What Is Sacroiliac Joint Pain?

Sacroiliac joint pain occurs where the sacrum meets the ilium, the two bones that form the pelvis. It can result from various factors, including lifting heavy objects, poor posture, overactivity or injury. Commonly referred to as SI joint pain, this condition is characterized by discomfort in and around the lower back or buttocks.

Types of Sacroiliac Joint Pain

Sacroiliac (SI) joint pain is classified as either inflammatory or noninflammatory. Your doctor will further diagnose your condition based on the cause:

  • Arthritis: results from wear and tear (osteoarthritis) in the joint
  • Biomechanical issues: posture-related, often associated with leg-length discrepancies, scoliosis or poor posture
  • Pregnancy-related SI joint pain: results from a combination of pregnancy-related weight gain and hormonal changes
  • Sacroiliitis: triggered by autoimmune diseases, infection, trauma and osteoarthritis
  • SI joint dysfunction: can result from too much or too little movement

Causes of Sacroiliac Joint Pain

Sacroiliac joint pain can result from various factors, including poor posture, excessive activity or injury. It may also be linked to other conditions, such as spondylolisthesis, degenerative disc disease or osteoarthritis. In addition to these underlying causes, prolonged standing or repetitive activities may worsen SI joint pain.

Risk Factors for Sacroiliac Joint Pain

The highest risk factors for developing SI joint pain are pregnancy, inflammatory arthritis, previous injuries and different leg lengths. Other factors include: 

  • Carrying extra weight/obesity
  • Gait problems
  • Infection near the joint
  • Overuse injuries
  • Sedentary lifestyle

Screening for & Preventing Sacroiliac Joint Pain

Preventing SI joint pain begins with proper sitting and standing posture, regular, low-impact exercise and maintaining a healthy weight. Incorporating resistance training and strengthening your core and gluteal strength also helps stabilize the SI joint.

Signs & Symptoms of Sacroiliac Joint Pain

SI joint pain can be a sharp, burning sensation in the lower back due to sacroiliac joint inflammation. Other symptoms may include stiffness, tingling and shooting pains down the legs. Sometimes, it can lead to difficulties with standing, bending forward and turning.

Diagnosing Sacroiliac Joint Pain

Diagnosing SI joint pain depends on the severity and duration of the symptoms. Your doctor will usually inquire about your medical history and conduct a physical exam to evaluate the affected area. Imaging tests like X-rays, magnetic resonance imaging (MRI) scans and computed tomography (CT) scans may be suggested to exclude other conditions or injuries.

Treating Sacroiliac Joint Pain

In addition to an individualized at-home exercise program, the experts at the Montefiore Einstein Department of Physical Medicine and Rehabilitation may recommend these steps for the first few days or weeks after your injury or when starting treatment for SI joint pain:

  • Rest. Keep activity to a minimum and stop movements or activities that worsen the pain.
  • Physical therapy
  • Ultrasound or X-ray-guided cortisone injections
  • Ice your lower back or upper buttocks for about 20 minutes two to three times a day. Do not apply ice directly to the skin.
  • Use a heating pad on the low setting to help loosen tight muscles and relieve soreness.
  • Massage the muscles in the lower back, buttocks and thighs.

Living with Sacroiliac Joint Pain

Keep strenuous activity to a minimum. The more time the injury has to rest, the better. A sacroiliac belt or lumbar brace can provide support during activity. Physical therapy is an essential part of the healing process. It will help relieve pain and increase strength. Work with your provider to develop an at-home exercise plan that can help alleviate pain.