Sacroiliac Joint Dysfunction: The Hidden Culprit Behind Your Lower Back Pain

If you've ever dealt with nagging lower back pain that just won’t quit, your sacroiliac (SI) joint might be the troublemaker. This often-overlooked joint plays a crucial role in stability and movement, but when things go wrong, it can lead to persistent discomfort that impacts your daily routine. Let’s dive into what sacroiliac joint dysfunction is, what causes it, and—most importantly—how to get relief.

What is Sacroiliac Joint Dysfunction?

Sacroiliac joint dysfunction (SIJD), also known as SI joint disorder, sacroiliac syndrome, or sacroiliitis, occurs when the SI joint moves too much or too little, causing inflammation and pain. This joint, which connects your spine to your pelvis, is designed for stability, but when it gets irritated, you can feel it with every step, twist, or even when sitting for long periods.

Common Causes of SI Joint Dysfunction

Several factors can contribute to SI joint pain, including:

Osteoarthritis – Wear and tear over time can cause joint inflammation.
Rheumatoid Arthritis – An autoimmune condition that attacks joints, including the SI joint.
Pregnancy – Increased joint flexibility and added stress on the pelvis can lead to SI joint dysfunction.
Post-Traumatic Arthritis – Injuries like falls or car accidents can damage the SI joint.
Collagen Vascular Disease – Conditions affecting connective tissue can weaken the joint’s stability.

Signs and Symptoms: Is Your SI Joint to Blame?

SI joint dysfunction often mimics other conditions, making it tricky to diagnose. However, common symptoms include:

Pain in the lower back, hips, buttocks, or groin (but not below the knee)
Discomfort when standing up, climbing stairs, or turning in bed
Pain that worsens with movement but improves with rest or heat
Aching, persistent pain that feels deep in the pelvis

How Is SI Joint Dysfunction Diagnosed?

A combination of physical exams and imaging tests can help pinpoint SI joint dysfunction. Here are some common diagnostic methods:

Physical Exam Tests:

Gaenslen Test: Stresses the SI joint by applying pressure while the patient lies down.
Iliac Gapping & Compression Tests: Apply pressure to the pelvis to check for pain response.
FABER (Patrick Test): Assesses pain during hip and SI joint movement.

Imaging & Injections:

X-Rays & MRI Scans: Rule out fractures, arthritis, or other spine conditions.
Fluoroscopy-Guided SI Joint Injection: The “gold standard” for diagnosis, this test involves injecting a local anesthetic into the SI joint to confirm if it’s the source of pain. If pain relief occurs, SI joint dysfunction is likely the culprit.

Effective Treatments for SI Joint Dysfunction

The good news? You don’t have to live with SI joint pain. Here’s how you can find relief:

Non-Surgical Treatments:

Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) help reduce inflammation and pain.
Physical Therapy: Strengthening core and pelvic muscles can stabilize the joint.
Heat and Cold Therapy: Applying heat can relax muscles, while ice can reduce inflammation.

Advanced Pain Management Options:

SI Joint Injections: A combination of a local anesthetic and a steroid to reduce pain and inflammation.
Radiofrequency Ablation (RFA): If injections provide only short-term relief, RFA can target the lateral branch nerves (L4-S3) to disrupt pain signals and offer long-term relief.

When Surgery May Be Considered

For severe, persistent cases that don’t respond to conservative treatments, surgical options like SI joint fusion may be explored. However, this is typically a last resort.

Find Relief at California Sports & Spine Institute

If SI joint pain is keeping you from enjoying life, it's time to take action. At California Sports & Spine Institute, our team specializes in diagnosing and treating SI joint dysfunction with personalized, cutting-edge treatments.