Sacroiliac Joint Pain: Causes, Diagnosis, And Treatment

The sacroiliac (SI) joint plays a crucial role in linking the iliac bones (pelvis) to the sacrum, the lowest part of the spine just above the tailbone. It helps absorb shock, preventing excessive impact on the spine. However, this joint can also be a common source of lower back pain when injured or affected by degeneration.

Symptoms of SI Joint Dysfunction

When the SI joint becomes problematic, it can lead to localized pain and discomfort in multiple areas, including:

• Lower back pain (below the L5 vertebra)
• Pelvis, hip, and buttock pain
• Pain in the thigh or groin
• Numbness, tingling, or weakness in the legs
• Difficulty sitting for long periods or discomfort on one side
• Pain during transitional movements (e.g., from sitting to standing)
• Sleep disturbances due to discomfort
• Leg instability or sudden “giving way” sensation

Diagnosing SI Joint Disorders

Diagnosing SI joint dysfunction can be challenging, as its symptoms often mimic those of disc-related or general lower back pain. To confirm whether the SI joint is the source of discomfort, doctors may use:

• Physical examination tests
• Imaging scans (X-ray, CT scan, MRI)
• Diagnostic injections – A local anesthetic is injected into the SI joint under X-ray or CT guidance. If pain is reduced by at least 50%, the SI joint is likely the cause. If there’s no change in pain levels, other causes must be considered.

Treatment Approaches

Once the SI joint is identified as the pain source, treatment can begin. Conservative options include:

• Physical therapy to strengthen muscles and improve mobility
• Oral medications to reduce inflammation and pain
• Injections for temporary relief

If these treatments provide only short-term relief, more advanced options may be necessary.

Minimally Invasive SI Joint Fusion

For patients with persistent pain, SI joint fusion using the cannulated cancellous screws may be recommended.

By understanding SI joint dysfunction, its symptoms, and available treatments, patients can take informed steps toward effective pain management and improved mobility.