SI Joint

Sacroiliac Joint Pain Causes and Treatments

Do you have stiffness in the lower back when getting up after sitting for long periods of time or pain in the lower back and/or hip that radiates into groin area? If so, you may be experiencing Sacroiliac (SI) joint pain. There are two SI joints in your body, located on either side of the triangle-shaped bone at the bottom of your spine where it connects to your pelvis. The SI joints are a shock absorber for your spine and provide stability for your body as you run, walk, or jump. Interestingly, the SI joints usually don’t move more than 2 to 4 millimeters themselves. Each SI joint contains many nerve endings that can cause significant pain if the joint is damaged or loses its ability to move properly.  Screen Shot 2016-05-10 at 1.58.19 PM

Everyday wear and tear, arthritis, or a single injury can damage these joints, changing their normal movement and creating chronic and sometimes debilitating SI joint pain that often feels like generic low back pain.

Within the past couple of years, there has been resurgence in the recognition of the SI joint as a source of low back pain. In a recent study, Bernard & Kirkaldy-Willis found that the SI joint is a real, yet underappreciated pain generator in an estimated 15% to 25% of patients with low back pain.  Furthermore, 22.5% of patients with reported low back pain had SI Joint pain.

While it’s not clear how the pain is caused, it is widely considered by medical professionals that an alteration in the normal joint motion may be the culprit that causes sacroiliac pain. This source of pain can be caused by:

  • Too much movement (hypermobility or instability): The pain is typically felt in the lower back and/or hip and may radiate into groin area.
  • Too little movement (hypomobility or fixation): The pain is typically felt on one side of the low back or buttocks, and can radiate down the leg. The pain usually remains above the knee, but at times pain can extend to the ankle or foot. The pain is similar to sciatica, or pain that radiates down the sciatic nerve and is caused by a radiculopathy.

Othercauses of SI joint pain

  • Degenerative sacroilitis
  • Sacral disruption
  • Ankylosing spondylitis
  •  Post-traumatic SI Joint disruption
  • Leg length discrepancy
  • Structural pelvic asymmetry
  • Tumor (pituitary or metastatic)
  • Infection
  • Inflammation
  • Degenerative osteoarthritis
  • Ligamentous laxity (pregnancy)
  • Trauma Adjacent segment disease

Common symptoms of SI joint pain

  • Pain located on one side of lower back Pain radiating into the buttocks
  • Lower back and groin referred pain into the lower limbs (which can be mistaken for sciatica)
  • Difficulty turning over in bed,
  • Struggling to put on shoes and socks
  • Leg pain while getting in and out of car
  • Stiffness in the lower back when getting up after sitting for long periods
  • When getting up from bed Aching on one side of lower back when driving long distances


During a physical examination, the doctor may try to determine if the sacroiliac joint is the cause of pain through movement of the joint. If the movement recreates the patient’s pain, and no other cause of pain can explain the patient’s pain and symptoms such as a disc herniation on an MRI scan, the sacroiliac joint may be the cause of the pain.Screen Shot 2016-05-10 at 1.58.39 PM

There are several orthopedic tests that can be used in an attempt to reproduce the symptoms associated with sacroiliac joint dysfunction. As a rule, several positive tests that reproduce pain specifically located at the sacroiliac joint improve the probability of the diagnosis of sacroiliac joint dysfunction.


Sacroiliac joint fusion is a technique used to stabilize the SI joint. The majority of patients can be treated through physical therapy, anti-inflammatory medications, or SI joint injections. However, some will require surgical treatment when conservative therapies have not improved symptoms.

One surgical technique is The Silex SI joint fusion system, which is intended for SI joint disruptions. In the Silex system, implants are placed across the SI joint, which provides initial stabilization and can offer significant improvement in pain.Screen Shot 2016-05-10 at 1.59.01 PM

The device optionally incorporates a proprietary dual-pitch compression-thread design and titanium plasma coating to stabilize the SI Joint in fusion procedures.

For more information about how you can get relief for life from your recurring low back pain, contact us on (713) 461-8555 or email us at We also have a seminar coming up on May 21st, 2016 at the Briar Club, register online to secure your place today!