The sacroiliac (SI) joint connects the sacrum (tailbone) to the iliac bones of the pelvis. It plays a crucial role in supporting the upper body, absorbing shock, and maintaining stability. Although small, this joint can become a source of chronic pain due to dysfunction, leading to discomfort in the lower back, buttocks, and legs.

Symptoms of Sacroiliac Joint Dysfunction

SI joint dysfunction can often be mistaken for sciatica or other lower back conditions. Common symptoms include:

• Pain in the lower back, buttocks, or thighs, sometimes radiating down the leg.
• Discomfort on one side of the lower back.
• Stiffness in the hips and lower back, especially after waking up.
• Increased pain while sitting, rolling in bed, or changing positions.

This condition is more common in young and middle-aged women due to hormonal changes and pregnancy-related ligament laxity.

Causes of Sacroiliac Joint Dysfunction

SI joint dysfunction occurs when the joint moves too much (hypermobility) or too little (hypomobility). Some common causes include:

• Hypermobility (Excessive Movement): Often seen in pregnancy due to hormonal changes, leading to joint instability.
• Hypomobility (Restricted Movement): Can result from arthritis, aging, or pelvic fractures, causing stiffness and pain.
• Inflammatory Conditions: Conditions like sacroiliitis and degenerative joint diseases can lead to SI joint dysfunction.
• Injury or Trauma: Falls, accidents, or repetitive strain can impact the joint’s function.

Diagnosing Sacroiliac Joint Dysfunction

Since SI joint dysfunction mimics other lower back conditions, proper diagnosis is essential. A doctor may perform:

• Physical Examination: Checking pain points, range of motion, and posture.
• Diagnostic Injections: A numbing injection (lidocaine) into the joint can confirm the diagnosis if pain relief occurs.
• Imaging Tests: X-rays, CT scans, or MRIs help rule out other conditions like herniated discs.

Additionally, piriformis syndrome, a condition affecting the muscle near the SI joint, can cause similar symptoms and may need evaluation.

Best Treatments for Sacroiliac Joint Pain1. Ice, Heat, and Rest

Applying an ice pack for 15-20 minutes helps reduce inflammation in acute pain. After a few days, heat therapy can relax tight muscles. Avoid excessive movement during the healing phase.

2. Medications

• NSAIDs (like ibuprofen) help with pain and inflammation.
• Acetaminophen can be used if NSAIDs cause stomach irritation.

3. Advanced Physiotherapy

A specialized physiotherapist can provide:

• Myofascial Release & Soft Tissue Therapy
• IASTM (Instrument-Assisted Soft Tissue Mobilization)
• Dry Needling & Kinesiology Taping
• Laser & Shockwave Therapy
• Manual Therapy Techniques like joint mobilization and manipulation

4. Support Braces or SI Belts

For hypermobility, wearing a sacroiliac belt can help stabilize the joint and reduce pain.

5. Physical Therapy & Exercise

Gentle exercises strengthen supporting muscles, preventing excessive joint movement. Water therapy and low-impact aerobics improve mobility and stability.

6. SI Joint Injections

Corticosteroid or lidocaine injections reduce pain and inflammation, allowing patients to engage in physical therapy with less discomfort.

7. Stem Cell Regeneration (Experimental Treatment)

Stem cell therapy aims to regenerate damaged joint tissues. This procedure, often performed with CT guidance, shows promising results but requires further research.

8. SI Joint Fusion Surgery (Last Resort)

If other treatments fail, minimally invasive SI joint fusion surgery may be recommended. It involves inserting screws and bone grafts to stabilize the joint, reducing pain.

Final Thoughts

Sacroiliac joint dysfunction is a common yet often overlooked cause of lower back pain. With proper diagnosis and treatment, most people can manage their symptoms effectively. Whether through physiotherapy, injections, or lifestyle changes, finding the right approach can help restore movement and relieve discomfort. If you suspect SI joint dysfunction, consult a specialist for a personalized treatment plan.