Sacroiliac Joint Pain
Pain low in the back and buttock from the joints that connect the spine to the pelvis.
Sacroiliac joint pain comes from one or both SI joints, where the base of the spine meets the pelvis. It usually causes pain low in the back and buttock, often on one side, that can spread into the groin or thigh. Dr. Patel confirms the SI joint as the source with an exam and an image-guided diagnostic injection, then treats it with physical medicine and targeted procedures.
- Where it isBack & spine
- Treatment options03
- Who you seeAnup H. Patel, D.O.
- First visitExam and imaging review
Sacroiliac Joint Pain
The sacroiliac, or SI, joints connect the sacrum, the triangle-shaped bone at the base of the spine, to the pelvis on each side. They are strong, stable joints with very little movement. Their job is to absorb and pass forces between your upper body and your legs when you walk, stand and lift.
When an SI joint becomes inflamed, too stiff or too loose, it can cause pain low in the back, just off the midline, and into the buttock. Pain may spread to the groin, hip or back of the thigh, and occasionally below the knee. It is often worse when standing up from sitting, climbing stairs, standing on one leg or rolling over in bed.
SI joint pain is a common and often missed source of what people call low back pain. It can follow a fall or car accident, develop with arthritis, appear during or after pregnancy, or start after a lumbar fusion that shifts stress onto the pelvis. Inflammatory conditions such as ankylosing spondylitis can also affect these joints.
No single exam test or scan proves SI joint pain. Dr. Patel uses several exam tests together and, when needed, an image-guided injection of numbing medicine into the joint. If your pain improves, the joint is likely the source. Treatment can include physical therapy, a steroid injection into the joint and, for lasting pain, radiofrequency ablation of the nerves that supply it.
What it feels like · Why it happens
Mention these at your first visit. It saves time and helps focus the exam.
- A fall onto the buttocks or a car accident
- Osteoarthritis and wear of the joint
- Pregnancy, when ligaments loosen and posture changes
- A difference in leg length or an uneven walking pattern
- Inflammatory arthritis such as ankylosing spondylitis
- A prior lumbar fusion, which can add stress to the SI joints
- Repetitive heavy lifting or impact sports
How Dr. Patel finds the source
Treatment only works when it is aimed at the right thing. This is how the source is confirmed.
- Step 01
A history, including exactly where you point when asked where it hurts
- Step 02
A group of SI joint stress tests during the exam
- Step 03
Checking the hip and lumbar spine, which can cause similar pain
- Step 04
X-rays or MRI to look for arthritis, inflammation or other causes
- Step 05
Blood tests when inflammatory arthritis is suspected
- Step 06
A diagnostic SI joint injection with numbing medicine under X-ray guidance
Your path to relief
Care moves one step at a time, from the least invasive option up, and only as far as you need.
First-line care
- Physical therapy for core strength, hip strength and pelvic stability
- Anti-inflammatory medications during flares, when appropriate
- Heat or ice
- A sacroiliac belt for short-term support, in some cases
- Activity changes to limit high-impact or one-sided loading
- Addressing leg length differences or walking mechanics
Targeted treatment
Back to function
As a rehabilitation physician, Dr. Patel pairs every treatment with a plan to rebuild strength, movement and daily activity, so relief lasts.
Physical medicine & rehabilitation
Joint Injections
Medicine placed in or around a painful knee, hip, shoulder or other joint to ease pain and inflammation.
Radiofrequency Ablation
Heat applied to small pain-carrying nerves to quiet joint pain in the spine, knee or hip for months.
Nerve Blocks
Numbing medicine placed at specific nerves to find a pain source and, in many cases, ease the pain.
When to call
When to see a specialist
- Low back or buttock pain that lasts more than a few weeks
- Pain with sitting, standing up or stairs that limits your day
- Pain that started after a fall, car accident or pregnancy
- Low back pain that has not improved with treatment aimed at the spine
- Buttock pain after a lumbar fusion
- Morning stiffness in the low back that improves with activity, which can suggest inflammatory arthritis
Go to the emergency room if
- Pelvic or buttock pain with fever, which can signal a joint infection
- Severe pain and trouble bearing weight after a fall, which can mean a fracture
- New leg weakness or loss of bladder or bowel control
Questions
How is SI joint pain different from a herniated disc?
What happens during an SI joint injection?
Can pregnancy cause SI joint pain?
Can radiofrequency ablation help SI joint pain?
Should I wear an SI belt?
This page explains a condition or treatment in general. It is not a diagnosis or medical advice for you. Dr. Patel will explain what applies to you at your visit.
Back & spine
Back Pain
Aching, stiff or sharp pain in the back, from strained muscles to disc, joint and nerve problems.
Sciatica
Pain that runs from the lower back or buttock down the leg, caused by an irritated nerve root.
Herniated Disc
A disc whose soft center pushes through its outer ring, causing back or neck pain and nerve symptoms.