Sacroiliitis Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

Pain from the sacroiliac joints

Sacroiliitis is inflammation of one or both sacroiliac joints,[1] the two large joints at the base of the spine where it meets the pelvis. It typically causes pain in the low back or buttock, sometimes referring into the groin or the back of the thigh, and is often aggravated by prolonged standing, climbing stairs, or rising from a chair. Because the symptoms overlap with lumbar spine problems, SI joint pain is easy to misattribute. At IPC, a diagnostic SI joint injection under image guidance is used to confirm whether the joint is actually the pain generator; when it is, options range from therapeutic injections to radiofrequency ablation and, for joints that remain unstable, stabilization or fusion procedures.

Symptoms of sacroiliitis

• Pain in the low back or buttock, usually on one side, sometimes both
• Pain that refers into the groin or down the back of the thigh, typically not past the knee
• Worse with prolonged standing, climbing stairs, rising from a chair, or rolling over in bed
• Stiffness in the low back after sitting for a while
• Tenderness directly over the joint — a spot low and to one side of the spine, near the dimple of the pelvis

Noting which specific movements provoke the pain — stairs, standing from sitting, turning in bed — is useful history, because that pattern is part of what distinguishes the SI joint from the lumbar spine.

When to see a pain specialist about sacroiliitis

One-sided low back or buttock pain that has not settled after a few weeks of activity modification is a reasonable point to get it checked, especially if it follows the movement pattern above. The distinguishing test is a diagnostic SI joint injection under image guidance: numbing the joint and seeing whether the pain stops is the most direct way to confirm it as the source.

A hot, swollen, intensely painful joint with a fever needs same-day medical assessment — joint infection is uncommon but is treated urgently.

Treatment options for sacroiliitis

A diagnostic injection comes first: it establishes the joint as the source before anything longer-lasting is considered.

References

Clinical sources for this page.

1. Sacroiliitis. StatPearls [Internet], National Library of Medicine; updated August 8, 2023. Back to first citation ↑