Sacroiliac Joint Dysfunction

Sacroiliac Joint Dysfunction

Sacroiliac joint dysfunction (SIJ dysfunction) is a common but often overlooked cause of lower back, buttock, or pelvic pain, particularly in adults who have had previous spinal surgery, trauma, or long-standing postural imbalance. It occurs when one or both sacroiliac joints — located where the spine meets the pelvis — become irritated, inflamed, or unstable.

At The New Foscote Hospital, our orthopaedic and pain management specialists offer a comprehensive approach to diagnosing and managing SIJ dysfunction. Treatment may include physiotherapy, spinal injections, and, in selected cases, sacroiliac joint fusion surgery.

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What Is the Sacroiliac Joint?

The sacroiliac joints are two strong joints located at the base of the spine, connecting the sacrum (the triangular bone at the base of the spine) to the iliac bones (pelvis). These joints help support the weight of the upper body and absorb shock during movement.

If the joint becomes too stiff or too mobile — or the surrounding ligaments are weakened — it can cause localised pain and inflammation, referred to as sacroiliac joint dysfunction.

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Symptoms

Symptoms of SIJ dysfunction can overlap with other lower back or hip conditions. Common signs include:

• Lower back pain, often one-sided
• Buttock, hip or groin pain
• Pain when standing from a seated position
• Pain when climbing stairs or turning in bed
• Stiffness or instability in the pelvis
• Pain that improves when lying down

Some patients describe a dull, aching pain that worsens with certain movements, such as standing for long periods, walking long distances, or bending.

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Causes and Risk Factors

SIJ dysfunction may arise from:

• Joint wear and tear (degenerative sacroiliitis)
• Pelvic asymmetry or leg length discrepancy
• Previous lumbar spine surgery
• Pregnancy or childbirth – due to hormonal and biomechanical changes
• Trauma (e.g. a fall or car accident)
• Inflammatory arthritis (e.g. ankylosing spondylitis)
• Repetitive lifting or twisting

It is more common in middle-aged adults and women, particularly postpartum.

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Diagnosis

Diagnosis can be challenging, as SIJ pain often mimics lumbar disc or hip problems. Our consultants use a combination of:

• Detailed clinical history
• Physical examination – including SIJ provocation tests
• Imaging – X-rays or MRI to rule out other causes
• Diagnostic SIJ injection – local anaesthetic is injected into the joint to confirm it as the pain source

At The New Foscote, we offer access to advanced imaging and pain management specialists to ensure accurate diagnosis.

View our diagnostic imaging services

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Treatment Options

Conservative Treatment

Initial treatment may include:

• Physiotherapy – to strengthen core and pelvic muscles
• Postural correction and movement advice
• Anti-inflammatory medication
• Activity modification

Many people respond well to a combination of physiotherapy and lifestyle adjustments.

Interventional Pain Management

If pain persists, targeted injections can help:

• Sacroiliac joint injection – a combination of local anaesthetic and steroid to reduce pain and inflammation
• Radiofrequency denervation – uses heat to disrupt the nerve signals from the joint (longer-lasting relief)

Learn more about pain management

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When Is Surgery Needed?

If non-surgical treatments fail and pain significantly limits daily life, your consultant may recommend minimally invasive sacroiliac joint fusion surgery. This procedure stabilises the joint using surgical implants, reducing movement and associated pain.

Surgery is only considered after thorough evaluation and diagnostic confirmation.

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Recovery and Rehabilitation

Following treatment — whether conservative or surgical — rehabilitation is tailored to:

• Restore pelvic stability and mobility
• Strengthen postural muscles
• Improve overall spinal alignment
• Reduce flare-ups and long-term recurrence

Our multidisciplinary team supports every step of your recovery.

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Why Choose The New Foscote Hospital?

• Experienced orthopaedic consultants
• Fast access to imaging and diagnosis
• On-site interventional pain services
• Private, calm environment with short waiting times
• Personalised care plans and physiotherapy support