Sacroiliac (SI) Joint Pain

Reviewed by Dr. Kshitij Chaudhary, Spine Surgeon, P.D. Hinduja Hospital, Mumbai. Last reviewed June 2026.

What Is Sacroiliac Joint Pain?

The sacroiliac (SI) joints connect the base of the spine (the sacrum) to the pelvis, one on each side. They're supported by strong ligaments and normally allow very little movement, but they absorb significant shock during activities like walking, running, and standing. When these joints or their supporting ligaments are irritated or injured, the result is SI joint pain — a common but often under-recognized cause of lower back and buttock pain.

What Causes It?

• Arthritis affecting the joint
• Injury or trauma (a fall, or repetitive impact)
• Pregnancy — hormonal changes loosen the ligaments supporting the joint
• Previous spinal fusion surgery, which can place extra stress on the SI joints
• Sometimes, no clear cause is identified

Common Symptoms

• Pain in the lower back, buttock, hip, or groin — usually on one side
• Pain that worsens with standing, walking, or climbing stairs
• Pain when transitioning from sitting to standing
• Occasionally, numbness or tingling radiating into the leg, which can mimic sciatica

How Is It Diagnosed?

Diagnosis is based on a careful history and specific physical examination tests that stress the SI joint to reproduce the pain. Imaging (X-ray, CT, or MRI) is sometimes used, mainly to rule out other causes like a disc herniation. In some cases, a diagnostic injection — numbing the joint directly — is used both to confirm the diagnosis and provide temporary relief.

Treatment

Non-Surgical Care (effective for most patients)

• Activity modification
• Anti-inflammatory medication
• Physiotherapy targeting core and pelvic stability
• A supportive SI belt, particularly useful during pregnancy

Injections

A corticosteroid injection into the joint can provide longer-lasting relief and is sometimes also used to help confirm the diagnosis.

When Is Further Treatment Considered?

For the minority of patients with persistent pain despite these measures, options like radiofrequency ablation (to reduce pain signals from the joint) or, rarely, SI joint fusion surgery may be discussed.

Frequently Asked Questions

Is SI joint pain the same as sciatica?

Not the same, though it can feel similar and sometimes radiate down the leg. SI joint pain originates at the pelvis rather than from a compressed spinal nerve.

Can SI joint pain go away on its own?

Yes, particularly when related to a specific injury or pregnancy — many cases improve with simple measures over weeks to months.

Does pregnancy-related SI pain mean something is wrong?

No — it's a common, expected change due to hormonal loosening of the pelvic ligaments, and it typically improves after delivery.

When Should You Seek Medical Attention Urgently?

Seek prompt care if pain is accompanied by fever, difficulty walking, or new bladder/bowel symptoms, which could indicate a different, more serious cause.

About Dr. Kshitij Chaudhary

This page was written by Dr. Kshitij Chaudhary, a fellowship-trained spine surgeon at P.D. Hinduja Hospital, Mumbai, trained in complex spine surgery at Harvard Medical School (Beth Israel Deaconess) and the Twin Cities Spine Center, Minneapolis. Learn more about Dr. Chaudhary →

This information is for general education and does not replace a consultation with your doctor.