Sacroiliac joint pain

Sacroiliac joint pain affects the joints between the lower spine and pelvis and can cause discomfort in the lower back, buttock or upper leg. Symptoms are often mechanical in nature but can sometimes mimic nerve-related pain.

At Total Spine Health, sacroiliac joint pain is assessed carefully to identify the source of symptoms and provide clear, practical advice on the most appropriate treatment.

AT A GLANCE

  • Specialist assessment of lower back and pelvic pain
  • Diagnosis of mechanical and joint-related causes
  • Clear advice on scans, injections and treatment options
  • Conservative treatment and targeted interventions where appropriate

Understanding sacroiliac joint pain

Specialist assessment for lower back and pelvic joint pain

Sacroiliac joint pain can present in a number of ways, from localised discomfort in the lower back or buttock to pain that spreads into the upper leg. It is commonly related to joint movement, posture or load through the pelvis.

Because symptoms can overlap with other spinal conditions such as disc problems or sciatica, a specialist spinal assessment is important to identify whether the sacroiliac joint is the primary source of pain and to guide appropriate treatment.

What is sacroiliac joint pain?

Understanding the sacroiliac joint

The sacroiliac joints sit on either side of the lower spine, connecting the sacrum to the pelvis. These joints help transfer weight between the upper body and the legs and play an important role in stability.

Pain can arise when the joint becomes inflamed, stiff or overloaded. This may occur due to altered movement patterns, injury or changes in surrounding structures.

COMMON SYMPTOMS

Symptoms often linked to sacroiliac joint pain

Symptoms are typically felt in the lower back or buttock and may vary depending on activity and position. In some cases, the pain can resemble nerve-related symptoms.
  • pain in the lower back or buttock
  • pain on one side, sometimes alternating
  • discomfort spreading into the upper leg
  • pain when standing, walking or climbing stairs
  • pain when turning in bed or getting up from sitting
  • stiffness in the lower back or pelvis
  • symptoms that worsen with prolonged activity

COMMON CAUSES

Conditions we assess and treat

Sacroiliac joint pain may arise from a range of mechanical or structural factors affecting the pelvis and lower spine.

Mechanical joint strain

Repetitive movement or overload can place stress on the sacroiliac joint.

Postural imbalance

Changes in posture or movement patterns may affect how forces are distributed through the pelvis.

Pregnancy-related changes

Hormonal and biomechanical changes can increase stress on the sacroiliac joints.

Previous injury

Trauma or falls may lead to ongoing joint dysfunction or irritation.

Leg length difference

Differences in leg length may alter pelvic alignment and loading.

Lumbar spine conditions

Lower back problems may contribute to or coexist with sacroiliac joint pain.

Inflammatory conditions

Certain inflammatory conditions can affect the sacroiliac joints.

Degenerative change

Wear and tear over time can contribute to joint-related pain.

WHEN TO SEEK HELP

When specialist spinal advice may be helpful

Sacroiliac joint pain can often improve with simple measures, but specialist review may be helpful if symptoms persist or are difficult to diagnose.

  • pain is persistent or not improving
  • symptoms are affecting daily activity
  • pain is difficult to localise or diagnose
  • symptoms resemble sciatica
  • previous treatment has not helped
  • pain is limiting movement or function

Important note

Urgent medical assessment is important if symptoms are associated with significant leg weakness, numbness affecting the groin or saddle area, loss of bladder or bowel control, fever, unexplained weight loss, or severe pain following injury.

DIAGNOSIS AND ASSESSMENT

How sacroiliac joint pain is assessed

Assessment begins with a detailed discussion about your symptoms, activity levels and how pain is affecting daily life. This is followed by a focused clinical examination of the spine, pelvis and hips.

  • where the pain is felt
  • how symptoms relate to movement or activity
  • how long symptoms have been present
  • what worsens or relieves pain
  • any previous back or pelvic problems
  • the impact on work, mobility and daily life

Examination may include assessment of posture, movement, joint stress testing and hip function.

Where appropriate, further investigation may include:

  • X-rays
  • MRI scan
  • diagnostic injections to confirm the source of pain

TREATMENT OPTIONS

Treatment for sacroiliac joint pain

Treatment depends on the cause of symptoms, how long they have been present and how much they are affecting daily life.

Non-surgical treatment

Physiotherapy, strengthening, movement retraining and pain management can help improve joint function and reduce symptoms.

Injection treatment

Targeted injections into the sacroiliac joint may help reduce inflammation and confirm the source of pain.

Surgical treatment

Surgery is rarely required but may be considered in selected cases where symptoms are severe and persistent despite appropriate treatment.

SELF-CARE AND RECOVERY

Practical steps that may help

Simple changes to activity, posture and movement can help reduce strain on the sacroiliac joint and support recovery over time.

  • maintain gentle activity where possible
  • avoid movements that trigger pai
  • adjust posture and sitting position
  • build strength gradually
  • follow physiotherapy advice
  • pace activity rather than overloading
  • seek review if symptoms worsen

FAQs

Frequently asked questions about sacroiliac joint pain

Can sacroiliac joint pain feel like sciatica?

Yes. Pain from the sacroiliac joint can sometimes mimic nerve-related pain and spread into the leg, which can make diagnosis more challenging.

Do I need a scan?

Not always. Diagnosis is often based on symptoms and examination, although scans or diagnostic injections may be used where needed.

Will it improve on its own?

Many cases improve with appropriate treatment, activity modification and rehabilitation.

When are injections used?

Injections may be used to reduce inflammation or help confirm that the sacroiliac joint is the source of symptoms.

RELATED CONDITIONS

Conditions linked with sacroiliac joint pain

RELATED TREATMENTS

Treatment pathways that may be relevant