Sacroiliac Joint Syndrome

Lower Back Pain: What Is Sacroiliac Joint Syndrome?

The sacroiliac joint—often abbreviated as SIJ—is also known as the sacroiliac joint. Strictly speaking, there are two joints—one on the left and one on the right—each connecting the sacrum to the iliac bones. These joints transfer the weight of the upper body to the legs, provide shock absorption, and support movement. When pain occurs, specialists refer to it as sacroiliac joint syndrome. This is a functional disorder of the sacroiliac joint that typically manifests as one-sided pain in the lower back. Common causes of SIJ syndrome include sacroiliac joint blockage, sacroiliac joint osteoarthritis, and instability in the pelvic ring.

What is sacroiliac joint dysfunction?

An ISJ dysfunction is a temporary, usually unilateral dysfunction of the sacroiliac joint in which the joint surfaces between the sacrum and the pelvis become misaligned and the surrounding muscles spasm. This typically causes pain on one side below the spine, which can radiate across the buttock and down into the thigh.

Causes and Risk Factors for Sacroiliac Joint Pain

Sacroiliac joint pain can have various causes. For example, functional disorders such as sacroiliac joint dysfunction—triggered by improper loading, sudden movements, or poor posture.

Muscle shortening, for example in the hip flexor (iliopsoas muscle), can also disrupt joint mechanics. Additionally, osteoarthritis, inflammation in the sacroiliac joint, or bone fractures resulting from an accident or osteoporosis can be potential triggers.

Furthermore:

• Spinal misalignments such as scoliosis or a leg length discrepancy also lead to uneven stress. As a result, the pelvis tilts slightly forward on one side, placing excessive strain on the sacroiliac joint.
• During pregnancy, hormonal changes affect the ligaments of the pelvis—they soften to prepare for childbirth. This can cause the sacroiliac joint to become unstable and lead to pain. Pain may also occur in the pubic symphysis (symphysis pain).

Symptoms of sacroiliac joint syndrome

Diagnosis: How is sacroiliac joint syndrome diagnosed?

Doctors make the diagnosis through a physical examination and targeted functional tests. They check whether the pain is triggered by pressure on the joint, certain movements, or raising the legs. A sacroiliac joint (SI) joint dysfunction may be present. Imaging tests such as MRI or X-rays are not usually used, but they can help rule out other causes such as herniated discs or hip problems.

Therapy and Treatment Options for Sacroiliac Joint Syndrome and Sacroiliac Joint Block

In most cases, SI joint pain is treated conservatively, meaning without surgery. The goal is to relieve pain, restore mobility, and stabilize the joint.

Movement is a key component of treatment—patients should move as much as possible, even if they are experiencing pain.

Heat treatments—such as hot water bottles, heating pads, or warm baths—relax the muscles and can relieve acute pain. In addition, anti-inflammatory ointments can be applied to promote blood circulation and support healing. Anti-inflammatory medications such as ibuprofen or diclofenac can also be taken after consulting a doctor.

In some cases, a local anesthetic containing cortisone may be injected into the joint to reduce inflammation. However, this method is only used for severe and persistent symptoms. If there is no improvement within six weeks at the latest, surgery may be considered.

An SI joint lock can resolve spontaneously or through specific movements. Targeted exercises can help with this.

Exercises for Sacroiliac Joint Syndrome

Which doctor treats sacroiliac joint syndrome?

For sacroiliac joint syndrome (SIJ syndrome), the primary care physician’s office is usually the first point of contact. The goal is to assess the symptoms, rule out other causes, and, if necessary, refer the patient to an orthopedic specialist.

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