SI Joint Pain
Sacroiliac (SI) joint pain occurs when the joint connecting your spine to your pelvis becomes inflamed or dysfunctional. This condition can cause significant lower back and hip pain that affects daily activities.
Symptoms of SI Joint Pain
- Lower back pain - Usually one-sided, below the belt line
- Hip pain - Deep aching in the buttock area
- Groin pain - May radiate to the front of the hip
- Leg pain - Can extend down the back or side of the thigh
- Pain with sitting - Especially on the affected side
- Difficulty with stairs - Pain when climbing or descending
- Morning stiffness - Worse after periods of inactivity
- Pain with rolling in bed - Difficulty changing positions
Causes of SI Joint Pain
Arthritis
Degenerative changes in the SI joint cartilage leading to inflammation and pain, often age-related.
Pregnancy
Hormonal changes and increased joint mobility during pregnancy can stress the SI joint.
Trauma
Falls, motor vehicle accidents, or direct impact to the pelvis can damage the SI joint.
Previous Surgery
Lumbar fusion surgery can increase stress on the SI joint, leading to dysfunction.
Leg Length Discrepancy
Unequal leg lengths can create abnormal stress patterns on the SI joint.
Inflammatory Conditions
Conditions like ankylosing spondylitis can affect the SI joint.
Diagnosis
Physical Examination
Dr. Greenberg will perform specific provocative tests to stress the SI joint and reproduce your symptoms. These tests help differentiate SI joint pain from other sources of lower back pain.
Diagnostic Studies
- X-rays: Assess joint structure and rule out other conditions
- MRI: Detailed view of soft tissues and inflammation
- Diagnostic injection: Confirms SI joint as pain source
Why Greenberg Spine
Dr. Greenberg's fellowship training at Mayo • Hopkins • Brown provides expertise in advanced SI joint evaluation and minimally invasive fusion techniques using robotic precision.
- Comprehensive diagnostic approach
- Minimally invasive fusion options
- Robotic-assisted precision
Conservative Treatment
Physical Therapy
Strengthening exercises for core and hip muscles, along with stretching and stabilization techniques.
Medications
Anti-inflammatory medications, muscle relaxants, and pain relievers to manage symptoms.
SI Joint Injections
Steroid injections to reduce inflammation and provide diagnostic confirmation of the pain source.
When to Consider Surgery
Objective Surgical Criteria
SI joint fusion is considered when conservative treatments fail and the SI joint is confirmed as the primary pain source.
Clinical Indications
- Chronic pain for 6+ months
- Failure of conservative treatment
- Positive response to diagnostic injection
- Significant functional impairment
Surgical Goals
- Eliminate abnormal joint motion
- Reduce pain and inflammation
- Improve function and quality of life
- Maintain pelvic stability
Recovery Expectations
Recovery Timeline
First 2 Weeks
Limited activity, no bending or twisting, gradual increase in walking.
2-6 Weeks
Return to light activities, physical therapy begins, no lifting over 10 pounds.
6-12 Weeks
Gradual return to normal activities, continued strengthening exercises.
3-6 Months
Full fusion healing, return to all activities including sports.
What to Expect
Pain Relief
Most patients experience significant pain reduction within 6-12 weeks.
Improved Function
Daily activities become easier as the joint stabilizes and heals.
Long-term Stability
Successful fusion provides permanent stabilization of the SI joint.
Frequently Asked Questions
What causes SI joint pain?
SI joint pain can be caused by arthritis, pregnancy-related changes, trauma, leg length discrepancy, or previous lumbar fusion surgery that increases stress on the SI joint.
How is SI joint pain diagnosed?
Diagnosis involves physical examination with specific provocative tests, imaging studies, and often diagnostic SI joint injections to confirm the joint as the pain source.
What is SI joint fusion and when is it needed?
SI joint fusion is a minimally invasive procedure that stabilizes the sacroiliac joint with implants. It's considered when conservative treatments fail and the SI joint is confirmed as the pain source.
How long does recovery take after SI joint fusion?
Most patients can return to light activities in 2-4 weeks and full activities in 3-6 months. The fusion process typically takes 3-6 months to complete.
Can SI joint pain be treated without surgery?
Yes, non-surgical treatments include physical therapy, anti-inflammatory medications, SI joint injections, and activity modification. Surgery is reserved for cases where conservative treatment fails.
Related Conditions
Experiencing SI Joint Pain? Schedule a consultation with Dr. Marc Greenberg.
Get expert evaluation and learn about your treatment options.
This information is for educational purposes only and should not replace professional medical advice. Individual results may vary. Consult with Dr. Greenberg to determine the most appropriate treatment for your specific condition.