Sacroiliac Joint Pain
Sacroiliac joint pain: an often overlooked cause of lower back and buttock pain
Lower back and buttock pain does not always come from the spine. Sacroiliac joint pain is common and quite often misdiagnosed.
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Understanding sacroiliac joint pain
What is sacroiliac joint pain
Sacroiliac joint pain or SI joint pain refers to pain that originates from the sacroiliac joints. These are two joints located at the base of your spine, where the spine connects to the pelvis. Their role is to transfer load between your upper body and legs while allowing a small amount of controlled movement.
Although these joints move very little, they are exposed to significant forces during everyday activities such as standing, walking, lifting, and bending. When the joint becomes irritated or inflamed, it can generate ongoing pain.
At Pain Specialists WA, sacroiliac joint pain is something we see frequently. It is not rare, but it is often overlooked because its symptoms overlap with other causes of lower back and leg pain.
“We often see patients who have been told by their physiotherapist that the pain may be coming from the sacroiliac joint. That information is helpful, but it still requires careful medical assessment.”
Dr Reshad Mirnour
Why sacroiliac joint pain is often missed
One reason sacroiliac joint pain is missed is because it behaves like other conditions. Pain from this joint can feel similar to sciatica, facet joint pain, or disc related pain in the lower back.
Imaging such as X-rays or MRI scans does not always clearly show sacroiliac joint irritation. Because of this, diagnosis relies heavily on clinical assessment, movement testing, and response to targeted treatments rather than scans alone.
This is why some patients spend months or years being treated for the wrong pain source before the SI joint is considered.
Symptoms of sacroiliac joint pain
What does sacroiliac joint pain feel like
People describe sacroiliac joint pain in different ways, but there are consistent patterns.
Pain is often felt deep in the buttock, close to where the spine meets the pelvis. Some people feel it across the lower back, while others notice it more on one side.
The pain may radiate into the upper leg or groin. This does not automatically mean nerve damage. It is referred pain, meaning the joint sends pain signals that are felt in nearby areas.
Certain activities can make symptoms more noticeable. For example, sitting for a long time in the same position, or standing for long periods, climbing stairs, rolling over in bed, or getting out of a car. Some people notice pain when walking on uneven ground or when putting weight through one leg.
“Because these symptoms overlap with many other conditions, careful assessment is needed to identify the true source of pain.”
Dr Reshad Mirnour
What can lead to sacroiliac joint pain
Sacroiliac joint pain usually develops through a combination of factors rather than one clear cause.
Pregnancy and childbirth can cause SI joint pain. Hormonal changes may increase joint flexibility, and the mechanical load through the pelvis may change significantly. For some people, this strain continues after delivery and leads to persistent pain.
Inflammatory conditions also can affect the sacroiliac joints. Rheumatoid arthritis and ankylosing spondylitis are conditions where inflammation targets joints, including those in the pelvis.
Previous trauma such as a fall or accident may irritate the joint. Changes in movement patterns following hip, knee, or spine problems can also place extra stress on one side of the pelvis.
Sometimes the joint becomes painful because it is compensating for stiffness or weakness elsewhere in the body.
How sacroiliac joint pain is identified
We begin by understanding how your pain started, how it behaves, and how it affects your day-to-day life.
A physical examination helps identify movement patterns that suggest the sacroiliac joint as the pain source rather than the spine or nerves. Imaging may be reviewed, but normal scans do not rule out sacroiliac joint pain.
This process is part of the standard approach outlined on our what to expect at your appointment page.
Sacroiliac joint pain management
Treatment options for sacroiliac joint pain
Treatment is individualised and depends on the underlying cause, symptom duration, and impact on function.
First-line management for joint pain often includes rest, heat or cold packs, simple pain relief, and physiotherapy.
Physiotherapy often is part of management. Our team works collaboratively with allied health professionals to support this process.
When pain persists or interferes with daily life, assessment by a pain specialist is recommended. At Pain Specialists WA, treatment options that may be considered for SI joint pain include:
- Specialised physiotherapy and rehabilitation programmes
- Supporting devices such as braces where appropriate
- TENS machines to assist with pain modulation
- Cortisone injections to reduce joint inflammation in selected patients
- Rhizotomy procedures targeting the nerve supply to the joint
- Platelet-rich plasma injections in selective cases (not a first-line treatment)
“In carefully selected cases, injections can play a role in both diagnosis and symptom management, but they are only one part of a broader plan.”
Dr Reza Feizerfan
Living with sacroiliac joint pain
Living with ongoing pain can be physically and emotionally draining. Please know that SI joint pain is a recognised condition and that you are not imagining your symptoms.
We kindly suggest staying gently active rather than resting for prolonged periods. Movement helps maintain joint health and reduces stiffness. Activity is adjusted to your comfort and ability, not pushed beyond limits.
Attention to posture, sleep positions, and daily habits can also influence symptoms. Our team provides practical guidance tailored to your situation.
Pain management focuses on reducing pain, improving movement, and supporting your ability to engage in meaningful activities safely.
Sacroiliac joint pain specialists Perth
How our team at Perth Pain Specialist can help
Pain Specialists WA is a pain management clinic in Perth, with consultation rooms in Nedlands at Hollywood Medical Centre and at our private practice in Ardross. Our team provides assessment and management for joint pain, including sacroiliac joint pain.
We understand how discouraging it feels to live with ongoing pain, especially after conflicting opinions or treatments that did not help.
To learn more about your options, please get in touch with our team. You can request an appointment using our online form or contact our clinic directly.