Understanding the Sacroiliac Joints

You have two SI joints, one on each side of your pelvis. Although these small joints have limited movement, they are essential for absorbing shock and stabilizing your lower body during activities such as walking, running, and lifting.

Causes of SI Joint Dysfunction

• Injury or Trauma: Falls, car accidents, or sudden impacts can injure the SI joint, causing inflammation and pain.
• Pregnancy: Hormonal changes during pregnancy cause pelvic ligaments to loosen, increasing SI joint movement and discomfort.
• Arthritis: Osteoarthritis or ankylosing spondylitis can lead to joint inflammation or degeneration.
• Leg Length Discrepancy: Uneven leg lengths can place extra stress on the SI joints.
• Repetitive Stress: Extended periods of standing, heavy lifting, or twisting can cause wear and tear on the SI joints.
• Prior Spinal Fusion: Fusion procedures (especially to the sacrum) may increase stress transfer to the SI joints.

Symptoms of SI Joint Dysfunction

• Lower back pain: Often felt on one side of the lower back or buttocks, sometimes radiating down the leg (mimicking sciatica).
• Pelvic pain: Discomfort in the pelvic area, especially when sitting or standing for long periods.
• Hip or groin pain: Pain may also be felt in the hips or groin region.
• Instability: A sensation that the SI joint will “give out.”
• Leg pain and Sciatica: Pain shooting down the leg due to proximity of the sciatic nerve.
• Difficulty with Movement: Bending, twisting, or lifting can exacerbate the pain; symptoms may worsen when lying on the affected side.
• Stiffness: Particularly in the lower back or hips after periods of inactivity.

Diagnosis

Diagnosing SI joint dysfunction can be challenging because its symptoms often mimic those of herniated discs or hip problems. A/Prof Buckland will take a detailed medical history, perform a physical examination, and use imaging tests such as X-rays, CT scans, or MRIs. In some cases, an injection of a local anesthetic into the SI joint under CT guidance is used to confirm the diagnosis.

Treatment

• Physiotherapy: Exercises to strengthen the muscles around the SI joint, improve flexibility, and stabilize the pelvis.
• Sacroiliac Belt: A supportive belt worn around the pelvis to help stabilize the SI joints during activity.
• Lifestyle Modifications: Adjusting activities such as avoiding heavy lifting or prolonged standing.
• Pain Management: NSAIDs, pain relievers, or corticosteroid injections to manage pain and reduce inflammation. Radiofrequency Ablation (RFA) may be considered if there is a good initial response to SI joint injection.
• Surgery: In severe cases, minimally invasive SI joint fusion may be performed when conservative treatments fail. Learn more about SI Joint Fusion results.

Prognosis

Many people with SI joint dysfunction manage their symptoms effectively with conservative treatments. In some cases, the condition may resolve over time—especially if related to pregnancy or a temporary injury. For chronic or severe cases, advanced treatments such as radiofrequency ablation or surgery may be considered. Early diagnosis and intervention are key to preventing permanent nerve damage.

Patient Reported Outcomes - Sacroiliac Joint Fusion