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Sacroiliac (SI) Joint Dysfunction as a Source of Back Pain: Evaluation and Treatment

Do you have unremitting back pain that’s causing lost hours at work? You’re not alone. Back pain is the most frequent reason for workplace disability claims across the globe. If the pain is in your lower back, it could be sacroiliac joint (SIJ) dysfunction. Between 15% and 30% of those with lower back pain are diagnosed with this condition every year. 

Dr. Jordi Kellogg, a board-certified neurosurgeon at Kellogg M.D. Brain & Spine treats SIJ dysfunction patients frequently with state-of-the-art expertise. He’s ready to help you regain a better quality of life. 

What is sacroiliac joint dysfunction? 

You have joints on each side of your lower spinal vertebrae. The joints connect your sacrum, the large bone at the base of your spine above your tailbone, to your pelvic bone. The joints help carry the load of your upper body and shift the load to your legs when you stand and move. 

The SI joints become inflamed when they don’t move as they should, causing low back pain and/or pain in your legs. The dysfunction can be a result of the joints moving too much or too little. If they move too much, the supporting ligaments are too loose. If they don’t move enough, arthritis may be the culprit. 

How is sacroiliac joint function diagnosed?

SIJ dysfunction can mimic other musculoskeletal conditions, so Dr. Kellogg performs various tests. He examines how you stand and walk and then asks you to lie on a table or stand for the physical tests. 

Two commonly used tests are the distraction test and the thigh thrust. During the distraction test, you lie on a table while Dr. Kellogg applies pressure to both sides of your pelvis simultaneously. During the thigh thrust, he bends one knee toward your chest and moves the other leg sideways off the table. If you have pain during both tests, you may have SIJ dysfunction.  

SIJ dysfunction isn’t the easiest condition to diagnose because the SI joints lie deep inside your pelvis. Following the examination if 3 of the five provocative tests are positive he will send you to a pain specialist for an SI joint injection. These injections though possibly beneficial are also used as a diagnostic tool. If significant relief is achieved with the SI joint injections then the likelihood that you are experiencing back pain from SI joint dysfunction is high.

What are the most effective treatments for sacroiliac joint dysfunction? 

The following are treatments used for SIJ dysfunction, ranging from conservative treatments to surgery for severe cases that don’t improve with other methods. 


For temporary relief, you’ve likely been using over-the-counter pain relievers. Dr. Kellogg can prescribe a stronger pain reliever, but this medication simply masks the problem. Drugs have side effects, so you don’t want to take them long-term. 

Physical therapy and stretching

You may have been walking with a limp or leaning to one side when you walk to avoid the pain. That can cause other joint problems. 

Physical therapy helps strengthen the muscles surrounding your joints so they can better support you. The therapy also improves your mobility and flexibility. 

Make a habit of the daily stretches your therapist shows you how to do; they help keep your joints mobile. 


Dr. Kellogg may recommend a cortisone shot to lessen the inflammation. If the steroid shot doesn’t work, he can use a nerve block to your SI joint that provides pain relief. 

Nerve treatment 

If the nerve block provides at least 50% pain relief, the pain management specialist can perform radiofrequency ablation to burn the nerves which can eliminate the transmission of pain along the nerves. This procedure can result in six to 18 months of pain relief.  

SI joint fusion 

Most cases of SIJ dysfunction can be treated with the methods described above. If the pain doesn’t resolve, though, you may think about opting for SI joint fusion, an elective surgery. Using the IFuse system the SI joint can be stabilized. The surgery can lessen pain and provide you with more stability when you move.  

Call Kellogg M.D. Brain & Spine for expert treatment for SIJ dysfunction and all of your spine and neuro health needs.

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