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The Importance of Proper SI Joint Pain Diagnosis and Treatment


By joining the base of the spine to the pelvis, the sacroiliac joint, or SI joint, is critical to connecting the upper body to the lower body. Because of this, the SI joint is also placed under tremendous stress and can be overloaded from repetitive motions or injury, resulting in SI joint pain.

Chronic SI joint pain can have a negative impact on your quality of life, affecting relationships, work and leisure activities and hobbies. To find relief, receiving a correct diagnosis for the source of your pain is particularly important for SI joint dysfunction. This is because SI joint pain can often mimic the symptoms of conditions that affect the lower spine, such as a herniated disc.

To help you learn more about diagnosing and treating SI joint pain, please take a moment to read the following information. The USA Spine Care team is committed to helping you find relief and we encourage you to reach out if you’d like to learn more about your treatment options.

Why SI joint pain is often mistaken for lower back pain

It is very easy for SI joint dysfunction to be misdiagnosed as a lower spine condition such as a herniated disc or facet joint arthritis. This is because the symptoms can be remarkably similar, including:

  • A dull ache or pain in the lower back
  • Shooting pains into the buttocks and hips
  • Leg pain that causes limping and muscle spasms

Correct diagnosis by finding the true source of pain can have a major impact on long-term prospects for pain relief. This is especially true when exploring options such as steroid injections or spine surgery. When seeking a diagnosis for the underlying source of pain, also consult with a qualified medical professional and never try to self-diagnose or treat a potential case of SI joint pain.

How do doctors diagnose SI joint pain? 

You should expect to receive a thorough diagnostic evaluation when reporting any symptoms that could potentially be related to SI joint pain. A doctor will typically first review your medical history and ask detailed questions about your specific symptoms and daily activities.

The next step should be a physical examination that includes hands-on movement tests. Evaluations that are often used to identify SI joint pain include:

  • Direct palpation, using targeted hands-on pressure on the SI joint to find painful areas
  • Distraction test, which is pressure applied to the front of the hips to see if it causes pain
  • Sacral thrust test, which is pressure applied to the back of the hips to see if it causes pain
  • FABER test, which is a specific bent-knee movement test that can produce a painful reaction in the SI joint

Additional diagnostic tests to identify SI joint dysfunction include SI joint injections, or nerve blocks, and diagnostic imagery such as an X-ray or MRI. A nerve block temporarily numbs the area believed to be the source of pain. If a patient experiences relief, then the physician can confirm that SI joint pain is the cause of problems. Diagnostic imagery can help to confirm the presence of SI joint dysfunction or rule out other causes.

Treatment for SI joint pain typically begins with conservative options

Most people with SI joint pain are able to find relief through nonsurgical therapies, such as periods of rest, hot/cold therapy, gentle stretches, over-the-counter medication and physical therapy. Steroid injections can help to relieve pain and inflammation for a period of weeks or longer.

Working with a physical therapist can be extremely helpful for SI joint dysfunction. A combination of manual therapy and therapeutic exercise can help to strengthen the joint and increase range of motion. A physical therapist can also help you improve your biomechanics to reduce stress and load on the SI joint.

Considering SI joint surgery 

Like other types of spine surgery, SI joint surgery usually becomes a serious consideration when weeks or months of conservative treatment has not delivered the relief necessary for a good quality of life. As described above, positively identifying SI dysfunction as the source of pain is critical to a procedure helping to deliver long-term relief.

Thanks to advances in the field of minimally invasive spine surgery, it is now possible to perform procedures such as an SI joint fusion on an outpatient basis without the need for overnight hospitalization, significant muscle disruption or a long recovery.

If you’d like to learn more about treatment options for SI joint pain, from physical therapy and SI joint injections to minimally invasive spine surgery, contact the caring team at USA Spine Care today. Our treatment professionals can help you create a highly personalized treatment plan that can help you overcome pain and dysfunction and get back to the healthy and active lifestyle you deserve.

Contact us today to learn more.

SI Joint Pain Quick Answers

What does SI joint pain feel like?

SI joint pain typically consists of aches, pains and stiffness in the lower back, hips, buttocks and even the legs. Because of this it can very often be misdiagnosed as a lower spine condition such as a herniated disc or arthritis. Although some basic treatments are similar, ensuring long-term relief is often dependent on getting a proper diagnosis.

How do you relieve SI joint pain?

SI joint pain is usually first treated with conservative therapies. This can include rest, over-the-counter medication, physical therapy and pain-relieving injections. If conservative treatments have been exhausted, spine surgery may become an option.

What aggravates SI joint pain?

Many everyday activities can put excess pressure on the SI joint, particularly those with repetitive motions that put rotational stress on this area. This includes raking or shoveling, running and lifting. People with a risk of SI joint pain should practice proper mechanics and take frequent breaks to rest the joint.

When do you consider spine surgery for SI joint pain?

SI joint surgery is typically seen as a treatment of last resort, but can offer relief if conservative therapies have been fully explored. To ensure a positive outcome, proper diagnosis of SI joint pain is critical to ensure that another condition is not the source of symptoms.

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