Sacroiliac Joint Dysfunction Treatment in Castle Rock
What is Sacroiliac Joint Dysfunction?
Sacroiliac (SI) joint dysfunction is a condition in which the SI joint - the large joint where the lower spine connects to the pelvis - becomes a source of pain. The SI joints are weight-bearing joints that absorb force during walking, running, and bending. When they become inflamed, arthritic, or mechanically dysfunctional, they can cause pain in the lower back, buttock, hip, and sometimes the upper leg.
SI joint dysfunction is one of the most commonly overlooked causes of low back pain. Studies estimate that the SI joint is responsible for 15 to 30% of chronic low back pain cases. It is especially common after lumbar spine surgery (particularly fusion), in patients with leg-length differences, in women during or after pregnancy, and in patients with spondylolisthesis.
What Does SI Joint Pain Feel Like?
Pain in the lower back and buttock, usually on one side
Pain that is worse with prolonged sitting or when transitioning from sitting to standing
Pain going up stairs, getting in and out of a car, or rolling over in bed
Pain that radiates into the upper thigh or groin (but typically not below the knee)
Stiffness in the lower back and hips in the morning or after inactivity
How is SI Joint Pain Different from Other Causes of Low Back Pain?
SI joint pain is frequently confused with lumbar spine problems (like disc herniations, facet arthritis, or sciatica) because the pain location overlaps. The key differences are:
SI joint pain is typically centered in the buttock and lower back, worse with position changes, and does not radiate below the knee.
Sciatica radiates down the leg, often below the knee, following a specific nerve pattern.
Facet joint pain is worse with extension (leaning back) and twisting.
Hip bursitis causes pain on the outside of the hip, not the buttock.
Dr. Carrera's team uses specific physical exam maneuvers (provocative tests) to stress the SI joint and reproduce your pain. If the exam is suspicious, a diagnostic SI joint injection confirms whether the joint is the source.
What Causes SI Joint Dysfunction?
Arthritis: Osteoarthritis or degenerative changes in the SI joint, common with aging.
Post-surgical changes: Lumbar fusion alters spine mechanics and places increased stress on the SI joints. SI joint pain after fusion is very common.
Pregnancy and postpartum: Hormonal changes during pregnancy loosen the ligaments around the SI joint. Combined with the mechanical stress of carrying a baby, this can cause persistent SI joint pain.
Leg-length discrepancy: Uneven leg lengths place asymmetric stress on the SI joints.
Trauma: Falls, car accidents, or other injuries can damage the SI joint or its ligaments.
Inflammatory conditions: Ankylosing spondylitis and related conditions can cause SI joint inflammation (sacroiliitis).
How is SI Joint Dysfunction Treated?
Physical therapy: SI joint stabilization exercises strengthen the muscles and ligaments that support the joint. An SI belt (a supportive belt worn around the hips) may help during physical activity.
SI joint injection: A sacroiliac joint injection delivers steroid medication directly into the joint to reduce inflammation. It also serves as a diagnostic test - if the injection significantly reduces your pain, it confirms the SI joint as the source.
SI joint radiofrequency ablation: For patients with confirmed SI joint pain that responds to injections but does not last long enough, radiofrequency ablation of the lateral branch nerves that supply the SI joint can provide 6 to 12 months or more of relief.
PRP: Platelet-rich plasma injections into the SI joint are available as a steroid-free alternative.
Medications: Anti-inflammatory medications (NSAIDs) can help during flares.
Schedule an Evaluation
If you have low back or buttock pain that has not responded to treatment for lumbar spine conditions, the SI joint may be the overlooked source. Dr. Carrera's team can evaluate your symptoms and determine whether a diagnostic SI joint injection is the right next step.