SI Joint Pain – What it is and how to manage pain

Sacroiliac (SI) joint pain is a highly specific type of pain that is commonly felt in the lower back or buttocks. This pain and discomfort can, however, radiate to the thighs, legs, or groin. This can make diagnosis difficult since other conditions may cause similar problems. Sacroiliac joint pain occurs when a person experiences inflammation in one or both of the sacroiliac joints, which are located at the point where the spine meets the pelvis. In many cases, SI joint pain can be managed with at-home care. If you are feeling similar symptoms in your lower back, be sure to get a proper diagnosis to determine if SI joint pain is the cause of your discomfort. 

The Sacroiliac joints

The sacroiliac joints, often called the SI joints, make up the main connection between the spine and the pelvis. Each joint is composed of two main parts. The first is the “sacrum,” or the triangular bone below the lumbar vertebrae. The second part is the combination of the two “innominates” on either side of the sacrum, which are the bones that make up the pelvis. This includes the ilium, the ischium, and the pubic bone. 

Similar to the meniscus, the SI joints help with shock absorption and weight distribution from the upper half of the body. They also help provide stability to the lower half of the body. These joints can become inflamed, and eventually lead to SI joint pain.

Symptoms of SI joint pain

If you are experiencing symptoms of SI joint pain, daily tasks may become uncomfortable or even painful. SI joint pain may occur on one or both sides, and create discomfort while performing a variety of daily functions. Walking, standing, sitting, climbing stairs, and sleeping can all cause SI joint pain. Sitting, sleeping on your side, or standing up in particular can be painful for individuals affected with SI joint pain. This is why it is important to diagnose and treat this condition early as possible. 

How common is SI joint pain?

It is not known how common SI joint pain occurs in the United States. It has been estimated, however, that approximately 15% of all patients who experience lower back pain are affected by SI joint pain. 

Causes of SI joint pain

Like most other forms of joint pain, SI joint pain is commonly associated with age. If a persons’s ligaments become too tight or too loose, the SI joint pain will become more prevalent. The most common causes of SI joint pain include: 

• Pregnancy and childbirth
• A bad fall
• Work or sports injury
• Car accidents
• Hip or spine surgery

Another common cause comes from existing osteoarthritis due to regular wear and tear. It is also possible that uneven movement may often trigger sacroiliac joint pain as a result of one leg being longer or weaker than the other. 

How is SI joint pain diagnosed

A medical examination is necessary in order to identify if the sacroiliac joints are the cause of pain in the hips, thighs, lower back, or other nearby areas. Undergoing X-rays, MRI scans, or a CT scan can help to identify if the sacroiliac joints or other issues are causing pain. 

If you are going to be tested for SI joint pain, your doctor will most likely start with a physical examination to determine if your spine is in proper alignment. You might either be asked to move into certain positions, or the doctor may apply pressure to different areas of your body. This may include direct pressure to the sacroiliac joint. If you respond “yes” to feeling pain during the majority of these tests, the sacroiliac joint may be the cause.

A steroid injection may also be used as a diagnostic test as well. If the sacroiliac joint is the cause of your pain, a steroid injection to the area can help to alleviate pain, which can reveal sacroiliac joint pain as the cause of your discomfort. 

Treatment Options

The most common form of treatment for SI joint pain is physical therapy (PT). This type of therapy helps to strengthen the muscles, which in turn improves stability and alleviates pain. With proper therapy those affected by SI joint pain are able to restore full range of motion and mitigate pain in the affected area. 

Medications like ibuprofen can also help in reducing the inflammation that can be responsible for pain.

If your SI joint pain has advanced to the point where it is too debilitating, there are surgical methods for treatment. Sacroiliac joint fusion is one such method of SI joint surgery, and this is a minimally invasive procedure. During SI joint fusion, special surgical tools drill holes into the sacrum and ilium and implants are placed which help to stabilize the joint. 

Surgery for SI joint pain requires several weeks of recovery. You will also need crutches for about five weeks after this surgery is performed. Although the SI joint surgery procedure may be completed in approximately one hour, the recovery period before you are able to return to normal activities may take anywhere from five-to-six months.

How to sit with SI Joint pain

When sitting down, you put a lot of tension on the ligaments that can lead to pain and irritation. When trying to sit, the goal is to reduce this pressure by keeping your hips at an even level. 

To keep your hips level while seated to help manage SI joint pain:

1. Sit with your chest raised
2. Relax your shoulders
3. Use a chair or seat that has some degree of lumbar support. 
4. Keep the weight evenly distributed on your buttocks. It should feel as though there is 

even contact with the seat you’re in. 

If you experience SI joint pain while sitting, try to avoid leaning, rotating, or twisting to one side. This causes uneven weight distribution, which can lead to additional discomfort if there is inflammation in the joint. 

Seated exercises for SI joint pain

While sitting, there are also certain exercises that you can perform in order to help mitigate or even alleviate pain or discomfort around the SI joint: 

Seated leg raise

Place your feet flat on the floor in front of you. Then, gently lift one foot off the floor and keep it elevated a few feet off the ground for 10-to-15 seconds. Place the foot back down and repeat with the other foot. 

Seated torso stretch

While seated, place both feet firmly on the ground. Place one hand on the back of the chair or armrest and rotate from the hips in that direction. Hold the position for about 30 seconds and then repeat with the other side. 

Thigh squeeze

Place an object – such as a pillow or ball – between your knees and squeeze the legs together gently and release. You should feel some tension in the inner thighs. Repeat this about 10-to-15 times. 

Schedule your appointment

If you are experiencing discomfort in your hip, thighs, or lower back, it may be as a result of sacroiliac joint pain. MSJ+Today can help diagnose and treat SI joint pain with our team of SI joint specialists. Call or schedule an appointment today.