Sacroiliac Joint Dysfunction Treatment

Sacroiliac (SI) joint pain can turn the simplest movements into a challenge. Walking across a room, getting in and out of a car, standing in line, or trying to find a comfortable sleeping position can all become frustrating and exhausting when the SI joints are inflamed or unstable.

The SI joints sit low in the back, where the spine meets the pelvis. You have one on each side, connecting the sacrum (the base of the spine) to the iliac bones of the pelvis. These joints play a key role in stabilizing your body and transferring weight between your upper body and legs. When they aren’t working properly, everyday movements can feel unstable, achy, or sharply painful.

Sacroiliac joint dysfunction is often confusing. It can feel like low back pain, hip pain, or even mimic sciatica, with discomfort that may radiate into the buttock or thigh. Because the symptoms overlap with other conditions, it’s easy for SI joint problems to be overlooked or misdiagnosed.

At Medici Orthopaedics & Spine, our focus is on restoring your quality of life through precise diagnosis, minimally invasive treatment, and the least drug-dependent strategies possible. We take the time to understand exactly where your pain is coming from so we can create a plan that targets the true source—not just the symptoms.

Comprehensive Diagnostic Approach at Medici Orthopaedics & Spine

Medical History and Symptom Discussion

Your care at Medici begins with a thorough conversation. We listen closely as you describe:

• When your pain started and how it has changed over time
• What makes the pain better or worse—sitting, standing, walking, twisting, lifting, or lying down
• Previous treatments you’ve tried, including medications, injections, physical therapy, or chiropractic care

We also review important background details, such as:

• Work demands and daily activities
• Sports and exercise routines
• History of falls, accidents, or repetitive strain
• Pregnancies and childbirth
• Any prior spine, hip, or pelvic surgeries

Physical Examination

Next, we perform a focused physical exam designed to evaluate the SI joints along with the spine and hips. This may include:

• Palpation of the SI joint region: Gently pressing over specific areas to identify tenderness or localized pain.
• Provocative maneuvers: Guided movements and positions that safely stress the SI joints to see if they reproduce your typical pain.
• Assessment of gait and posture: Observing how you stand, walk, and shift your weight from side to side.
• Leg length evaluation: Looking for differences that might increase stress on one SI joint.
• Hip and lumbar spine mobility testing: Checking surrounding joints and muscles to distinguish SI joint pain from other sources.

Imaging Studies

When appropriate, imaging is used to further evaluate the SI joints and surrounding structures. Depending on your situation, this may include:

• X-rays to look at alignment, joint spacing, and arthritic changes
• MRI scans to assess soft tissues, discs, nerves, and inflammation
• CT scans in select cases to provide a more detailed view of the bones and joint surfaces

Diagnostic Injections

One of the most reliable ways to confirm the SI joint as the main pain source is through a diagnostic injection. At Medici Orthopaedics & Spine, this is performed using precise image guidance.

The process typically involves:

• Using fluoroscopy or ultrasound to guide a needle into the sacroiliac joint
• Injecting a small amount of local anesthetic, sometimes combined with anti-inflammatory medication

Conservative, Non-Surgical Treatment Options

Activity Modification and Education

One of the first steps in treating sacroiliac joint dysfunction is learning how to move in ways that protect the joint instead of aggravating it. Small changes in daily habits can significantly reduce pain and help the SI joint heal.

We often recommend:

• Avoiding or limiting movements that provoke pain, such as prolonged standing on one leg, repetitive twisting, or heavy lifting
• Using strategies for safer bending and lifting, like bending at the knees and hips instead of rounding the back
• Being mindful when transitioning from sitting to standing, using both legs evenly and avoiding sudden, jerky movements
• Choosing supportive footwear and temporarily avoiding high-impact exercises such as running or jumping while the joint is irritated

Physical Therapy and Targeted Exercise

Physical therapy is a cornerstone of conservative SI joint treatment. The goal is to stabilize the area, improve mechanics, and reduce the strain placed on the joint.

A customized physical therapy program typically focuses on:

• Strengthening core muscles (abdominals, back, pelvic floor) to support the spine and pelvis
• Strengthening the gluteal muscles to improve hip stability and decrease abnormal motion at the SI joint
• Improving hip and lumbar mobility so surrounding joints move well and don’t overload the SI region
• Correcting muscle imbalances and posture, including addressing tight hip flexors, weak glutes, or poor alignment

Bracing and Support Devices

For some patients, an SI joint belt or brace can provide meaningful relief by giving the pelvis extra external support.

We may recommend bracing when:

• The joint feels unstable, especially with walking, standing, or transitioning positions
• Pregnancy-related ligament laxity or recent injury has increased motion at the SI joint
• Additional support is needed while beginning physical therapy or returning to activity

Braces are typically used short-term or intermittently, and they’re meant to support—not replace—other therapies like strengthening and mobility work. Our team helps you choose the right brace, fit it properly, and understand when and how long to wear it.

Medications and Non-Opioid Pain Management

When appropriate, medications can be used carefully to reduce pain and inflammation while you work on underlying causes.

Options may include:

• Short-term use of anti-inflammatory medications (when medically appropriate) to calm irritation in and around the joint
• Topical creams or patches that provide localized relief without affecting the whole body
• Nerve-calming medications in select cases, especially when nerve irritation is contributing to symptoms

At Medici Orthopaedics & Spine, we are committed to minimizing dependence on pain medications. Our focus is on non-opioid strategies and addressing the root of the problem—so medications become a tool, not a long-term crutch.

Lifestyle Changes to Support Healing

Your daily habits play a big role in how your SI joints feel and function. A few key lifestyle changes can significantly support your recovery:

• Weight management to reduce the load on the spine, pelvis, and hips
• Increased posture awareness, especially during standing, walking, sitting, and lifting
• Incorporating low-impact exercise, such as walking, swimming, or stationary cycling, to improve circulation and reduce stiffness
• Adding stretching routines for the hip flexors, hamstrings, and lower back to relieve tension that can pull on the pelvis and SI joints

Interventional Treatments for Sacroiliac Joint Dysfunction

Image-Guided SI Joint Injections

When conservative measures are not enough, image-guided SI joint injections can provide both diagnostic clarity and therapeutic relief.

At Medici Orthopaedics & Spine, these injections are performed using fluoroscopy or ultrasound to ensure precise placement of the needle into the sacroiliac joint. The injection typically contains:

• A local anesthetic to numb the joint
• An anti-inflammatory medication to calm irritation

The goals of these injections are to:

• Reduce inflammation and pain
• Break the pain cycle, allowing muscles to relax and movement to normalize
• Make it easier for you to participate fully in physical therapy and exercise, which are critical for long-term success

Many patients experience a meaningful reduction in pain, which can last weeks to months, depending on the individual.

Radiofrequency Ablation

For some patients with persistent SI joint pain, radiofrequency ablation (RFA) may be an option. This procedure uses controlled heat to target specific pain-transmitting nerves around the SI joint.

RFA works by:

• Interrupting pain signals traveling from the SI joint to the brain
• Providing longer-lasting relief than injections alone in select cases

It is typically considered after diagnostic injections have confirmed the SI joint as the primary pain source. RFA fits into a comprehensive plan by offering a non-surgical, non-opioid option that can significantly reduce pain and improve function.

Trigger Point or Myofascial Injections

Chronic SI joint dysfunction often leads to secondary muscle tightness or spasm in the lower back, buttocks, and hips. Trigger point or myofascial injections are designed to address these painful, knot-like areas.

These injections:

• Target tight muscle bands that are contributing to pain and restricted movement
• Help relax the muscles, improve blood flow, and reduce referred pain
• Support better alignment and movement patterns, especially when combined with stretching and strengthening

By calming both the joint and the surrounding muscles, we can create a more stable, comfortable foundation for movement.

Find Relief from Sacroiliac Joint Pain—Safely and Effectively

Sacroiliac joint dysfunction can be frustrating, limiting your ability to sit, stand, walk, or sleep comfortably. You don’t have to keep pushing through the pain. With a careful diagnosis, a thoughtful combination of conservative therapies, and minimally invasive options when needed, it’s possible to regain stability, comfort, and confidence in your movement.

At Medici Orthopaedics & Spine, Dr. Sonny Dosanjh and our experienced team are committed to using the most effective, least invasive, and least drug-dependent treatments to help you move forward with less pain and more freedom.

If you’re ready to explore comprehensive, personalized treatment for sacroiliac joint dysfunction, we’re here to help.

Contact Medici Orthopaedics & Spine

📞 Main Line: +1-844-328-4624
🌐 Website: https://www.mediciortho.com/

Marietta Ambulatory Surgery Center
792 Church Street, Unit 101
Marietta, GA 30060
(470) 795-8398

Snellville Ambulatory Surgery Center
2220 Wisteria Dr, Unit 100
Snellville, GA 30078
(470) 795-8398

Kennesaw Clinic
2911 George Busbee Parkway, Suite 50
Kennesaw, GA 30144
(770) 545-6404

Snellville Clinic
2220 Wisteria Drive, Unit 101
Snellville, GA 30078
(470) 645-9297

Buckhead PM&R Clinic
3200 Downwood Circle, NW, Suite 520
Atlanta, GA 30327
(770) 872-7549