What is Sacroiliac Joint Pain?

The SI joints are located between the iliac bones and the sacrum, connecting the spine to the hips. The two joints provide support and stability, and play a major role in absorbing impact when walking and lifting. From the back, the SI joints are located below the waist where two dimples are visible. Ligaments that are tough bands of connective tissue and hold the joint together.

 What causes Sacroiliac Joint Syndrome?

Many problems can cause degenerative arthritis of the SI joints. One of the most common causes is an injury. The injury can come from a direct fall on the buttocks, a motor vehicle accident, or even a blow to the side of your pelvis. The force from these injuries can strain the ligaments around the joint. Tearing of these ligaments can lead to too much motion in the joint. The excess motion can lead to wear and tear of the joint and pain from degenerative arthritis. Injuries can also cause direct injury of the cartilage lining the surfaces of the joint. 


Women are at special risk for developing SI joint problems later in life due to childbirth. Female hormones are released during pregnancy that allow the connective tissues in the body to relax. The relaxation is needed so the pelvis can stretch enough to allow the baby to be born. This stretching causes changes to the SI joints, making them extra or overly mobile. Over a period of years these changes can lead to wear-and-tear arthritis. During pregnancy, the SI joints can cause discomfort both from the effects of the hormones that loosen them and from the stress of the growing baby. The more pregnancies a woman has, the more chance she has of developing SI joint problems.

What are the symptoms of Sacroiliac Joint Syndrome?

Symptoms of SI joint syndrome are often hard to distinguish from other types of low back pain. In most cases, there is a confusing pattern of back and pelvic pain that mimic each other, making diagnosis of SI joint syndrome very difficult. The most common symptoms of SI joint syndrome include:

  • Low back pain
  • Buttock pain
  • Thigh pain
  • Difficulty sitting in one place for too long due to pain


  • Patient education. Your physical therapist will work with you to identify and change any outside factors causing your pain. The type and amount of exercises you perform, your athletic activities, or your footwear may be discussed. He or she will suggest improvements to your daily activities.
  • Pain management. Your physical therapist will develop a treatment plan to address your pain. Your physical therapist may recommend decreasing some activities that cause pain. Physical therapists are experts in prescribing pain-management techniques that reduce or eliminate the need for medicine, including addictive opioids.
  • Body mechanics. How you use your body for daily work and other activities can contribute to your SIJ dysfunction and pain. Your physical therapist will teach you ways to improve your unique movement. He or she may help you improve the way you sit, lift, or carry objects.
  • Functional training. Once pain and strength return back to normal, you will need to safely transition back to your full sport and/or daily activity levels. To reduce the stress and tension on the sacroiliac joint, you will need to learn safe, controlled movements. This training also will reduce your risk of repeated injury. Your physical therapist will teach you how touse and move your body correctly based on your unique physical condition. 

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