Sacroiliac Joint Pain
The sacroiliac joint (or SI joint) connects the sacrum of your spine to the pelvis. It is similar to joints like our knees and hips because it has cartilage and joint fluid that allow it to have small amounts of motion. The SI joint experiences large forces in multiple directions during our daily living, making it susceptible to pain and degeneration.
The SI joint can mimic pain from the spine or even hip joint. It generally causes low back and buttock pain on either side of the midline of the back. It can be produced by trauma such as a fall onto the buttock, which causes a severe force through the SI joint. It can also occur in patients who already have back problems or in those with previous spine fusions, because these patient are compensating by transferring energy to their SI joints.
During a physical examination, there are several different and unique tests which are performed that alert the physician that a patient has SI joint pain. If it is suspected that the SI joint is the culprit for the pain, there are several options. Many patients improve with physical therapy and SI joint injections. However, if these do not last or symptoms continue to worsen, surgical options can be discussed.
Overview
Your sacroiliac joints (we call them the “SI” joints) are the places where your hips meet your spine. These joints don’t have a lot of flexibility, but they do move slightly as you move your body. And if SI joints become damaged or diseased, it can be painful.
Causes
SI joints hurt when tiny nerves in the joints become irritated. That happens if your joint is damaged in a traumatic injury. It can happen if you have arthritis, which causes the joints to break down over time as you age. You can also feel pain in the SI joints if the supporting ligaments become irritated. That happens if you walk with a limp or have some other issue that places more stress on one hip than the other.
Symptoms
SI joint pain starts in your lower back and buttock. It can radiate to your hip, groin and thigh. Your leg may feel weak. It may feel numb or tingly. You may notice SI joint pain when you are sitting or lying down. You may also notice it when you are walking or climbing stairs, or when you try to stand up after sitting. Usually, SI joint pain is felt only on one side. But if both joints are affected, you may feel pain on both sides.
Treatment
Treatment depends on the cause of your pain. You may benefit from physical therapy, or from injections of medicine into your joint. You may benefit from a procedure called “radiofrequencyablation.” It uses electricity to destroy the painful nerve endings in your joint. If these aren’t helpful, you may need surgery to stabilize your joint. Your healthcare provider can create a plan that’s right for you.