The sacroiliac joint (SI joint) is where the bones of the spine connect to the pelvis. There is one joint on the right side and one on the left. These joints are held together with very strong bands of fiber called ligaments.
The SI joint has very little movement. Its main job is to decrease impact to the spine during activities like walking. Problems in this area can cause pain in the lower back which may also pass into the groin or down the legs.
Damage to bones or ligaments of the joint can cause inflammation. The inflammation can cause pain and irritate nearby nerves which leads to more pain. Inflammation of the joint may be caused by:
SI joint pain may be more likely to happen with:
SI joint pain will differ based on the exact cause of the pain. The pain may be dull or sharp and may be any of the following:
Pain may increase with certain activities such as walking, twisting, rising to stand, or bending
You will be asked about your symptoms and medical history. A physical exam will be done.
The doctor will most likely make a diagnosis based on your symptoms. If there are other more serious symptoms or severe pain your doctor want to take images of the area. This can be done with x-rays or CT scan. Most will not need these tests.
If needed, the doctor may use a nerve block to make sure the pain is coming from the SI joint. Medicine that blocks pain is injected near the SI joint. If pain stops, then the joint is confirmed as the cause.
Treatment depends on the cause of the pain. Any underlying condition would receive treatment specific for that disease. For all causes, short-term rest is often the first step to allow time for the joint to heal.
Talk with your doctor about the best treatment plan for you. Options may include one or more of the following:
Medication can help manage inflammation and reduce pain while the joint heals. Medication options include
The joint may be moving too much or too little. An imbalance of muscles around the joint can also cause more problems. Physical therapy may help to speed healing and find a cause. Therapy sessions may include:
Decreasing stress on the back with lower the chance of SI joint pain. Healthy steps include:
Ortho Info—Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Chronic low back pain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116935/Ch...ic-low-back-pain. Updated August 18, 2016. Accessed September 23, 2016.
Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005 Nov;101(5):1440-1453.
d'Hemecourt PA, Gerbino PG II, et al. Pediatric and adolescent sports injuries: back injuries in the young athlete. Clinics In Sports Medicine. 2000 Oct;19(4):663-679.
Dreyfuss P, Dreyer S, et al. Positive sacroiliac screening tests in asymptomatic adults. Spine. 1994;19(10):1138-1143.
Inflammatory arthritis of the hip. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00396. Updated July 2014. Accessed June 2, 2016.
Sacroiliac joint dysfunction. Orthogate website. Available at: http://www.orthogate.org/patient-education/lumbar-spine/sacroiliac-joint-dysfunction.html. Updated September 4, 2015. Accessed June 2, 2016.
Sciatica. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115166/Sciatica. Updated February 8, 2016. Accessed June 2, 2016.
Scopp JM, Moorman CT III. The assessment of athletic hip injury. Clinics In Sports Medicine. 2001 Oct;20(4):647-659.
Speldewinde GC. Outcomes of percutaneous zygapophysial and sacroiliac joint neurotomy in a community setting. Pain Med. 2011;12(2):209-218.
Spinal injections. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00560. Updated December 2013. Accessed June 2, 2016.
van Benten E, Pool J, Mens J, Pool-Goudzwaad A. Recommendations for physical therapists on the treatment of lumbopelvic pain during pregnancy: a systematic review. J Orthop Sports Phys Ther. 2014;44(7):464-473,A1-15. Available at: http://www.jospt.org/doi/pdf/10.2519/jospt.2014.5098. Accessed June 2, 2016.
Last reviewed June 2016 by Laura Lei-Rivera, PT, DPT, GCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.