Musculoskeletal Condition · Glastonbury, CT

Sacroiliac (SI) Joint Pain

Low back and buttock pain from the sacroiliac joint: careful diagnosis and non-surgical treatment options with Dr. Paul Tortland, DO.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Condition

What is sacroiliac (SI) joint pain?

SI joint pain is pain low in the back or buttock where the base of your spine meets your pelvis. It tends to flare when you get up from a chair, climb stairs, or lie on one side, and it can feel like a disc or hip problem. Dr. Paul Tortland, DO, checks the joint carefully, and a numbing injection can confirm it is the source before any other treatment is chosen.

Explore related conditions: Browse the Back and spine condition hub for related diagnoses and treatment options.

CARE OPTIONS

How is sacroiliac (SI) joint pain treated?

Dr. Tortland’s potential treatment options: Dr. Tortland assesses whether the sacroiliac (SI) joint is truly the pain source rather than the hip, lumbar spine, or surrounding muscles. In selected cases, he may discuss PRP treatment or prolotherapy/prolozone; injection decisions follow clinical assessment, and the evidence varies by procedure.

Physical therapy and traditional care: Physical therapy often focuses on pelvic and trunk strength, hip mobility, movement mechanics, and a graded return to activity. Activity modification, heat, and medication when appropriate may also help. A diagnostic injection may be considered by a clinician when the source remains uncertain.

When other care may be needed: Progressive neurologic symptoms, fever, major trauma, or new bowel/bladder changes require prompt assessment. Persistent pain may warrant additional imaging or specialist evaluation.

Common questions

Questions about sacroiliac joint pain

What causes SI joint pain?

SI joint pain can result from ligament sprain or laxity, arthritis, pregnancy-related changes, a fall, or altered mechanics from the spine or hip. The joint relies heavily on strong ligaments for stability.

What are the symptoms of SI joint pain?

People often notice one-sided low back or buttock pain that may spread to the groin or thigh. It is commonly worse with stairs, standing from a chair, or rolling over in bed.

What are the non-surgical treatment options for SI joint pain?

Treatment may include targeted physical therapy, activity modification, a brace in selected cases, and image-guided diagnostic or therapeutic injections. The diagnosis should be distinguished from hip and lumbar-spine pain; surgery is considered only for selected patients after appropriate evaluation.

What regenerative options may help SI joint pain?

When ligament laxity is a suspected driver, prolotherapy or PRP injections to the supporting ligaments may be considered. Research is promising but still limited, and candidacy is decided after examination.