Sacroiliac Joint Pain

Sacroiliac joints

The sacroiliac joints are located in the pelvis between the sacrum and the ilium. The sacroiliac joints play a significant role in stress absorption and the general smooth operation of the lower spine, despite the fact that the movements of the joints themselves are restricted.


What is sacroiliac joint pain – Causes and symptoms

Sacroiliac joint pain is the pain that develops in the sacroiliac joints as a result of the inflammation that occurs there. The inflammation may be caused by the fusion of the involved bones over the years, due to arthritis, pregnancy, injury, or other factors.
It typically coexists with or is linked to conditions including chronic spinal inflammation, chronic back pain, localized muscle weakness, and hip joint inflammation.
Apart from the joints themselves, the rest of the pelvis may also experience pain. This condition makes it difficult for a person to perform daily tasks including walking, sitting, and standing. Due to increasing pain, sleep is frequently disturbed as well. Daily patient functionality is reduced and, therefore, Quality of Life is affected.


Relaxin – a hormone secreted during pregnancy – makes the sacroiliac joints more flexible so that the pelvis can expand during labor. Additionally, this hormone weakens the stability of the joints. Combined with the weight of the fetus and the gained weight of the expectant mother, this condition often leads to sacroiliac disease. Sacroiliac joint arthritis, a risk factor that rises with each subsequent pregnancy, is more likely in women who experience sacroiliac joint pain during pregnancy.

Sacroiliac Joint Pain and Pregnancy

Symptoms of sacroiliac joint pain

To some degree, every individual differs in how they experience sacroiliac joint pain symptoms. Some of the most common symptoms are:

  • Pain in the lower back
  • Pain in the buttocks, hips, and pelvis
  • Pain in the groin
  • Pain limited to only one of the sacroiliac joints
  • Increased pain when a person stands after sitting
  • Stiffness or burning sensation in the pelvis
  • Numbness
  • Weakness
  • Pain that spreads to the thighs and upper legs
  • Feeling that the legs are unable to support the body

Diagnosing problems in the sacroiliac joints

Diagnosing problems in the sacroiliac joints is not always a straightforward case. Imaging methods including X-ray, MRI, and CT scans frequently fail to identify joint problems. Furthermore, the symptoms manifested in such cases are very similar to symptoms of other conditions, such as sciatica, bulging disc, or hip arthritis.
To correctly diagnose problems in the sacroiliac joints, the following steps are usually followed:

An examination in which the patient is asked to move and stretch in specific ways in order to locate the source of the pain.

  • Injection of local anesthetic into the sacroiliac joint. If the pain resolves after a short period of time, it is very likely that the patient is facing a problem in their sacroiliac joints.
  • Imaging techniques, such as X-ray, MRI, and CT.


Treatment Options

Sacroiliac joint pain is often treated non-surgically, with an emphasis on reducing pain and inflammation while regaining normal joint motion.
Non-surgical treatment may include a therapeutic approach or a combination of the options below.

Conservative Management

  • Ice, heat, and rest. Initial treatment recommendations include the use of ice or cold packs applied for approximately 15-20 minutes, with the aim of treating inflammation and – combined with rest – reducing irritation. Patients may gradually resume their regular activities as soon as the inflammation begins to resolve. Heat therapy (such as a hot pad or hot bath) can speed up recovery, but not while a person is in excruciating pain.
  • Rehabilitation through physiotherapy and customized, specific activities
  • Pain killers and anti-inflammatory medication
  • Use of a pelvic sling to provide stabilization of the pelvic area, especially for pregnant women
  • Manual therapy and mobilization of the sacroiliac joint

Invasive Techniques

  • Corticosteroid and/or local anesthetic injections. This technique is recommended for more serious cases of sacroiliac joint pain and it should always be performed fluoroscopy- or ultrasound-guided (especially in pregnant women who must avoid radiation).
  • Radiofrequency denervation (neurolysis) of the sacroiliac joint is a minimally invasive technique for long-term pain relief.
  • Subcutaneous electrodes used for neurostimulation at the sacroiliac joint. Although not scientifically established, this technique is supported by some case reports in which it has been tried with satisfactory outcomes.