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Sacroiliac (SI) Joint Dysfunction 

Sacroiliac (SI) joint dysfunction occurs when the joint connecting the lower spine to the pelvis becomes irritated, inflamed, or does not move properly. The SI joint helps stabilize the pelvis and transfer forces between the spine and legs. 

Pain from the SI joint is often felt in the lower back, buttock, or hip area and can sometimes be confused with pain coming from the spine or nerves. 

Common causes include injury, arthritis, pregnancy-related changes, changes in movement patterns, and stress placed on the joint after spine surgery. 

At Fortera Health, we evaluate the SI joint along with the surrounding spine, hips, and soft tissues to identify the true source of pain and create a personalized treatment plan. 

Common Symptoms 

Symptoms of SI joint dysfunction may include: 

  • Pain in the lower back or buttock, often on one side 
  • Pain near the back of the pelvis or below the waistline 
  • Pain that may extend into the hip, groin, or back of the thigh 
  • Increased pain with prolonged sitting, standing, walking, or climbing stairs 
  • Pain when transitioning from sitting to standing 
  • Discomfort with bending or single-leg activities 
  • Pelvic discomfort or a feeling of instability 

Unlike nerve compression conditions, SI joint dysfunction typically does not cause numbness, tingling, or muscle weakness. 

What Causes SI Joint Dysfunction? 

SI joint dysfunction can occur when normal joint movement or stability is disrupted. Common causes include: 

  • Injury or trauma: Falls, accidents, or sudden stress through the pelvis 
  • Pregnancy-related changes: Increased joint mobility and ligament changes 
  • Degenerative changes: Arthritis or age-related wear affecting the joint 
  • Biomechanical issues: Abnormal gait, leg-length differences, or pelvic alignment changes 
  • Previous spine surgery: Increased stress on the SI joint after lumbar fusion 
  • Inflammatory conditions: Arthritis conditions that affect the SI joints 

How Is SI Joint Dysfunction Diagnosed? 

Diagnosis begins with a review of symptoms, medical history, and physical examination. 

Your provider may assess: 

  • Location and pattern of pain 
  • Hip and spine movement 
  • Pelvic stability 
  • Specific examination tests that reproduce SI joint pain 

Additional testing may include: 

Imaging findings are interpreted together with your symptoms because changes seen on scans do not always represent the true source of pain. 

Treatment Options 

Treatment focuses on reducing pain, improving stability, and restoring function. 

Treatment options may include: 

  • Physical therapy focused on core strengthening, pelvic stabilization, and movement patterns 
  • Activity modification and guided exercises 
  • Anti-inflammatory medications when appropriate 
  • SI joint injections to reduce inflammation and confirm the pain source 
  • Radiofrequency ablation (RFA) to reduce pain signals from nerves around the joint 

For patients with persistent symptoms despite conservative treatment, minimally invasive SI joint procedures may be considered. 

Physician using a lumbar spine and pelvis model to explain a diagnosis to a patient

At Fortera Health, we focus on identifying the underlying cause of SI joint pain rather than treating symptoms alone. Through a comprehensive evaluation and personalized treatment approach, our team helps patients return to improved mobility and daily function. 

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