What is SI Joint Syndrome? 8 Things a Spine Specialist Says You Should Know

It can literally feel like a pain in the rear end. Sacroiliac joint syndrome, or SI joint syndrome, is a frequent culprit of low back pain, and may also create pain in the buttock region, groin and lower extremities.

The SI joint sits between the sacrum and the ilium where the base of the spine connects with the backbone and hip bones, and also absorbs shock. SI joint syndrome is not of the more common diagnoses that we see at OrthoCarolina, but is more common in women and is very treatable. If you suspect you may be dealing with an SI joint issue it is best to get it properly diagnosed so you can quickly begin a course of treatment to correct it.

Here are eight things to know about SI joint syndrome:

1. All of the weight of your upper body is transferred through the sacroiliac joints. They support your entire structure.

2. You really have two sacroiliac joints; one on each side of the spine that helps to support your body weight, particularly upper body weight.

3. Pain associated with SI joint syndrome is localized in the buttock. It is usually in a reproducible place, meaning it occurs in the same place over and over.

4. SI joint syndrome can also be associated with sciatica or leg pain. It can feel very similar to pain associated with disc herniation or low back diagnoses.

5. SI joint syndrome can happen as a result of overuse, physical trauma, tight or weak musculature, or even from pregnancy.

6. Working on core strength can help alleviate and prevent future SI joint pain.

7. Radiographs, CT scans and MRIs can help differentiate between low back and disc problems, as opposed to SI joint problems.

8. Patients typically undergo multiple injections to evaluate the true etiology and source of the pain as there can be coexisting problems, such as SI joint pain with disc herniation.

Once the SI joint has been confirmed as the root cause of the pain, treatment can be focused and targeted. Treatment can consist of physical therapy, injections, medications, pain patches and others. If non-operative management does not result in relief of symptoms, a minimally invasive sacroiliac joint fusion can be performed.

Todd “Matt” Chapman, MD is a spine surgeon with the OrthoCarolina Spine Center.