SI Joint Dysfunction: Could It Be the Source of Your Pain?

Living with ongoing lower back or pelvic pain can make everyday activities more difficult. While there are many possible causes of this type of discomfort, one that's often overlooked is sacroiliac (SI) joint dysfunction. If your symptoms have been difficult to pinpoint, here's what to know about SI joint dysfunction and how it might be contributing to your pain.

What Are the Sacroiliac (SI) Joints?

The sacroiliac (SI) joints form the connection between your spine and your pelvis. One joint sits on each side of the sacrum, the triangular bone at the bottom of the spine, connecting it to the ilium, or upper portion of the pelvis.

The SI joints help transfer the weight of your upper body through your pelvis, providing stability during everyday activities like standing, walking, climbing stairs, and bending. These joints have a very small range of motion, but when irritated or stressed, pain can spread beyond the joint itself, often into the lower back, buttocks, or upper legs.

Common Symptoms of SI Joint Dysfunction

SI joint dysfunction can affect everyone differently, but common symptoms include:

• Pain in the lower back, buttock, hip, or pelvis
• Pain that is more noticeable on one side of the body
• Discomfort that may radiate into the groin or upper thigh
• Pain that worsens after prolonged sitting, standing, or walking
• Increased pain when climbing stairs, changing positions, or putting weight on one leg
• Stiffness in the lower back or hips, particularly in the morning
• A feeling of instability or weakness around the pelvis

Because these symptoms overlap with other musculoskeletal conditions, a proper diagnosis is essential.

How Is SI Joint Pain Diagnosed?

An accurate diagnosis begins with a detailed history and physical exam. Your provider will ask about when the pain started, what makes it better or worse, and where exactly you feel it. Then they may ask you to perform certain movements or apply gentle pressure around the pelvis to assess the joint.

To help rule out other possible causes of pain, your provider may also recommend imaging studies, such as X-rays, CT scans, or MRI scans. If additional information is needed, your provider may use a diagnostic injection, which delivers a small amount of anesthetic directly to the SI joint to help determine whether it is the source of your pain. If symptoms improve significantly after the injection, that's a strong indication of SI joint dysfunction.

What Causes SI Joint Dysfunction?

Several factors can disrupt how the SI joint moves or bears weight, including:

• Injury: A fall, direct impact, or sudden twisting motion can damage the ligaments that stabilize the joint.
• Arthritis: Degenerative changes in the joint, including osteoarthritis, can wear down cartilage and lead to inflammation over time.
• Pregnancy: Hormonal changes loosen the ligaments around the pelvis to prepare for childbirth, which can hinder joint stabilization. At the same time, the added weight and shifting posture of pregnancy can also place extra stress on the SI joints.

In some cases, repetitive stress from uneven gait, prior spine surgery, or biomechanical imbalances can also contribute to SI joint dysfunction.

Conservative and Interventional Pain Management Options

Treatment for SI joint dysfunction often begins with conservative care and may progress to interventional pain management when symptoms persist. Depending on the cause and severity of your pain, treatment options may include:

• Medication: Anti-inflammatory medications may help manage pain and reduce inflammation, particularly during symptom flare-ups.
• Physical therapy: Exercises and stretches can help improve mobility in the hips and lower back, strengthen the muscles that support the pelvis, and address posture or movement patterns that may place additional stress on the SI joint.
• SI joint injections: Image-guided injections can deliver corticosteroid medication directly to the SI joint to reduce inflammation and provide pain relief. These injections may also help confirm whether the SI joint is the source of your symptoms.
• Radiofrequency ablation (RFA): If pain returns after temporary relief from injections or other treatments, radiofrequency ablation may be considered. This minimally invasive procedure uses heat to target nerves responsible for transmitting pain signals from the SI joint.

An interventional pain management specialist can help determine which treatments are appropriate based on your symptoms, examination, diagnostic findings, and response to previous care.

When to Seek Evaluation

Lower back or pelvic pain that lingers, especially pain that interferes with daily activities like sleeping, sitting for long periods, or climbing stairs, is worth having evaluated. The sooner SI joint dysfunction is identified, the sooner you can start a treatment plan built around what's actually causing your symptoms.

At Visco Spine & Joint Center, our board-certified physicians specialize in accurately diagnosing conditions like SI joint dysfunction and offering advanced, non-surgical treatment options to help you find lasting relief. If you're dealing with persistent pain that hasn't responded to previous treatment, schedule a consultation to find out whether your SI joints may be contributing to your symptoms.