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Commonly Overlooked, SI Joint Dysfunction May Be the Cause of Your Back Pain

March 18, 2021

Are you experiencing pain, numbness, tingling, or weakness in your lower back, pelvis, or hips? Leg instability? Disturbed sleep or sitting patterns due to pain? Or pain going from sitting to standing, and have not been able to find a solution? Sacroiliac (SI) joint dysfunction is a commonly overlooked source of pain for many individuals.

What is Sacroiliac Joint Dysfunction?

The SI joint is located in the pelvis, linking the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone). The joint is an essential component for shock absorption to prevent impact forces from reaching your spine.

Like any joint in the body, the SI joint can be injured or become degenerative. SI joint dysfunction can cause back pain that may either be localized in your lower back or radiate all the way down through your buttocks and legs. This pain can range from mild to severe and often shows up while lifting, running, walking, or even sleeping on the involved side.

Clinical publications have identified the SI joint as a pain generator in 15-30% of chronic lower back pain patients. In addition, the SI joint is a pain generator in up to 43% of patients with continued or new onset lower back pain after a lumbar fusion.

There are several causes of SI joint dysfunction, so it can be difficult to pinpoint the primary issue. However, most common causes include injury due to an accident, triggering of pregnancy hormones, degenerative diseases such as osteoarthritis, and an inflammatory arthritis that primarily affects the spine called ankylosing spondylitis.

Making a Diagnosis

According to scientific data, it’s common for pain from the SI joint to feel like disc or lower back pain. For this reason, SI joint disorders should always be considered in lower back pain diagnosis.

A variety of tests performed during a physical examination may help reveal the SI joint as the cause of your symptoms. Sometimes, X-rays, CT-scan or MRI may also be helpful in the diagnosis of SI joint-related problems.

The most relied upon method to accurately determine whether the SI joint is the cause of lower back pain symptoms is to inject the SI joint with a local anesthetic. The injection will be delivered under either X-ray or CT guidance to verify accurate placement of the needle in the SI joint. If symptoms are decreased by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to the lower back pain.


Once the SI joint is confirmed as the cause of symptoms, treatment can begin. Some patients respond to physical therapy, use of oral medications, or injection therapy. These treatments are often performed repetitively. If symptom improvement using these therapies only lasts temporarily, your surgeon may consider other options, including minimally invasive surgery.

If an SI joint fusion surgery is chosen as the next best course of action, Neurosurgeon Dr. Matthew T. Davies, MD is trained in the latest minimally invasive surgical technique, the iFuse Implant System from SI-Bone, Inc., which is proven to improve pain, patient function, and quality of life.

Join us on March 23 from 6-7 p.m. for a free patient educational webinar where Dr. Davies will discuss and review SI joint dysfunction. Click Here to Register