Table of ContentsView AllTable of ContentsCausesSymptomsFlare TriggersAt-Home TreatmentMedicationsSurgeryStretchesSpecialists
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Flare Triggers
At-Home Treatment
Medications
Surgery
Stretches
Specialists
Sacroiliac(SI) joint dysfunction describes pain due to abnormal movement (too much or too little) or misalignment of the SI joint. It can cause sharp, stabbing pain that starts in the hips and pelvis and radiates into the lower back and down the thighs.
Pain is the main symptom of SI joint dysfunction. It can be felt on one side of the body in the lower back and the hip, buttock, and leg on the same side. While rare, SI joint dysfunction can also affect both sides of the lower body.
SI joint dysfunction is a treatable and manageable condition. It is treated with both nonsurgical and surgical therapies. This article will cover SI joint dysfunction causes, symptoms, treatment options, and more.
SI Joint
What Causes SI Joint Dysfunction?
Causes and risk factors for SI joint dysfunction include:
What Is the Sacroiliac (SI) Joint?Thesacroiliac jointsare located where thesacrum(tailbone) andiliummeet in the lower back.The sacrum is the triangular bone near the bottom of the spine. The ilium is one of the three bones of the hip bones at the uppermost point of the pelvis.You have two SI joints connecting the pelvis to the lower part of the spine. They support the body’s weight and function as shock absorbers to reduce spinal pressure.The SI joint structure is designed to be tough enough to keep the body upright and support the pelvis when giving birth.Inflammation of one or both SI joints, calledsacroiliitis, is sometimes to blame for SI joint pain. It typically affects people with AS and other types of inflammatory arthritis.
What Is the Sacroiliac (SI) Joint?
Thesacroiliac jointsare located where thesacrum(tailbone) andiliummeet in the lower back.The sacrum is the triangular bone near the bottom of the spine. The ilium is one of the three bones of the hip bones at the uppermost point of the pelvis.You have two SI joints connecting the pelvis to the lower part of the spine. They support the body’s weight and function as shock absorbers to reduce spinal pressure.The SI joint structure is designed to be tough enough to keep the body upright and support the pelvis when giving birth.Inflammation of one or both SI joints, calledsacroiliitis, is sometimes to blame for SI joint pain. It typically affects people with AS and other types of inflammatory arthritis.
Thesacroiliac jointsare located where thesacrum(tailbone) andiliummeet in the lower back.The sacrum is the triangular bone near the bottom of the spine. The ilium is one of the three bones of the hip bones at the uppermost point of the pelvis.
You have two SI joints connecting the pelvis to the lower part of the spine. They support the body’s weight and function as shock absorbers to reduce spinal pressure.
The SI joint structure is designed to be tough enough to keep the body upright and support the pelvis when giving birth.
Inflammation of one or both SI joints, calledsacroiliitis, is sometimes to blame for SI joint pain. It typically affects people with AS and other types of inflammatory arthritis.
Symptoms: How Does SI Joint Dysfunction Feel?
SI joint dysfunction occurs either ashypermobility(too much movement) or hypomobility (too little movement).With hypermobility, there is extended movement of the SI joints, leading to pain and instability of the pelvis, with pain in the lower back and hip that radiates into the groin area. With hypomobility, mobility is limited, and pain is felt in the buttocks and the back of the leg.
The pain can vary in intensity and severity and be felt in the lower back, pelvis, buttocks, or tailbone.It can sometimes be described as numb, popping, or clicking pain in the groin area or just below the waist.
SI joint pain can affect one or both sides of the lower body. Unilateral SI joint pain is four times more likely than bilateral.
The most common symptoms of SI joint dysfunction are:
What Causes Lower Back and Groin Pain in Women?
What Triggers SI Joint Flares?
Certain physical activities can cause sacroiliitis, including:
SI dysfunction flare (worsening symptoms) triggers include:
An Overview of Sacroiliac Joint Pain
At-Home Treatment to Soothe SI Joint Pain
Treatment for SI joint dysfunction varies depending on the pain and symptom severity. For most people, home remedies can help ease symptoms.
At-home remedies for managing SI joint pain include:
Medications That Target Sacral Back Pain
If your SI joint pain cannot be managed with self-care and at-home treatments, your healthcare provider might recommend medications to manage pain and inflammation.
Medications that might help target SI joint and sacral back pain include:
Surgery for Severe SI Joint Dysfunction
Surgery is a treatment of last resort for SI joint dysfunction. It is considered after you have tried all the nonsurgical options available and are still experiencing severe pain that affects walking and your ability to perform daily activities.
Surgery to treat SI joint problems is typically an outpatient procedure that involves the insertion of titanium implants across the SI joint to provide stability.
Recovery and Long-Term Management
Your recovery time will depend on the surgical approach, the severity of symptoms before the surgery, your overall health, and your surgeon’s preference for rehabilitation.
Depending on your pain levels and the healing of the surgical site, physical therapy typically begins six to 12 weeks later.Full recovery can take up to six months, and during that time, your healthcare provider will want you on nonsurgical therapies (i.e., pain medications, activity modification, and physical therapy).
Gentle Stretches and Exercises
Research shows that focusing on key muscles and muscle groups can best treat and improve SI joint pain.For example, thehamstring(a muscle at the back of the thigh) provides stability to the SI joints because of its direct connection to ligaments involved in joint stability.
Knee to chest: This exercise helps strengthen the muscles of the lower back, hips, and buttocks.It is performed as follows:
Double knee to chest:This involves both knees. It is performed in this way:
Quadriceps stretch: This exercise stretches the quadriceps and muscles around the hips and knees.Its steps include:
Seated hamstring: This exercise stretches the hamstrings, hips, and calves.It involves:
Seated butterfly: The seated butterfly stretches the inner thigh, groin, knee, and hip muscles.Do it as follows:
Cat-cow stretch: This stretch can keep the spine mobile.It involves:
Seated spinal twist: This stretch improves posture and spinal mobility.Do it in this way:
Physical Therapy
Physical therapycan help manage SI joint pain with exercises that improve the strength and flexibility of the spine, hips, and pelvis. Aphysical therapistcan help you find safe and practical exercises to best manage symptoms and pain.Continuing with a home exercise program might prevent symptom recurrences.
Chiropractic Care
Achiropractorcan diagnose and treat SI joint dysfunction. They use spinal manipulation techniques to help relieve pain and improve mobility and function.
Spinal manipulation has risks, including fracture, disk herniation, and blood vessel dissection. Chiropractors are not physicians.
Specialists Who Understand SI Joint Dysfunction
Your primary healthcare provider is the first person you might see if you are experiencing low-back, hip, groin, and buttock pain. After getting a complete medical history, including symptoms experienced, a physical exam, and imaging, your provider may refer you to another specialist to confirm and adequately treat you.
Depending on the results of such testing, you may be referred to arheumatologist,orthopedist, physical therapist, orpain management doctor, whose specialties include:
A diagnostic method that can help confirm SI joint dysfunction involves the injecting a numbing medicine into the affected SI joint. If the injection brings relief, the SI joint is likely the source of pain.If it does not, other tests will be done to ascertain the cause of your symptoms.
A second helpful test is an arthrogram, a type of joint X-ray that uses a contrast dye injected into a joint to take detailed images of the SI joint.It is sometimes used with an SI joint injection.
Summary
The SI joints are the small and robust joints next to the sacrum and the iliac portion of the pelvic bone. They act as shock absorbers for the lower back and hips. Sometimes, these joints can cause pain due to arthritis conditions, degeneration (older age), trauma, repetitive stress, pregnancy, abnormal walking patterns, and other causes.
Pain is the main symptom and typically affects one side of the body. Sometimes, the pain is sharp and stabbing. It might start in the hips and pelvis and radiate into the back and legs. While rare, SI joint dysfunction can also affect both sides of the lower body.
SI joint dysfunction is a manageable and treatable condition. Surgery is rarely needed. You can manage it at home with OTC pain relievers, ice and heat therapy, improving posture, making dietary changes, and using an SI joint brace, as well as with physical therapy. You will also want to avoid activities that worsen pain.
Your healthcare provider can prescribe medications to treat pain and its underlying cause, such as inflammatory arthritis. Physical therapy and chiropractic care can help relieve pain and reduce misalignment of the SI joint. A physical therapist or a chiropractor can also educate you on gentle exercises and stretches to reduce and prevent further pain.
Contact your healthcare provider if you are experiencing low-back, hip, or pelvic pain. They can perform tests and refer you to the appropriate specialists to help you manage pain and other symptoms of SI joint dysfunction.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Newman DP, Soto AT.Sacroiliac joint dysfunction: Diagnosis and treatment.Am. Fam Physician. 2022;105(3):239-245.Spondylitis Association of America.Overview of ankylosing spondylitis.Baronio M, Sadia H, Paolacci S, et al.Etiopathogenesis of sacroiliitis: Implications for assessment and management.Korean J Pain. 2020;33(4):294-304. doi:10.3344/kjp.2020.33.4.294Falowski S, Sayed D, Pope J, et al.A review and algorithm in the diagnosis and treatment of sacroiliac joint pain.J Pain Res. 2020;13:3337-3348. doi:10.2147/JPR.S279390Ziegeler K, Kreutzinger V, Diekhoff T, et al.Impact of age, sex, and joint form on degenerative lesions of the sacroiliac joints on CT in the normal population.Sci Rep. 2021;11(1):5903. doi:10.1038/s41598-021-85303-5Guan F, Sun Y, Zhu L, et al.Risk factors of postoperative sacroiliac joint pain for posterior lumbar surgery: ≥2-year follow-up retrospective study.World Neurosurg. 2018;110:e546-e551. doi:10.1016/j.wneu.2017.11.053Betts, JG, Wise J, Young KA, et al.The pelvic girdle and pelvis.Anatomy & Physiology.OpenStaxCollege, 2017.Weill Cornell Medicine Brain and Spine Center.Symptoms of sacroiliac joint dysfunction.Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082MedlinePlus.Guide to good posture.Ricker MA, Haas WC.Anti-inflammatory diet in clinical practice: A review.Nutr Clin Pract.2017;32(3):318-25. doi:10.1177/0884533617700353Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV.Sacroiliac joint pain and its treatment.Clin Spine Surg.2016;29(2):42-48. doi:10.1097/BSD.0000000000000359Yale Medicine.Sacroiliac joint fusion.Buchanan P, Lee DW, Comer A, et al.Best practices for postoperative management of posterior sacroiliac joint fusion.J Pain Res. 2022;15:1149-1162. doi:10.2147/JPR.S357123Arthritis Foundation.Lower body stretches.Arthritis Foundation.Arthritis-friendly yoga.Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key.J Inflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494Weill Cornell Medicine Brain and Spine Center.Doctors who treat SI joint dysfunction.Weill Cornell Medicine Brain and Spine Center.Diagnosing and treating sacroiliac joint dysfunction.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Newman DP, Soto AT.Sacroiliac joint dysfunction: Diagnosis and treatment.Am. Fam Physician. 2022;105(3):239-245.Spondylitis Association of America.Overview of ankylosing spondylitis.Baronio M, Sadia H, Paolacci S, et al.Etiopathogenesis of sacroiliitis: Implications for assessment and management.Korean J Pain. 2020;33(4):294-304. doi:10.3344/kjp.2020.33.4.294Falowski S, Sayed D, Pope J, et al.A review and algorithm in the diagnosis and treatment of sacroiliac joint pain.J Pain Res. 2020;13:3337-3348. doi:10.2147/JPR.S279390Ziegeler K, Kreutzinger V, Diekhoff T, et al.Impact of age, sex, and joint form on degenerative lesions of the sacroiliac joints on CT in the normal population.Sci Rep. 2021;11(1):5903. doi:10.1038/s41598-021-85303-5Guan F, Sun Y, Zhu L, et al.Risk factors of postoperative sacroiliac joint pain for posterior lumbar surgery: ≥2-year follow-up retrospective study.World Neurosurg. 2018;110:e546-e551. doi:10.1016/j.wneu.2017.11.053Betts, JG, Wise J, Young KA, et al.The pelvic girdle and pelvis.Anatomy & Physiology.OpenStaxCollege, 2017.Weill Cornell Medicine Brain and Spine Center.Symptoms of sacroiliac joint dysfunction.Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082MedlinePlus.Guide to good posture.Ricker MA, Haas WC.Anti-inflammatory diet in clinical practice: A review.Nutr Clin Pract.2017;32(3):318-25. doi:10.1177/0884533617700353Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV.Sacroiliac joint pain and its treatment.Clin Spine Surg.2016;29(2):42-48. doi:10.1097/BSD.0000000000000359Yale Medicine.Sacroiliac joint fusion.Buchanan P, Lee DW, Comer A, et al.Best practices for postoperative management of posterior sacroiliac joint fusion.J Pain Res. 2022;15:1149-1162. doi:10.2147/JPR.S357123Arthritis Foundation.Lower body stretches.Arthritis Foundation.Arthritis-friendly yoga.Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key.J Inflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494Weill Cornell Medicine Brain and Spine Center.Doctors who treat SI joint dysfunction.Weill Cornell Medicine Brain and Spine Center.Diagnosing and treating sacroiliac joint dysfunction.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Newman DP, Soto AT.Sacroiliac joint dysfunction: Diagnosis and treatment.Am. Fam Physician. 2022;105(3):239-245.Spondylitis Association of America.Overview of ankylosing spondylitis.Baronio M, Sadia H, Paolacci S, et al.Etiopathogenesis of sacroiliitis: Implications for assessment and management.Korean J Pain. 2020;33(4):294-304. doi:10.3344/kjp.2020.33.4.294Falowski S, Sayed D, Pope J, et al.A review and algorithm in the diagnosis and treatment of sacroiliac joint pain.J Pain Res. 2020;13:3337-3348. doi:10.2147/JPR.S279390Ziegeler K, Kreutzinger V, Diekhoff T, et al.Impact of age, sex, and joint form on degenerative lesions of the sacroiliac joints on CT in the normal population.Sci Rep. 2021;11(1):5903. doi:10.1038/s41598-021-85303-5Guan F, Sun Y, Zhu L, et al.Risk factors of postoperative sacroiliac joint pain for posterior lumbar surgery: ≥2-year follow-up retrospective study.World Neurosurg. 2018;110:e546-e551. doi:10.1016/j.wneu.2017.11.053Betts, JG, Wise J, Young KA, et al.The pelvic girdle and pelvis.Anatomy & Physiology.OpenStaxCollege, 2017.Weill Cornell Medicine Brain and Spine Center.Symptoms of sacroiliac joint dysfunction.Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082MedlinePlus.Guide to good posture.Ricker MA, Haas WC.Anti-inflammatory diet in clinical practice: A review.Nutr Clin Pract.2017;32(3):318-25. doi:10.1177/0884533617700353Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV.Sacroiliac joint pain and its treatment.Clin Spine Surg.2016;29(2):42-48. doi:10.1097/BSD.0000000000000359Yale Medicine.Sacroiliac joint fusion.Buchanan P, Lee DW, Comer A, et al.Best practices for postoperative management of posterior sacroiliac joint fusion.J Pain Res. 2022;15:1149-1162. doi:10.2147/JPR.S357123Arthritis Foundation.Lower body stretches.Arthritis Foundation.Arthritis-friendly yoga.Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key.J Inflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494Weill Cornell Medicine Brain and Spine Center.Doctors who treat SI joint dysfunction.Weill Cornell Medicine Brain and Spine Center.Diagnosing and treating sacroiliac joint dysfunction.
Newman DP, Soto AT.Sacroiliac joint dysfunction: Diagnosis and treatment.Am. Fam Physician. 2022;105(3):239-245.
Spondylitis Association of America.Overview of ankylosing spondylitis.
Baronio M, Sadia H, Paolacci S, et al.Etiopathogenesis of sacroiliitis: Implications for assessment and management.Korean J Pain. 2020;33(4):294-304. doi:10.3344/kjp.2020.33.4.294
Falowski S, Sayed D, Pope J, et al.A review and algorithm in the diagnosis and treatment of sacroiliac joint pain.J Pain Res. 2020;13:3337-3348. doi:10.2147/JPR.S279390
Ziegeler K, Kreutzinger V, Diekhoff T, et al.Impact of age, sex, and joint form on degenerative lesions of the sacroiliac joints on CT in the normal population.Sci Rep. 2021;11(1):5903. doi:10.1038/s41598-021-85303-5
Guan F, Sun Y, Zhu L, et al.Risk factors of postoperative sacroiliac joint pain for posterior lumbar surgery: ≥2-year follow-up retrospective study.World Neurosurg. 2018;110:e546-e551. doi:10.1016/j.wneu.2017.11.053
Betts, JG, Wise J, Young KA, et al.The pelvic girdle and pelvis.Anatomy & Physiology.OpenStaxCollege, 2017.
Weill Cornell Medicine Brain and Spine Center.Symptoms of sacroiliac joint dysfunction.
Prather H, Bonnette M, Hunt D.Nonoperative treatment options for patients with sacroiliac joint pain.Int J Spine Surg. 2020;14(Suppl 1):35-40. doi:10.14444/6082
MedlinePlus.Guide to good posture.
Ricker MA, Haas WC.Anti-inflammatory diet in clinical practice: A review.Nutr Clin Pract.2017;32(3):318-25. doi:10.1177/0884533617700353
Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV.Sacroiliac joint pain and its treatment.Clin Spine Surg.2016;29(2):42-48. doi:10.1097/BSD.0000000000000359
Yale Medicine.Sacroiliac joint fusion.
Buchanan P, Lee DW, Comer A, et al.Best practices for postoperative management of posterior sacroiliac joint fusion.J Pain Res. 2022;15:1149-1162. doi:10.2147/JPR.S357123
Arthritis Foundation.Lower body stretches.
Arthritis Foundation.Arthritis-friendly yoga.
Slobodin G, Hussein H, Rosner I, Eshed I.Sacroiliitis - early diagnosis is key.J Inflamm Res. 2018;11:339-344. doi:10.2147/JIR.S149494
Weill Cornell Medicine Brain and Spine Center.Doctors who treat SI joint dysfunction.
Weill Cornell Medicine Brain and Spine Center.Diagnosing and treating sacroiliac joint dysfunction.
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