Chronic low back pain is one of the most common reasons adults seek medical care, but not all back pain comes from the spine. In fact, up to 25% of persistent low back pain may actually originate from the sacroiliac (SI) joints, the small but powerful joints where the spine connects to the pelvis.
At Pain & Vascular Institute, we understand how frustrating it is to live with ongoing back or leg pain, especially when the cause isn’t clear. If you’ve been told your MRI is normal, or that your pain must be coming from a disc or nerve, sacroiliac joint dysfunction could be the missing piece of your diagnosis.
What Is the Sacroiliac Joint?
You have two sacroiliac joints: one on each side of your lower back, where the sacrum (the triangle-shaped bone at the bottom of your spine) meets the ilium (part of your pelvic bone). These joints support the weight of your upper body and transfer that load to your legs when you stand or walk.
The SI joints don’t move very much, but when they become inflamed or out of alignment, they can cause significant pain and instability. This condition is known as sacroiliac joint dysfunction or SI joint pain.
Signs and Symptoms
Because the sacroiliac joint is located so close to the lower spine, SI joint pain is often misdiagnosed as a lumbar disc problem or sciatica. But the pain patterns are distinct in some important ways.
Common signs of SI joint dysfunction include:
- Pain on one side of the lower back or buttock
- Pain that radiates into the groin, hip, or thigh
- Pain that worsens with standing, walking, or climbing stairs
- Discomfort when transitioning from sitting to standing
- Difficulty sleeping on the affected side
- A feeling of instability or “catching” in the pelvis or lower back
If you’ve been treated for sciatica or spinal arthritis without relief, and your imaging doesn’t show significant disc damage, it may be time to evaluate your SI joints.
What Causes SI Joint Dysfunction?
There are several potential causes of sacroiliac joint pain, including:
- Pregnancy and childbirth, which place added stress on the pelvis and can loosen ligaments
- Leg length differences that shift body mechanics
- Spinal fusion surgery, which alters how weight is transferred through the spine
- Osteoarthritis or joint inflammation
- Trauma, such as a fall or motor vehicle accident
- Repetitive stress or overuse, especially in athletes or laborers
Even seemingly minor imbalances in posture or walking patterns can lead to SI joint inflammation over time.
Diagnosing Sacroiliac Joint Pain
Because SI joint dysfunction doesn’t show up clearly on most X-rays or MRIs, diagnosis requires a detailed history, physical exam, and in some cases, a diagnostic injection.
At Pain & Vascular Institute, we perform targeted diagnostic SI joint injections under image guidance. A small amount of numbing medication is placed directly into the joint. If your pain improves significantly after the injection, it confirms that the SI joint is the source of your symptoms.
This diagnostic step is crucial: it helps avoid unnecessary treatments aimed at the wrong area, and ensures that we develop the right plan for lasting relief.
Treatment Options
Treatment for SI joint dysfunction begins with conservative approaches and progresses to interventional therapies when needed.
Non-surgical options include:
- Physical therapy focused on core stability and pelvic alignment
- Anti-inflammatory medications
- Activity modification and postural correction
- Use of SI joint belts to stabilize the pelvis
If these treatments don’t bring enough relief, we may recommend image-guided injections of corticosteroids to reduce inflammation, or radiofrequency ablation (RFA) to interrupt pain signals from the joint.
RFA can provide several months of relief by targeting the small nerves around the SI joint that send pain messages to the brain. It’s a minimally invasive outpatient procedure with a quick recovery time.
In rare cases, where pain is severe and persistent despite conservative care, SI joint fusion may be considered. This procedure stabilizes the joint using small implants, and is usually reserved for cases that haven’t responded to other treatments.
Why SI Joint Pain Is Often Overlooked
Many patients with sacroiliac joint dysfunction have been through months, or even years, of treatment aimed at their spine, hips, or nerves. When imaging doesn’t reveal a clear cause, or when standard treatments fail, it’s easy to feel discouraged.
SI joint dysfunction is often missed because:
- Symptoms overlap with lumbar disc or nerve problems
- It doesn’t show up clearly on MRI or X-ray
- The pain may be mistaken for hip or pelvic issues
- Few general providers are trained to test and treat it accurately
At Pain & Vascular Institute, our specialized team understands the nuances of chronic pain and takes time to investigate all potential sources, including the SI joints. We believe that identifying the correct diagnosis is the first step to meaningful, long-term relief.
Compassionate Care, Comprehensive Answers
We know that persistent low back or leg pain can be physically and emotionally exhausting. If you’ve been told nothing is wrong, or you’re just managing the pain without improvement, you deserve a deeper look—and a provider who won’t give up on finding answers.
At Pain & Vascular Institute, we use a whole-person approach, combining advanced imaging, hands-on evaluation, and interventional therapies to help you get back to living life on your terms.
Relief in Fox River Grove, IL for An Under-Recognized Source of Low Back and Leg Pain
Sacroiliac joint dysfunction may be one of the most under-recognized causes of chronic low back and leg pain but it is also one of the most treatable. If you suspect your pain might be coming from the SI joint, we’re here to help.Call 224-357-4001 to schedule a consultation with Pain & Vascular Institute today and take the first step toward lasting relief, restored function, and a more confident future.
