The sacroiliac joint is in the low back where the spine meets the pelvis. Sacroiliac joint pain is discomfort in this area. This pain is a symptom that may come from a number of conditions or diseases.
Copyright © Nucleus Medical Media, Inc.
Doctors may be unsure if the pain starts in the joint or in its surrounding ligaments. Ligaments are bands of tissue that connect one bone to another. It is also difficult to tell if the pain is coming from the sacroiliac joint or the small joints in the lower spine. These smaller joints are called facet joints.
The sacroiliac joint has many nerve endings. The nerves send pain signals to the brain. Pain in this region may be caused by many factors:
Twisting, bending, or moving in a way that triggers sacroiliac joint painInfection of the jointOsteoarthritis
of the joint (more common in older adults)
Trauma, such as auto accidents
Inflammation of the joint, such as with
Factors that increase your chance for sacroiliac joint pain include:
Poor postureWeak musclesBending or twisting the backImproper liftingAnkylosing spondylitisPsoriatic arthritis
Mild-to-severe low back painPain in the buttocksPain that seems deep in the pelvisPain in the hip or groin or back of the thighPain that radiates down the leg on the affected sideStiffness of the lower spine
Certain activities may increase the pain, including:
WalkingTwistingBendingStoopingRolling over in bedGetting up from a chairClimbing the stairsCoughingSneezing
The doctor will ask about your symptoms and medical history, and perform a physical exam. Finding the source of sacroiliac joint pain is often difficult. Tests depend on your medical history and the suspected cause.
Tests may include:
of the pelvis and lower back
Bone scan—an injection of radioactive material into the body, followed by scanning with a machine that will find areas with higher concentrations of the injected material (these are areas of abnormal bone activity)
CT scan—a type of x-ray that uses a computer to make pictures of the inside of the pelvis and sacroiliac joint
MRI scan—a test that uses a strong magnetic field and radio waves to make pictures of the sacroiliac joints and the ligaments
or aspiration—removal of a sample of tissue from the joint for testing
Joint injections or nerve blocks—injection of a drug that blocks nerve signals into the joint to determine if the pain starts in the joint
Treatment depends on the cause of the pain. Any underlying condition would receive treatment specific for that disease. For stress fractures, doctors recommend limited weight-bearing. Regardless of the cause, short-term rest is often advised.
Other treatment may include:
Your doctor may recommend or prescribe any of the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
Steroid injections into the sacroiliac jointAntibiotics for infected jointsRadiowave treatment of nerves around the joint—for severe pain that does not respond to other treatments
Physical therapy may include:
Exercises to stretch the muscles of the lower backExercises to strengthen the muscles which support the areaExercises to affect the motion of the sacroiliac jointApplying ice to the painful areaApplying deep heat to the sore area
Prevent stress to the painful area with the following:
Proper bendingProper liftingNo twisting of the body
Practicing good back care may help you avoid sacroiliac joint pain. This includes:
Exercise regularly to keep muscles strong.Maintain good posture.Use proper techniques for bending or lifting.
WC, Canale T.
Campbell's Operative Orthopaedics. 9th ed. Philadelphia, PA: Mosby, Inc.; 1998.
Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment.
d'Hemecourt PA, Gerbino PG II, et al. Pediatric and adolescent sports injuries: back injuries in the young athlete.
Clinics In Sports Medicine. 2000 Oct;19(4):663-679.
Dreyfuss P, Dreyer S, et al. Positive sacroiliac screening tests in asymptomatic adults.
Harrison TR, Braunwald E.
Harrison's Principles of Internal Medicine. 14th ed. Columbus, OH: The McGraw-Hill Companies; 2000.
Frontera: Essentials of Physical Medicine and Rehabilitation. 1st ed. Philadelphia, PA: Hanley and Belfus; 2002.
Ruddy S, Harris ED, et al.
Kelley's Textbook of Rheumatology. 6th ed. Philadelphia, PA: WB Saunders Co.; 2001.
Scopp JM, Moorman CT III. The assessment of athletic hip injury.
Clinics In Sports Medicine. 2001 Oct;20(4):647-659.
Speldewinde GC. Outcomes of percutaneous zygapophysial and sacroiliac joint
neurotomy in a community setting.
Pain Med. 2011;12(2):209-218.
Last reviewed [Under Medical Review] by Lawrence Frisch, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.