Sacroiliac (SI) joint treatments are minimally invasive procedures used to diagnose and treat pain coming from the joint between the spine and pelvis. SI joint pain is a common but often overlooked cause of lower back pain.
Quick Facts:
- Common source of low back and pelvic pain
- Often mistaken for spine-related pain
- Diagnosed with targeted injections
- Usually treated without major surgery
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WHAT IS THE SI JOINT?
The sacroiliac (SI) joints connect:
- The base of the spine (sacrum)
- The pelvis (iliac bones)
These joints:
- Transfer weight between the upper body and legs
- Provide stability
- Allow limited movement
👉 Dysfunction of this joint can cause significant low back or pelvic pain
WHAT IS SI JOINT PAIN?
SI joint pain occurs when the joint becomes:
- Inflamed
- Irritated
- Mechanically dysfunctional
It can mimic other spine conditions, including:
- Disc herniation
- Facet joint pain
- Muscle strain
👉 Accurate diagnosis is essential because treatment differs from other causes of back pain
SYMPTOMS OF SI JOINT PAIN
Common Symptoms
- Pain in the lower back
- Pain over one side of the pelvis
- Pain near the buttock
Characteristic Pain Pattern
- Pain may radiate into the hip or upper leg
- Pain with standing, walking, or climbing stairs
- Pain when transitioning (sitting to standing)
Associated Symptoms
- Tenderness over the SI joint
- Difficulty with prolonged sitting or standing
What You Typically Do NOT See
- Significant numbness or weakness
- Classic nerve root pain below the knee
👉 If these are present, another diagnosis may be involved
HOW IS SI JOINT PAIN DIAGNOSED?
A. Clinical Evaluation
- Symptom history
- Physical exam with specific SI joint maneuvers
- Assessment of pain location
B. Diagnostic SI Joint Injection
- Local anesthetic is injected into the SI joint
- Temporary relief confirms the SI joint as the pain source
👉 This is the most reliable way to diagnose SI joint pain
TREATMENT OPTIONS
A. SI Joint Injections
- Steroid medication is injected into the joint
- Reduces inflammation and pain
👉 Often provides temporary relief and confirms diagnosis
B. Radiofrequency Ablation (RFA)
- Targets the nerves that supply the SI joint
- Interrupts pain signals
👉 May provide longer-lasting relief in selected patients
C. SI Joint Stabilization (Minimally Invasive)
- Considered in patients with persistent, confirmed SI joint pain
- Stabilizes the joint using minimally invasive techniques
👉 Typically reserved for patients who do not respond to other treatments
WHO BENEFITS FROM SI JOINT TREATMENTS?
These treatments are most effective for patients with:
- Localized low back or pelvic pain
- Pain near the SI joint
- Pain worsened by standing or transitions
- Symptoms confirmed by diagnostic injection
👉 Proper diagnosis is the key to success
WHAT TO EXPECT
Before the Procedure
- Evaluation and diagnosis
- Review of imaging
During the Procedure
- Performed outpatient
- Image-guided for accuracy
- Usually well tolerated
After the Procedure
- Short recovery time
- Gradual improvement in symptoms
ARE THESE TREATMENTS EFFECTIVE?
Potential Benefits
- Pain relief
- Improved mobility
- Reduced need for surgery
- Better diagnostic clarity
Important Considerations
- Relief may be temporary
- Some patients require repeat treatment
- Best results occur with accurate diagnosis
👉 These treatments work best when used appropriately and selectively
WHEN IS SURGERY CONSIDERED?
Surgery is rarely the first option.
It may be considered when:
- Pain is persistent and confirmed to be SI joint–related
- Conservative treatments have failed
- Symptoms significantly affect function
👉 Even then, minimally invasive options are typically used
OUR APPROACH
We focus on identifying SI joint pain accurately and treating it appropriately.
- SI joint pain is commonly missed or misdiagnosed
- We use targeted injections to confirm the diagnosis
- Treatments are tailored to the individual
- Surgery is reserved for clearly defined cases
👉 The goal is to treat the correct pain source with the least invasive effective option
OUTCOMES & RISKS
Outcomes
- Many patients experience meaningful relief
- Improved function and mobility
- Reduced need for more invasive procedures
Risks
- Temporary soreness
- Incomplete pain relief
- Rare procedural complications
👉 Risks are generally low when performed appropriately
FREQUENTLY ASKED QUESTIONS
How do I know if my pain is from the SI joint?
Diagnostic injections help confirm this.
Is this the same as a spine problem?
No, but symptoms can overlap.
How long does relief last?
This varies depending on the treatment.
Will I need surgery?
Most patients do not require surgery.
FOR REFERRING PHYSICIANS
- Refer patients with:
- Suspected SI joint–mediated pain
- Persistent low back or pelvic pain
- Unclear source of symptoms
- Consider:
- Diagnostic SI joint injection
- RFA for confirmed cases
- Stabilization in refractory cases
RELATED CONDITIONS / PROCEDURES
- Facet Joint Treatments
- Lumbar Disc Herniation
- Lumbar Arthritis
- Vertebral Body Pain
- Non-Surgical Treatment Options