Louisiana Pain Specialists
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Sacroiliac Joint Pain

What Is Sacroiliac Joint Pain?

The sacroiliac (SI) joint is a large, weight-bearing joint that connects the sacrum (the triangular bone at the base of the spine) to the iliac bones of the pelvis. This joint plays a crucial role in stabilizing the pelvis and transferring the weight of the upper body to the legs. Because of its function, the SI joint is under constant stress, making it susceptible to wear and tear, inflammation, and dysfunction over time.

As people age, the SI joint can begin to fuse naturally, leading to stiffness and discomfort. Some individuals develop arthritis in this joint, which can cause chronic pain. SI joint pain typically presents as lower back and buttock pain and can sometimes radiate to the hips, groin, or thighs. While it usually does not extend below the knee, in rare cases, it may.

Another common condition associated with SI joint dysfunction is bursitis, which refers to inflammation of the fluid-filled sacs that cushion the joints. When pain alters the body’s movement patterns, it can place stress on different areas, leading to bursitis. This pain can be quite severe and may radiate from the front or back of the hips down the legs.

Symptoms of Sacroiliac Joint Pain

SI joint pain can mimic other conditions, making diagnosis challenging. Some common symptoms include:

  • Pain in the lower back, buttocks, hips, or thighs
  • Stiffness and reduced mobility in the pelvis and lower back
  • Pain that worsens with prolonged sitting, standing, or certain movements
  • Pain that improves when lying down or changing positions
  • Discomfort while climbing stairs, getting out of a chair, or walking on uneven surfaces

If you’re experiencing any of these symptoms, it’s important to seek medical evaluation to determine if the SI joint is the source of your pain.

Treatment Options for Sacroiliac Joint Pain

SI joint pain can be managed through a variety of treatments, ranging from conservative therapies to advanced interventional procedures.

1. Diagnostic SI Joint Injection

One of the most common diagnostic and therapeutic procedures for SI joint pain is an SI joint injection. During this procedure:

  • A pain specialist injects a combination of local anesthetic and anti-inflammatory medication directly into the joint.
  • The injection is guided by fluoroscopy (X-ray imaging) to ensure accuracy.
  • If the patient experiences significant pain relief, this confirms that the SI joint is the primary source of discomfort.

For many individuals, SI joint injections provide substantial relief. However, if the pain returns, additional treatments may be needed.

2. Physical Therapy and Active Release Techniques

A structured physical therapy program can help strengthen the muscles supporting the SI joint, improve flexibility, and restore proper movement patterns. Active release techniques (ART) involve hands-on manipulation of soft tissues to reduce tension and enhance mobility.

3. Radiofrequency Ablation (RFA)

If SI joint injections provide temporary relief, a procedure called radiofrequency ablation (RFA) may be an option. This involves:

  • Using heat to cauterize and disrupt nerve signals responsible for pain.
  • Targeting the posterior SI joint nerves, which are the most common source of pain.
  • Offering long-term relief, with results typically lasting about a year before nerves regenerate.

4. Spinal Cord Stimulation (SCS)

If pain persists and is suspected to originate from the anterior nerves of the SI joint (which are difficult to target with injections), a spinal cord stimulator (SCS) may be recommended. This device sends mild electrical impulses to the spinal cord, altering pain signals before they reach the brain.

5. Minimally Invasive SI Joint Fusion

For patients with severe or persistent SI joint dysfunction that does not respond to other treatments, SI joint fusion may be considered. This minimally invasive surgical procedure stabilizes the joint by inserting small implants, reducing movement and relieving pain. Louisiana Pain Specialists offers advanced SI joint fusion procedures for patients who have exhausted other treatment options.

What Is Sacroiliitis?

Sacroiliitis, also called sacroiliac joint dysfunction, refers to inflammation in one or both of the sacroiliac joints. Despite being a fairly common condition, estimated to affect between 10 and 25 percent of people who suffer from back pain, many patients have limited knowledge of what it is, its symptoms, and its treatment options. Sacroiliitis is a type of spondyloarthropathy, a group of inflammatory spinal conditions, and is typically the first manifestation of a condition known as axial spondyloarthritis. It is also often the first symptom of ankylosing spondylitis. Because its symptoms mirror various other mechanical issues of the spine, sacroiliitis is often misdiagnosed.

How Is Sacroiliitis Diagnosed?

The first diagnostic measure for sacroiliitis is a physical exam. During the exam, your doctor will press on different areas of the hips and buttocks to find specific points of pain, and use tests of physical movement that engage the SI joints. The pelvic rock test, FABERE, and Gaenslen maneuvers are three provocation tests used to induce SI joint pain during diagnosis. X-rays and MRI may be used if underlying conditions like ankylosing spondylitis are suspected. Diagnostic anesthetic injections are also used to pinpoint the source of a patient’s lower back pain. If anesthetic injections into the sacroiliac joint provide relief, the SI joint is likely the cause of the pain.

For select patients, LinQ sacroiliac joint fusion offers a minimally invasive surgical option.

Related Treatments

An illustration of a spinal cord stimulator implant.

Spinal Cord Stimulator Implant (SCS)

Spinal Stimulator Implant Procedure When you come in for the procedure, you will have the opportunity to speak with a clinical staff member in order to have any questions answered, and you will sign a consent form. In the procedure room, you will lie on the treatment table, and the area on your body where […]
Lady at Yoga to prevent pain.

Radiofrequency Ablation

The Radiofrequency Ablation Procedure When you come in for the procedure, you will have the opportunity to speak with a clinical staff member in order to have any questions answered, and you will sign a consent form. In the procedure room, you will lie on the treatment table, and the area on your body to […]
A lady golfing, no longer experiencing shoulder pain due to a nerve block.

Sacroiliac Joint Steroid Injection

How Sacroiliac Joint Steroid Injections Work The sacroiliac (SI) joints connect the spine to the pelvis and help distribute weight between the upper body and legs. When inflammation or arthritis affects these joints, it can cause persistent pain in the lower back, buttocks, or legs. A sacroiliac joint steroid injection (SI injection) delivers anti-inflammatory medication […]

Louisiana Pain Specialists Offers Relief From Sacroiliac Joint Pain

SI joint pain can be debilitating, but effective treatments are available. Whether you need diagnostic injections, physical therapy, radiofrequency ablation, or a minimally invasive SI joint fusion, Louisiana Pain Specialists is here to help. Call us today to schedule a consultation and take the first step toward lasting pain relief.