Understanding and Managing Sacroiliac Joint Pain

Sacroiliac joint (SI joint) pain is a common yet often misunderstood condition that can significantly impact one’s quality of life. The SI joint connects the spine to the pelvis and plays a crucial role in providing stability and absorbing shock during movement. When this joint becomes painful or dysfunctional, it can lead to discomfort, limited mobility and pain in the lower back, buttocks, and thighs. In this comprehensive guide, with the help of Orthopedic Spine Surgeon, Dr. Andres Munk, we will explore the causes, symptoms, diagnosis, and treatment options of SI joint pain.

A Little About Dr. Munk’s Experience: Dr. Munk has been a leader in SI joint treatment for over 10 years and ranks in the Top 5 in the country for most SI joint procedures performed.  

Causes of SI Joint Pain

SI joint problems can stem from a variety of reasons, affecting people of all ages and genders. Dr. Munk has treated patients as young as 20 and up to their 80’s for SI joint pain.

  • Trauma and Injury – Physical injuries, such as a fall, car accident, or sports-related trauma, can cause strain or damage to the SI joint, leading to pain and dysfunction.
  • Pregnancy – During pregnancy, hormonal changes and increased ligament laxity can affect the stability of the SI joint, resulting in pain. The additional weight and altered biomechanics also contribute to SI joint discomfort.
  • Degenerative Arthritis – Over time, wear and tear on the SI joint due to aging or arthritis can lead to the degeneration of the joint surfaces, causing pain and inflammation.
  • Other underlying health issues – other conditions like Ankylosing Spondylitis (inflammatory arthritis primarily affecting the spine) or leg length discrepancies can cause pain and dysfunction of the SI joint.

Symptoms of SI Joint Pain

About 30% of all lower back pain is actually SI joint pain. Identifying this condition can be challenging, as its symptoms can overlap with sciatica or other musculoskeletal conditions. Common signs include:

Lower Back Pain: The most common symptom of SI joint dysfunction is lower back pain, often concentrated on one side, radiating to the buttocks and the back of the thigh.

Hip and Leg Pain: SI joint pain can radiate to the hip region, mimicking other hip-related issues. Some individuals may experience pain that radiates into the groin or down the leg, resembling sciatica.

Pain when Sitting or Standing: Prolonged sitting or standing may exacerbate SI joint pain, making it challenging to find a comfortable position.

Difficulty Sleeping:  SI joint pain in the back and hips can often make it difficult for the sufferer to fall asleep.


Like any medical examination, the physician first talks with you about your medical history, lifestyle and performs a physical examination. Imaging, like X-rays, CT scans, and MRI may help visualize the SI joint and identify abnormalities, such as inflammation, arthritis, or structural issues. However, SI joint deterioration cannot always be diagnosed based on imaging. In this case, Dr. Munk likes to perform a diagnostic injection to confirm the condition. Generally, this is performed in an outpatient surgery center as a live x-ray machine is required to visualize this condition.

Management and Treatment

Dr. Munk starts with conservative treatment like PT, anti-inflammatory medications and SI belts/braces whenever possible to see if these basic measures will correct the issue. Physical therapy is used to strengthen the core and the muscles around the joint, while medication is used to not only minimize pain, but reduce inflammation. In some cases, a therapeutic steroid injection can also resolve the pain.

In his experience, most SI joint patients respond well to conservative treatment and will not go on to surgery. Generally, surgery is only considered when conservative measures are exhausted and when the pain has been persistent for at least six months. In this case, minimally invasive surgery is used to stabilize the joint. Surgery is never at the top of someone’s list and some patients decided they’d like to wait to undergo surgery, even after unsuccessfully completing physical therapy. The good news is this condition will not deteriorate to the point of no return. Dr. Munk is always able to correct the condition with surgery whenever the patient is ready.

Sacroiliac joint pain is a complex condition that requires a thorough understanding of its causes and effective management strategies. A personalized treatment plan involving a combination of conservative approaches and in some cases, surgical interventions, can significantly improve the quality of life for individuals suffering from SI joint pain.

If you suspect you have sacroiliac joint dysfunction, contact our Warren or Auburn Hills office to schedule an appointment with Dr. Munk today!

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