Sacroiliac joint pain arises from dysfunction or inflammation in the joints connecting the sacrum to the pelvis. It is often described as deep, aching, or sharp pain localized in the lower back, buttocks, or posterior thigh, sometimes mimicking lumbar spine or hip pathology.
Etiologies include degenerative changes, trauma, pregnancy-related ligamentous laxity, prior lumbar fusion, or inflammatory conditions such as spondyloarthropathies. The joint’s limited motion and strong ligamentous support make it susceptible to mechanical dysfunction and microtrauma.
Epidemiologically, SIJ pain accounts for an estimated 15–30% of chronic low back pain cases, making it a significant contributor to disability. Women are more frequently affected, possibly due to hormonal and anatomical factors.
Treatment options include physical therapy (core stabilization, pelvic alignment), activity modification, anti-inflammatory medications, and image-guided corticosteroid injections. Radiofrequency ablation of the lateral branches can provide longer-lasting relief. In cases of refractory pain, minimally invasive SIJ fusion procedures offer an evidence-based surgical option.