Sacroiliac Joint Pain: Signs You Might Be Overlooking

Lower back pain is one of the most common reasons people seek medical care. But what many patients don’t realize is that the pain may not actually be coming from the spine itself. In some cases, the true source is the sacroiliac (SI) joint — a structure that often goes undiagnosed.

Understanding sacroiliac joint pain and its subtle symptoms can help you get the right treatment sooner and avoid prolonged discomfort.

What Is the Sacroiliac Joint?

The sacroiliac joints connect the sacrum (the triangular bone at the base of the spine) to the ilium bones of the pelvis. You have one on each side of your lower back.

Although these joints move only slightly, they play a critical role in:

• Transferring weight between the upper body and legs
• Stabilizing the pelvis
• Absorbing shock during walking, standing, and lifting

When the SI joint becomes inflamed, irritated, or unstable, it can cause significant pain.

Common Signs of Sacroiliac Joint Pain

Because SI joint pain often mimics other conditions — such as a herniated disc or sciatica — it’s frequently overlooked. Here are some signs that may suggest your pain is coming from the sacroiliac joint:

1. Pain on One Side of the Lower Back

SI joint pain is typically felt on one side rather than directly in the center of the spine. The discomfort is often located just below the beltline.

2. Pain That Radiates Into the Buttock or Hip

The pain may spread into the buttocks, hips, or upper thighs. Unlike classic sciatica, it usually does not travel far below the knee.

3. Pain That Worsens With Sitting or Standing Too Long

Prolonged sitting, standing, or shifting weight to one side can aggravate SI joint irritation.

4. Difficulty Transitioning From Sitting to Standing

Patients often report sharp pain when rising from a seated position or climbing stairs.

5. Pain After Pregnancy

Hormonal changes and pelvic ligament stretching during pregnancy can increase SI joint instability, making postpartum women especially susceptible.

6. Feeling of Pelvic Instability

Some patients describe a sensation that their pelvis feels “out of place” or unstable when walking.

Who Is at Higher Risk?

• Previous lower back injury
• Pregnancy or recent childbirth
• Leg length differences
• Arthritis
• Repetitive impact activities
• Prior lumbar spine surgery

Why Sacroiliac Joint Pain Is Often Missed

SI joint pain can closely resemble:

• Lumbar disc herniation
• Facet joint syndrome
• Hip joint problems
• Sciatic nerve irritation

Because imaging studies like MRIs don’t always clearly show SI joint dysfunction, a thorough physical examination and diagnostic injections are often used to confirm the diagnosis.

Treatment Options for Sacroiliac Joint Pain

The good news is that SI joint pain is treatable. Depending on severity, options may include:

• Physical therapy focused on pelvic stabilization
• Anti-inflammatory medications
• SI joint belts for temporary support
• Image-guided SI joint injections
• Radiofrequency ablation in select cases

In rare situations, surgical fusion may be considered, but most patients improve with conservative care.

When to Seek Evaluation

If you’ve been treating “low back pain” without improvement, and especially if your symptoms match the patterns above, it may be time for a more targeted evaluation.

Proper diagnosis is the first step toward effective relief. Sacroiliac joint pain can significantly impact mobility and quality of life — but with the right treatment plan, many patients experience substantial improvement.

Find Relief with Expert Care

If you are experiencing persistent lower back or pelvic pain, our experienced team  provides comprehensive evaluations and personalized treatment plans designed to address the root cause of your pain.

Don’t ignore ongoing discomfort. Schedule a consultation with North Lakes Pain Consultants today to determine whether sacroiliac joint dysfunction may be contributing to your symptoms and take the first step toward lasting relief.