The sacroiliac (SI) joints sit quietly at the base of your spine, connecting the sacrum (the triangular bone at the bottom of your spine) to the iliac bones of your pelvis. Even though they don’t move very much, they play a crucial role in how your body stands, walks, and absorbs forces from everyday activities.
When the SI joint becomes irritated or unstable, it can trigger sharp or aching low back pain, deep hip discomfort, or radiating symptoms that feel like they’re traveling into the buttocks, groin, or down the leg. Many people describe it as a nagging pain that makes walking, sitting, standing, or even rolling over in bed more difficult than it should be.
The good news is that with today’s modern diagnostics and minimally invasive treatments—like those offered at Medici Orthopaedics & Spine—SI joint dysfunction doesn’t have to be a lifelong burden. With the right evaluation and targeted care, meaningful and lasting relief is possible.
Understanding the Sacroiliac Joint
What the SI Joint Does
The SI joints may be small, but they do big work in your everyday movement:
- Connects the spine to the pelvis
Each SI joint forms a strong, weight-bearing link between your spine and your hips. - Transfers weight between the upper body and legs
Every time you walk, climb stairs, or stand up, forces pass through the SI joints as they help distribute load efficiently. - Supports stability during walking, bending, and standing
Unlike the more mobile hip or shoulder joints, the SI joints are designed to provide stability with only a small amount of motion—just enough to absorb shock and allow smooth movement.
What Sacroiliac Joint Dysfunction Means
“Sacroiliac joint dysfunction” is a broad term that simply means the SI joint is not working the way it should. That can look like:
- Inflammation or irritation within the joint
The cartilage and supporting ligaments become irritated, leading to pain and stiffness. - Too much or too little movement (hypermobility or hypomobility)
If the joint moves too freely, it can feel unstable; if it becomes too stiff, surrounding tissues are forced to compensate—either way, pain can result. - Pain patterns that mimic other conditions
SI joint pain often looks like other problems, such as sciatica, hip arthritis, or lumbar disc issues. This overlap is one reason it’s frequently overlooked or misdiagnosed.
Common Causes of SI Joint Dysfunction
Trauma or Injury
A sudden impact or unusual movement can overload the SI joint:
- Falls, sports injuries, or car accidents
Direct force through the pelvis or lower back can strain the joint and its supporting ligaments. - Sudden twisting or impact to the pelvis
Movements like pivoting awkwardly or absorbing a hard landing can trigger inflammation or instability.
Pregnancy and Postpartum Changes
Pregnancy places unique demands on the SI joints:
- Hormonal ligament relaxation
Hormones such as relaxin loosen ligaments to prepare for childbirth, which can reduce stability in the SI joints. - Pelvic instability from weight and posture changes
As the baby grows and posture shifts, more load is placed on the pelvis, sometimes leading to SI joint pain that can persist after delivery if not addressed.
Degenerative Joint Changes
Over time, normal wear can affect the SI joints just like other joints:
- Arthritis affecting the SI joint
Degenerative changes can irritate the joint surfaces and surrounding tissues, causing chronic discomfort. - Age-related wear contributing to stiffness or irritation
Years of load-bearing and small repetitive motions can lead to reduced mobility or persistent low back and pelvic pain.
Gait or Postural Imbalances
How you stand and move has a direct impact on the SI joints:
- Leg length discrepancies
Even a small difference in leg length can alter the way forces travel through the pelvis. - Flat feet or altered walking mechanics
Poor foot support, weak hips, or collapsed arches can cause the pelvis to tilt or rotate abnormally, stressing the SI joint over time.
Prior Spine Surgery
Changes made higher up in the spine can shift forces lower down:
- Fusion or structural changes altering load distribution
When parts of the spine are fused or stabilized surgically, more motion and force may be transferred to the SI joints, sometimes resulting in new or worsening pain in that area.
Modern Non-Surgical Treatments That Work
Physical Therapy and Stabilization Training
A strong and stable core-pelvic complex is essential for SI joint health. Physical therapy is often a first-line treatment and may include:
- Core strengthening
Strengthening the deep abdominal and back muscles helps support the spine and reduce excess strain on the SI joints. - Hip and glute activation
Targeted exercises to engage the gluteal muscles and hip stabilizers ensure that the pelvis moves correctly and shares load properly during walking, standing, and lifting. - Pelvic alignment and stability exercises
Corrective movements and stabilization drills help keep the SI joints in a more neutral, supported position, decreasing irritation over time.
Myofascial Release and Manual Therapy
Hands-on treatments can be extremely helpful for easing muscle tension and restoring natural movement in the SI region:
- Reduces muscle tension around the SI region
Tight muscles in the low back, hips, and pelvis can pull on the SI joint and worsen pain. Myofascial release and manual therapy help relax these tissues and reduce strain. - Improves mobility and restores balanced movement
Gentle joint mobilizations and soft tissue work can improve flexibility, alignment, and movement patterns, allowing the SI joint to function more smoothly.
These techniques often work best as part of a larger program that includes strengthening and stabilization.
Regenerative Medicine Solutions
For patients with persistent SI joint pain related to inflammation, ligament laxity, or degenerative changes, regenerative medicine can support the body’s own healing processes:
- PRP injections to calm inflammation and support healing
Platelet-rich plasma (PRP), prepared from your own blood, is concentrated with growth factors that can help reduce inflammation and promote tissue repair when injected into or around the SI joint. - Prolotherapy for ligament strengthening and joint stability
Prolotherapy uses a dextrose-based solution to stimulate a healing response in ligaments and supporting tissues. Over time, this can improve stability and reduce the micromovements that aggravate the joint.
These options are especially appealing for patients seeking non-surgical, drug-sparing approaches to pain relief.
Minimally Invasive Interventional Procedures
When pain is more severe or persistent, minimally invasive procedures can offer significant relief with little downtime:
- SI joint steroid injections
Steroid medication delivered directly into the SI joint can decrease inflammation and provide lasting pain reduction, often making it easier to participate in physical therapy. - Radiofrequency ablation to relieve nerve-mediated pain
Radiofrequency ablation (RFA) uses heat to gently disrupt pain-signaling nerve fibers around the SI joint. This can provide longer-term relief for patients who respond well to diagnostic or therapeutic injections.
These procedures are performed with image guidance for safety and precision.
Lifestyle Modifications
Small, strategic changes to the way you move and live can make a big difference in how your SI joint feels day to day:
- Posture adjustments
Improving sitting, standing, and lifting posture helps offload the SI joints and reduce strain over time. - Activity modifications
Adjusting how you perform certain tasks—such as bending, carrying, or repetitive motions—can help minimize aggravating forces on the joint. - Supportive bracing when appropriate
In some cases, a pelvic or SI belt can provide temporary external support, especially during flare-ups or physically demanding activities.
Restore Comfort, Stability, and Confidence
Sacroiliac joint dysfunction is often misunderstood and misdiagnosed, which means many people live with pain far longer than they need to. The reality is that with today’s modern diagnostics and minimally invasive treatment options, SI joint–related pelvic and low back pain is highly treatable. You don’t have to accept daily discomfort, stiffness, or pain that stops you from walking, sitting, working, or sleeping the way you want to.
At Medici Orthopaedics & Spine, our team focuses on finding the true source of your pain—not just masking symptoms. Through a combination of careful examination, targeted imaging, and advanced therapies, we create tailored treatment plans designed to restore comfort, stability, and confidence in your movement, using the least invasive, least drug-dependent options possible.
If you’re experiencing chronic low back, pelvic, or hip pain and suspect your SI joint may be involved, you don’t have to keep guessing. A personalized evaluation is the first step toward real relief.
Contact Medici Orthopaedics & Spine
📍 Ambulatory Surgery Centers
Marietta:
792 Church Street, Unit 101
Marietta, GA 30060
(470) 795-8398
Snellville:
2220 Wisteria Dr, Unit 100
Snellville, GA 30078
(470) 795-8398
📍 Clinics
Kennesaw:
2911 George Busbee Pkwy, Suite 50
Kennesaw, GA 30144
(770) 545-6404
Snellville:
2220 Wisteria Dr, Unit 101
Snellville, GA 30078
(470) 645-9297
Buckhead PM&R:
3200 Downwood Circle NW, Suite 520
Atlanta, GA 30327
(770) 872-7549
📞 Main Contact: +1-844-328-4624
🌐 Website: https://www.mediciortho.com/
