If you’re experiencing persistent pain in your lower back, hips, or buttocks, especially when sitting, standing, or climbing stairs, sacroiliitis may be the cause. This condition involves inflammation in one or both of the sacroiliac (SI) joints, which connect the lower spine to the pelvis. Though often overlooked, sacroiliitis can significantly impact mobility and quality of life if not properly addressed.
Understanding what causes sacroiliitis, how it presents, and what treatment options are available is the first step toward finding lasting relief.
Understanding Sacroiliac Joint Issues
Sacroiliitis is the inflammation of one or both SI joints—the joints that connect the base of your spine (the sacrum) to your pelvis. These joints play a vital role in stabilizing your body and absorbing shock between your upper body and legs. When inflamed, they can cause significant pain, stiffness, and reduced mobility.
Reports on the prevalence of sacroiliac joint pain vary, but some studies estimate that 10% to 25% of people with lower back pain[1] may have sacroiliac dysfunction as a contributing factor. Despite its impact, sacroiliitis is often underdiagnosed due to symptom overlap with other spinal or hip conditions. For some, the pain is dull and achy; for others, it can be sharp and debilitating, especially during daily movements.
Types of Sacroiliac Joint Issues
The type of sacroiliitis you have is often determined by how many joints are affected and the underlying cause. Recognizing whether one or both SI joints are involved can help guide diagnosis and treatment.
- Unilateral sacroiliitis: Involves inflammation in only one SI joint—typically causing pain on one side of the lower back or buttocks. This form is often linked to injury, uneven posture, or biomechanical stress.
- Bilateral sacroiliitis: Affects both SI joints and is more commonly associated with systemic inflammatory conditions like ankylosing spondylitis or other types of arthritis. Pain is usually felt on both sides and may be more widespread or persistent.
Recognizing Key Signs And Symptoms
Sacroiliitis can present with a variety of symptoms that may range from mild discomfort to more persistent, activity-limiting pain. Because the sacroiliac joints are located deep within the pelvis, symptoms are often mistaken for other types of back or hip problems. Recognizing the specific patterns and triggers of sacroiliitis-related pain is key to getting the right diagnosis and care.
Common symptoms include:
Joint Discomfort
Joint discomfort may stem from inflammation, wear, or injury, causing stiffness and limited mobility.
Read MoreRadiating Nerve Pain
Radiating nerve pain from compression or damage may cause tingling, weakness, or numbness in the limbs.
Read MorePain With Movement
Pain with movement may stem from joint, nerve, or muscle issues, making activity more difficult.
Read MoreLocalized Pain
Localized pain in one area may result from injury, inflammation, or nerve issues, impacting movement.
Read MoreChronic Back Pain
Chronic back pain may result from degeneration, nerve issues, or strain, impacting posture and mobility.
Read MoreLower Back Pain
Lower back pain may arise from strain, disc issues, or nerve compression, often limiting movement.
Read MoreButtock Pain
Buttock pain may result from sciatica, muscle strain, or joint issues, often limiting movement and comfort.
Read MoreChronic Leg Pain
Chronic leg pain may result from nerve, circulation, or joint issues, often affecting comfort and mobility.
Read MoreTingling And Numbness
Restricted range of motion may result from stiffness, inflammation, or damage, making movement difficult.
Read MoreMuscle Weakness
Muscle weakness may stem from nerve, muscle, or joint issues, making movement and activity more difficult.
Read MoreMuscle Spasms
Muscle spasms are sudden contractions from nerve issues, dehydration, or fatigue, causing pain and stiffness.
Read MoreDifficulty Standing Or Walking
Difficulty standing or walking may result from muscle, joint, or nerve issues, affecting daily mobility.
Read MoreFoot Drop
Foot drop is a symptom where lifting the front of the foot becomes difficult due to nerve or muscle dysfunction, leading to an altered gait.
Read MoreRestricted Range Of Motion
Difficulty moving the neck, back, or affected limbs due to pain or stiffness.
Read MoreCommon Triggers Of Sacroiliac Joint Pain
Sacroiliitis can develop from a variety of physical, inflammatory, and lifestyle-related factors. Understanding what may be triggering your sacroiliac joint pain is an important step in developing an effective treatment plan. Below are some of the most common contributors:
Injury Or Trauma
A fall, car accident, or sudden impact can damage the SI joint, leading to inflammation and instability. Even a seemingly minor incident can disrupt joint alignment and cause long-term discomfort if left untreated.
Inflammatory Conditions
Autoimmune disorders such as ankylosing spondylitis, psoriatic arthritis, or reactive arthritis can inflame the SI joints over time. These conditions often cause chronic inflammation that affects multiple joints, including the SI joint.
Repetitive Stress
Frequent bending, lifting, or twisting—especially with poor body mechanics—can strain the joints and lead to chronic irritation. Over time, this stress can wear down the joint and increase inflammation.
Pregnancy
Hormonal changes and added joint laxity during pregnancy can put extra pressure on the SI joints, often resulting in temporary or long-lasting pain. The shift in pelvic alignment can also contribute to instability in the joint.
Infections
Though rare, infections can spread to the sacroiliac joint and cause acute inflammation and pain. This can result from bacteria entering the bloodstream or following a surgical procedure.
Age
As we get older, natural wear and tear on the joints may increase the risk of sacroiliac dysfunction or inflammation. Degenerative changes in the cartilage can reduce joint cushioning and lead to irritation.
Poor Posture
Long-term sitting, standing unevenly, or improper lifting can cause imbalances that stress the SI joints. Over time, these habits can alter joint mechanics and contribute to chronic pain.
Obesity
Excess body weight can increase the mechanical load on the pelvis and lower back, placing additional strain on the SI joints. This added pressure may also worsen existing joint inflammation or instability.
Genetic Factors
Some people may have a genetic predisposition to inflammatory joint diseases or structural abnormalities that increase their risk of sacroiliitis. Conditions such as HLA-B27 positivity are associated with a higher likelihood of SI joint involvement.
How Doctors Pinpoint Sacroiliac Joint Issues
Diagnosing sacroiliitis can be challenging because its symptoms often mimic other conditions. To accurately identify the source of pain, providers use a combination of clinical evaluation and diagnostic tools:
- Physical exam: Your provider will check for tenderness, range of motion, and any pain during movement, especially around the lower back and pelvis.
- Medical history review: A detailed discussion about your symptoms, lifestyle, medical background, and any past injuries helps identify potential risk factors.
- Imaging tests: Diagnostic images are often used to look for joint inflammation, degeneration, or structural abnormalities such as X-ray, MRI (magnetic resonance imaging), and CT Scan (computed tomography).
- Blood tests: These may be ordered to check for markers of inflammation or autoimmune conditions that can contribute to sacroiliitis.
- Pain provocation tests: These involve applying controlled pressure or movement to the SI joint to see if pain is reproduced, helping to confirm the joint as the source of discomfort.
The Risks Of Ignoring SI Joint Pain
When sacroiliitis is left untreated, the inflammation can gradually worsen, leading to more persistent and widespread problems. What may start as mild discomfort can eventually progress to chronic pain and long-term joint damage. Early intervention is key to minimizing complications and preserving mobility.
Ignoring sacroiliac joint pain can increase the risk of:
- Reduced mobility and stiffness: Ongoing inflammation can limit joint movement, making it harder to bend, twist, or walk comfortably.
- Increased risk of disability: Severe or prolonged joint dysfunction may interfere with work, self-care, or other everyday responsibilities.
- Difficulty performing daily activities: Simple tasks like climbing stairs, sitting, or standing for long periods can become increasingly painful.
- Worsening inflammation: Without treatment, the inflammatory response can spread, leading to more tissue irritation and joint deterioration.
- Development of other conditions: Untreated sacroiliitis may contribute to the onset of related conditions such as sciatica, lumbar spine issues, or secondary arthritis, further complicating treatment and recovery.
We Provide Evidence-Based Treatments For Sacroiliitis
At Compass Pain and Wellness, we take a personalized, evidence-based approach to managing sacroiliitis. Our care plans are designed to reduce inflammation, ease discomfort, and improve function without defaulting to surgery. Depending on your needs, we may combine conventional therapies with advanced, minimally invasive procedures to create a balanced and effective treatment strategy.
Because no two patients experience sacroiliitis the same way, every care plan is tailored to your unique symptoms, lifestyle, and health goals. With expert guidance and thoughtful evaluation, our team helps you take meaningful steps toward relief, improved mobility, and better quality of life.
Treatment options may include:
Mindfulness and Meditation
Mindfulness and meditation help manage chronic pain by reducing stress and promoting emotional resilience.
Read MoreMassage
Massage therapy eases muscle tension and improves circulation to support pain relief and overall well-being.
Read MoreAcupuncture
Acupuncture stimulates targeted points on the body to reduce pain, support healing, and restore energy balance.
Read MoreChiropractic Care
Chiropractic care improves spinal alignment and joint function to reduce pain and enhance physical mobility.
Read MoreMedication Therapy
Medication therapy uses tailored prescriptions to reduce chronic pain and improve daily function and comfort.
Read MorePhysical Therapy
Physical therapy improves strength, flexibility, and mobility while addressing pain from injury or chronic conditions.
Read MoreJoint Injections
Joint injections deliver medication into affected joints to relieve inflammation and improve range of motion.
Read MorePeripheral Nerve Stimulation
Peripheral nerve stimulation sends mild electrical signals to disrupt chronic pain from damaged peripheral nerves.
Read MoreTrigger Point Injections
Trigger point injections treat muscle knots by relaxing tense tissue and relieving localized pain or stiffness.
Read MoreRadiofrequency Ablation
Radiofrequency ablation targets specific nerves to interrupt pain signals and provide lasting pain relief.
Read MoreSacroiliac Joint Fusion
SI joint fusion stabilizes the pelvis to relieve lower back or hip pain caused by joint dysfunction or instability.
Read MoreRelated Injuries You Need To Be Aware Of
Sacroiliac joint pain is often part of a broader picture, especially when triggered by trauma such as a car accident or fall. In many cases, other injuries may occur alongside or contribute to sacroiliitis. Being aware of these related conditions can help ensure a more accurate diagnosis and comprehensive treatment plan.
- Back injury from a car accident: Sudden impact can strain or damage the muscles, ligaments, and joints in the back—potentially triggering inflammation in the sacroiliac region.
- Spinal cord injury from a car accident: More severe trauma may affect the spinal cord or surrounding nerves, sometimes involving the sacroiliac joints or mimicking similar symptoms.
- Leg injury from an accident: Injuries to the leg can alter your gait or posture, placing uneven stress on the pelvis and SI joints over time.
Our Providers
Meet our experienced and compassionate team of doctors who specialize in helping you manage your condition. With a patient-centered approach, our doctors work to understand your unique needs and provide compassionate, personalized care. Trust our providers to guide you on your journey to better health and improved well-being.
Struggling with sacroiliitis pain? Find relief with our tailored treatments today.
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