“I Thought It Was a Disc… So Why Is the Pain Still There?”
If your low back pain lives off to one side, especially deep in the buttock or near the hip, there’s a good chance your SI joint is involved.
We hear it all the time at Vertrae®:
“My MRI was normal, but the pain’s real.”
“It hurts to stand up, roll over, or walk up the stairs.”
“I’ve tried everything… nothing really helps.”
This is exactly the pattern SI joint pain follows, and it’s why so many people go undiagnosed or misdiagnosed for months (or even years).
The good news?
SI joint pain is treatable when it’s correctly diagnosed.
Below are the 20 most common questions patients ask, written in clear terms and with guidance grounded in Vertrae®’s motion-preserving, minimally invasive approach.
What is the SI joint, and why does it matter?
The sacroiliac (SI) joint is where your spine connects to your pelvis, one joint on each side.
These joints:
- Absorb shock
- Transfer weight between upper and lower body
- Provide stability when walking, standing, or lifting
They move just a few millimeters, but when inflamed or unstable, even small movements can hurt a lot.
What does SI joint pain feel like?
Patients often describe it as:
- A deep ache on one side
- Pain near the dimples of the low back
- Discomfort radiating into the buttock, hip, or groin
- “Something feels stuck or out of place”
If it doesn’t travel below the knee, and bending forward doesn’t hurt, the SI joint might be the real culprit.
Is sacroiliitis the same as SI joint dysfunction?
Not exactly.
- Sacroiliitis = inflammation of the SI joint
- SI joint dysfunction = any issue causing pain in that joint (including inflammation, instability, wear, etc.)
Diagnosis matters more than terminology, and Vertrae® focuses on what’s causing the pain and how to treat it effectively.
What causes SI joint pain?
It often starts with:
- Trauma (falls, car accidents)
- Pregnancy or postpartum changes
- Uneven leg length or gait
- Overuse (lifting, running, twisting)
- Arthritis or degeneration
- Prior lumbar fusion (shifts force to SI joint)
Many patients don’t recall a specific injury, just pain that built slowly and never left.
How common is SI joint pain?
Up to 30% of chronic low back pain comes from the SI joint, but it’s frequently overlooked or misdiagnosed, especially when imaging appears normal.
Why is SI joint pain so easy to miss?
Because it mimics:
- Disc pain
- Hip arthritis
- Piriformis syndrome
- Sciatica
And most imaging (like MRIs) doesn’t clearly show SI joint inflammation, which is why a targeted physical exam is so critical.
How do Vertrae® providers diagnose SI joint dysfunction?
It starts with your story, and then we use:
- SI-specific movement tests
- Hands-on palpation
- Gait and posture analysis
- Sometimes a diagnostic injection to confirm
At Vertrae®, we’re trained to pick up the patterns others miss.
Will my MRI or X-ray show the SI problem?
Not always.
Imaging can rule out serious issues (like tumors or fractures), but many SI problems don’t show up at all.
That’s why we never rely on imaging alone; it’s just one part of the picture.
Can home exercises or posture changes really help?
Yes, especially early on.
- Strengthen glutes and core
- Avoid soft chairs or slouching
- Keep hips mobile and aligned
- Don’t carry weight on just one side
Small daily adjustments can offload stress from the joint.
What kind of physical therapy works best?
Generic back PT often fails.
What you need is SI-focused rehab, including:
- Pelvic stabilization
- Glute medius strengthening
- Hip mobility and balance retraining
- Postural awareness
- Gait correction
This kind of care is central to our motion-preserving model at Vertrae®.
Will an SI joint injection help?
Often, yes.
Injections deliver numbing medication and steroids directly into the joint to:
- Calm inflammation
- Relieve pain
- Confirm the diagnosis
- Let you progress in PT
Is it a permanent fix?
No, but it’s a powerful tool.
Relief may last weeks to months, depending on the cause.
If pain keeps coming back, it may mean the joint is unstable and needs more support.
When would someone need SI joint fusion?
If you’ve had:
- Pain > 6 months
- Tried PT and injections
- Confirmed diagnosis via injection
- Difficulty walking, standing, or sleeping
…then minimally invasive SI joint fusion may be the right next step.
What does the fusion procedure actually do?
It stabilizes the joint using small titanium implants, placed through a tiny incision, often under 3 cm (about 1 inch).
This reduces painful micro-motion and helps your body rebuild solid, stable support.
Will I lose movement if I fuse the SI joint?
Not at all.
The SI joint moves very little to begin with and you’ll keep full motion in your hips, lumbar spine, and walking patterns.
This is why Vertrae® prioritizes motion preservation at every step.
Is SI joint fusion safe?
Yes, especially when done minimally invasively by an experienced spine specialist.
Risks are low and include:
- Infection
- Implant issues
- Poor bone fusion (rare)
Careful screening helps ensure success, and that’s what Vertrae® does best.
What if SI joint pain isn’t treated?
It may become chronic leading to:
- Long-term pain
- Limping or altered gait
- Strain on other joints (hips, spine)
- Reduced mobility and quality of life
Early treatment often prevents bigger problems later.
Why is SI pain common during or after pregnancy?
Because of:
- Hormonal changes that loosen ligaments
- Pelvic widening
- Gait shifts
- Core weakness
Many postpartum women feel like something “never went back to normal.”
SI-focused rehab is often the missing piece.
Can SI joint pain cause leg pain like sciatica?
Yes, but it usually stays above the knee.
If pain shoots below the knee or involves numbness/tingling → it may be a nerve issue instead.
This is a key distinction our providers make early on.
How can I prevent future SI flare-ups?
Consistency matters more than intensity.
Focus on:
- Strong glutes and core
- Healthy hip mobility
- Good posture
- Even weight distribution
- Walking on flat surfaces
- Avoiding repetitive twisting or single-side loading
BONUS: What if I’ve already had a lumbar fusion?
You’re at higher risk for SI pain. It’s called adjacent segment dysfunction.
The good news?
We’ve helped many post-fusion patients stabilize their SI joints and regain function, often without another surgery.
When Should You Get Checked?
If your back or hip pain is:
- One-sided
- Worse with standing or stairs
- Not explained by MRI
- Not helped by general PT
- Still interfering with daily life
It’s time for a focused SI joint evaluation.
And at Vertrae®, we know exactly what to look for.
How Vertrae® Treats SI Joint Pain
We don’t rush to surgery.
We listen, examine, and build a plan that works for your life, not someone else’s checklist.
Our step-by-step approach:
- Accurate diagnosis
- Strategic conservative care
- Precision-guided injections
- Fusion when appropriate
- Focus on restoring confidence in movement
Now that you understand how SI joint pain is treated, here’s why patients across Southwest Ohio trust Vertrae® with their care.
Why Vertrae® for SI Joint Pain?
SI joint pain is often missed, misunderstood, or treated with a one-size-fits-all approach. At Vertrae®, SI joint dysfunction is something we diagnose and treat every week, and we do it differently.
Here’s what sets Vertrae® apart:
Spine-Only Expertise
We don’t treat everything, we treat spine and related joint conditions exclusively. That focus means we recognize SI joint pain patterns that are often overlooked when imaging looks “normal.”
Diagnosis Comes First
Many patients come to Vertrae® after months or years of frustration. We take the time to:
- Listen to your full story
- Perform SI-specific physical exams
- Analyze gait, posture, and movement
- Use diagnostic injections when needed to confirm the source of pain
Motion-Preserving Philosophy
Our care philosophy is MotionFirst.
We prioritize treatments that preserve movement, restore stability, and help you trust your body again, whether that’s targeted physical therapy, precision-guided injections, or minimally invasive procedures.
Precision-Guided Injections
When injections are part of your plan, they are:
- Image-guided
- Used strategically (not repeatedly without purpose)
- Designed to relieve pain and clarify diagnosis
This allows many patients to progress in therapy and avoid surgery altogether.
Minimally Invasive SI Joint Fusion
When surgery is truly the right next step, Vertrae® specializes in minimally invasive SI joint fusion designed to:
- Stabilize painful micro-motion
- Preserve overall spine and hip movement
- Allow faster recovery and earlier return to function
We don’t rush to surgery, but when it’s needed, you’re in experienced hands.
Integrated Care, One Location
At Vertrae®, your care is coordinated under one roof:
- Evaluation
- Physical therapy
- Injections
- Outpatient surgery
That means fewer delays, clearer communication, and a plan that actually moves forward.
The Vertrae® Difference
SI joint pain can feel isolating, especially when tests don’t show clear answers. At Vertrae®, patients often say the same thing:
“This is the first time someone really explained what was going on, and gave me a plan that made sense.”
If you’re dealing with persistent one-sided low back or hip pain, you don’t need more guessing.
You need clarity, experience, and a motion-preserving path forward.
Vertrae® Surgery Center | Dayton’s Leader in Outpatient Spine Care
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