SI joints (x-ray and MRI)

  • Imaging studies to rule out disc or hip pathology

X-Ray of the Sacroiliac Joints

Fluoroscopic-guided sacroiliac joint injection using contrast and x-ray

Non-Surgical Treatment Options

Dr. Sobel focuses on conservative, evidence-based treatments:

  • Physical Therapy Customized exercises to strengthen core muscles, stabilize the pelvis, and improve posture.

  • Activity Modification Advice on avoiding movements that aggravate the joint and promoting biomechanical balance.

  • Bracing Use of a sacroiliac belt to stabilize the joint, particularly for patients with joint hypermobility.

  • Anti-Inflammatory Medications NSAIDs may help reduce inflammation and relieve pain.

  • Image-Guided Injections Corticosteroids and local anesthetic are precisely injected into the SI joint to reduce inflammation. This can relieve pain for weeks or months and help confirm the diagnosis.

Fluoroscopic-guided sacroiliac joint injection

Fluoroscopic-guided sacroiliac joint injection using contrast and x-ray

Frequently Asked Questions

What is the difference between SI joint pain and sciatica?
Sciatica typically involves nerve pain that radiates below the knee due to spinal nerve compression. SI joint pain often stays in the buttocks or thigh and is more positional.
Can both SI joints be affected?
Yes. Although pain is often one-sided, both joints can become painful, especially in inflammatory conditions.
How do I know if I need an SI joint injection?
If physical therapy and medications haven't helped, and your exam suggests SI joint involvement, a diagnostic injection is often the next step.
Is surgery ever necessary for SI joint pain?
Most patients improve with non-surgical care. SI joint fusion may be considered in rare cases if conservative treatments fail.

Get Relief from SI Joint Pain in Phoenix

If you're experiencing persistent lower back or buttock pain, sacroiliac joint dysfunction may be the cause. At Sobel Spine & Sports, Dr. Jerry Sobel provides advanced, personalized care without unnecessary procedures.

Schedule a consultation today to begin your path toward long-term pain relief.

📍 4550 E Bell Road, Suite 110, Phoenix, AZ 85032
📞 (602) 385-4160
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