Sacroiliac Joint Pain: Causes, Symptoms, and Surgical Solutions

The sacroiliac (SI) joints form the critical bridge between your spine and pelvis. Though small in size, they play a significant role in stabilizing your body during walking, standing, and lifting. When one or both of these joints become inflamed or dysfunctional, the result can be significant (and often misdiagnosed) pain in the lower back, buttocks, or hip.

At ADR Spine, Dr. Todd Lanman and his team bring decades of expertise in diagnosing and treating complex spine conditions. This guide explores what causes SI joint pain, how to recognize its symptoms, and which advanced surgical solutions may offer long-term relief.

Understanding the Sacroiliac Joint

What Is the Sacroiliac (SI) Joint?

The SI joints are located where the sacrum (the triangular bone at the base of the spine) meets the iliac bones (part of the pelvis). These joints help absorb shock between the upper and lower body, playing a vital role in distributing forces during motion.

How the SI Joint Supports Spinal Function

When functioning correctly, SI joints allow just enough movement to support walking, standing, and bending without instability. Dysfunction in these joints can cause pain, limited mobility, and postural changes that affect other areas of the spine.

The Link Between SI Joint Dysfunction and Lower Back Pain

Studies estimate that SI joint dysfunction is responsible for 15–25% of chronic lower back pain cases, yet it is often mistaken for lumbar disc or nerve issues. This overlap can delay effective treatment and prolong patient discomfort.

Causes of Sacroiliac Joint Pain

Degeneration and Wear-and-Tear

As we age, the cartilage that cushions the SI joints can wear down, leading to inflammation, stiffness, and discomfort.

Trauma or Injury

Falls, motor vehicle accidents, or sports injuries can disrupt SI joint cartilage or damage surrounding ligaments.

Post-Surgical Changes

Patients who have undergone lumbar fusion are at higher risk for SI joint pain due to increased mechanical stress on adjacent joints.

Inflammatory or Autoimmune Conditions

Arthritis-related diseases such as ankylosing spondylitis can inflame the SI joints and contribute to chronic pain.

Pregnancy and Hormonal Shifts

Pregnancy causes ligaments in the pelvis to loosen, which may lead to joint instability and post-partum SI dysfunction.

Common Symptoms of Sacroiliac Joint Pain

• Localized Pain: Usually felt on one side, near the lower back dimple, and may radiate into the hip or groin.
• Pain That Mimics Sciatica: Sharp or burning pain down one leg, often confused with nerve compression from a herniated disc.
• Stiffness and Difficulty Sitting or Standing: Symptoms may worsen with prolonged sitting, stair climbing, or transitioning from a seated to a standing position.
• Limited Mobility and Gait Changes: Patients may favor one side, leading to an uneven walking pattern or avoidance of twisting motions.

Diagnosing Sacroiliac Joint Pain

A proper diagnosis is key to ruling out other spinal or hip-related conditions.

Clinical Examination

Specific physical tests, such as the FABER and Gaenslen maneuvers, can help isolate the SI joint as the source of pain.

Imaging Studies

X-rays, CT scans, or MRIs may reveal joint degeneration, asymmetry, or inflammation.

Diagnostic Injections

Targeted injections into the SI joint can confirm the diagnosis if they provide temporary pain relief.

Treatment Options for Sacroiliac Joint Pain

Non-Surgical Management

• Physical therapy to strengthen core and pelvic muscles
• Anti-inflammatory medications or muscle relaxants
• Corticosteroid or platelet-rich plasma (PRP) injections
• Radiofrequency ablation to disrupt pain signals

When Surgery Becomes Necessary

If conservative measures fail to provide lasting relief, surgical stabilization may be the next step.

Surgical Solutions for SI Joint Pain

SI Joint Fusion Surgery

Dr. Lanman does not recommend. This minimally invasive procedure involves inserting implants to fuse the sacrum to the ilium, limiting painful joint motion. When performed by experienced surgeons, SI joint fusion has consistently demonstrated decent outcomes in terms of pain relief and functional improvement if done in certain conditions.

Motion-Preserving Approaches and Adjacent Segment Care

Dr. Lanman’s comprehensive 4D Health™ philosophy considers the entire spinal chain. For patients who developed SI joint dysfunction after lumbar fusion, motion-preserving procedures such as artificial disc replacement (ADR) at adjacent levels may help prevent overload and maintain mobility elsewhere in the spine.

Recovery and Long-Term Outlook

Post-Surgical Recovery

Patients typically return home the same day or after an overnight stay. Physical therapy begins early, focusing on restoring strength, flexibility, and gait.

Long-Term Results

Some studies have shown high rates of pain relief and satisfaction following SI joint fusion, especially when combined with a personalized rehabilitation program.

Preventing Recurrence

Maintaining strong core muscles, avoiding high-impact activities, and managing weight can reduce long-term joint stress and prevent future dysfunction.

Why Choose ADR Spine for SI Joint Pain

• Deep expertise in both surgical and non-surgical spine and pelvic conditions
• Focus on motion-preserving techniques and long-term spinal wellness
• Dr. Lanman’s internationally recognized leadership in spinal surgery and innovation
• Comprehensive 4D Health™ approach, addressing spinal alignment, biomechanics, and overall health

FAQs: Sacroiliac Joint Pain

How can I tell if my pain is from my SI joint or my lower back?
A physical exam, diagnostic injections, and imaging can help differentiate between the two.

What causes SI joint pain after a spinal fusion?
Lumbar fusion alters the mechanics of the lower spine, increasing stress on the SI joints.

Can SI joint pain go away without surgery?
Yes, many patients find relief with conservative care. Surgery is only recommended if symptoms persist or worsen.

What is recovery like after SI joint fusion?
Most patients resume light activity within weeks and experience significant improvement in pain and function over the next few months.

How does ADR Spine treat patients with both lumbar and SI joint issues?
Dr. Lanman evaluates the entire spine and tailors treatment plans to maintain mobility and prevent further degeneration, often combining ADR with SI joint stabilization if needed.

Find Relief from Sacroiliac Joint Pain

If you’re experiencing persistent lower back, hip, or pelvic pain, don’t ignore the possibility of SI joint dysfunction. The team at ADR Spine can help you find clarity and relief through advanced diagnostics and motion-preserving treatment strategies.

Schedule a consultation today at one of our locations to begin your personalized path to healing.