Sacroiliac Joint Pain: Causes, Diagnosis, and When to Seek Care

Determining whether your SI (sacroiliac) joint is contributing to your pain is a key specialty at San Antonio Pain Consultants. Our experienced team begins with a detailed clinical evaluation, carefully tailored to your specific symptoms and medical history. During this initial consultation, your pain specialist will perform a thorough physical examination, evaluating your posture, gait, and various movements that might aggravate or relieve your discomfort. Our experts are trained in specific physical maneuvers designed to place stress or compression on the sacroiliac joint, noting if these tests provoke your pain.

One particularly effective diagnostic tool we use is an SI joint injection, performed in-office or at our affiliated procedure center. This minimally invasive technique involves injecting a local anesthetic directly into the SI joint under precise fluoroscopic guidance. If this injection significantly reduces or temporarily eliminates your pain, it strongly indicates that the SI joint is a primary contributor to your symptoms.

Depending on your clinical presentation, our specialists may also recommend laboratory tests, including blood work, particularly if we suspect an underlying inflammatory condition, autoimmune disorder, or infection.

By integrating comprehensive physical examinations, advanced imaging studies, targeted diagnostic injections, and laboratory tests when appropriate, our dedicated team ensures the most accurate diagnosis possible. This thorough approach allows us to effectively determine if the SI joint is the underlying cause of your pain, guiding us toward the optimal treatment plan for your comfort and recovery.

Sacroiliac joint pain can become a serious medical concern requiring specialized evaluation and care from the experts at San Antonio Pain Consultants. If your pain becomes severe, persistent, or is accompanied by other concerning symptoms, it may indicate an underlying issue that warrants professional attention. For example, if your sacroiliac joint pain significantly increases, interferes with your daily activities, or does not respond to rest and conservative treatments, our team of pain specialists can help identify the root cause and provide effective treatment strategies.

Additionally, symptoms such as numbness, tingling, weakness in the lower extremities, or loss of bowel or bladder control are considered urgent medical conditions and should prompt immediate consultation with the experienced physicians at San Antonio Pain Consultants.

Severe sacroiliac joint pain can also arise from traumatic injuries, infections, or inflammatory conditions such as ankylosing spondylitis or rheumatoid arthritis. If you experience persistent fever, unexplained weight loss, or intense pain that worsens at night, it could signal an infection or systemic inflammatory disorder. In these cases, prompt evaluation from the specialists at San Antonio Pain Consultants is essential to accurately diagnose your condition and provide individualized, comprehensive care.

At San Antonio Pain Consultants, we understand that sacroiliac joint pain can significantly impact your daily life. Our pain specialists recognize that this type of pain can be triggered by various factors. Injuries or trauma, such as falls, motor vehicle accidents, or sudden impacts, can disrupt the joint’s normal function and initiate discomfort. Degenerative arthritis, characterized by gradual wear and tear of joint cartilage, is another frequent cause of sacroiliac joint pain that we commonly diagnose and treat.

We also see many patients experiencing sacroiliac joint pain related to pregnancy, as hormonal changes during pregnancy result in ligament relaxation, affecting joint stability and potentially leading to pain. Certain everyday activities or postures, such as prolonged sitting, standing for extended periods, or repetitive bending and twisting movements, can further irritate the joint and exacerbate symptoms.

At San Antonio Pain Consultants, we carefully evaluate underlying conditions such as ankylosing spondylitis—an inflammatory form of arthritis affecting the spine and pelvis, which can cause inflammation and pain in the sacroiliac joint. Additionally, our team pays close attention to muscle imbalances around the hips, pelvis, and lower back, as these can increase stress on the joint and contribute to chronic pain.

Our specialists also assess patients for leg-length discrepancies or altered gait patterns, as these issues can affect body mechanics and place additional strain on the sacroiliac joint. Furthermore, we have extensive experience addressing sacroiliac joint pain resulting from previous spinal fusion surgeries or lumbar spine procedures, as these can change biomechanics and lead to discomfort.

At San Antonio Pain Consultants, we frequently evaluate and treat patients experiencing lower back and leg pain. Two commonly confused sources of discomfort are sacroiliac (SI) joint pain and sciatica. While both conditions can cause similar symptoms, understanding their differences is essential for accurate diagnosis and effective treatment.

SI joint pain arises from dysfunction or inflammation within the sacroiliac joint, the structure connecting your sacrum—the triangular bone at the base of your spine—to your pelvis. This joint is crucial for stability, balance, and supporting your body weight. When irritated or inflamed, the SI joint typically causes localized discomfort in the lower back, buttocks, or hip region. Patients often describe this pain as sharp, dull, or aching, usually occurring on one side. Activities such as prolonged standing, walking, or transitioning from sitting to standing can worsen the pain. While SI joint discomfort might radiate into the thigh or groin, it rarely extends below the knee.

Sciatica, in contrast, is not a condition itself but rather a symptom caused by irritation or compression of the sciatic nerve, the longest nerve in your body. This nerve travels from your lower spine through your buttocks and down the back of each leg. Sciatica often presents as pain, tingling, numbness, or weakness along the nerve’s pathway, frequently extending below the knee into the calf, foot, or even the toes. Common causes include lumbar disc herniation, spinal stenosis, or degenerative disc disease. Sciatic pain ranges from mild aching to severe burning sensations and typically worsens during prolonged sitting or activities involving bending forward, coughing, or sneezing.

At San Antonio Pain Consultants, our experienced specialists understand these subtle yet important distinctions. Proper diagnosis is crucial, as effective treatment depends upon accurately identifying the underlying cause of your symptoms. Our team will thoroughly assess your condition, provide comprehensive diagnostic testing when needed, and develop a tailored treatment plan to help you regain comfort and quality of life.

If you’re experiencing persistent lower back or leg pain, contact San Antonio Pain Consultants today. Let us help you pinpoint the source of your discomfort and guide you toward lasting pain relief. For more information, contact us or schedule an appointment online. We are located at 3903 Wiseman Blvd, Ste 117, San Antonio, TX 78251. We serve patients from San Antonio TX, Helotes TX, Alamo Ranch TX, Leon Valley TX, Shavano Park TX, Balcones Heights TX, Fair Oaks TX, Fair Oaks Ranch TX, Castroville TX, and surrounding areas.