What Is the Difference Between Sciatica & Sacroiliitis?

At San Antonio Pain Consultants, we understand that sacroiliitis—an inflammation of one or both sacroiliac joints located where the spine meets the pelvis—can significantly impact your quality of life. This condition frequently causes lower back pain and discomfort, prompting many of our patients to wonder if sacroiliitis could be the underlying cause of their sciatica-like symptoms.

Sciatica typically refers to nerve pain resulting from irritation or compression of the sciatic nerve, leading to symptoms such as pain, tingling, numbness, or weakness radiating from the lower back through the buttock and down into the leg. Although sacroiliitis itself stems from inflammation of the sacroiliac joints rather than direct nerve compression, the resulting inflammation and swelling can irritate surrounding tissues and nerves. This irritation may cause symptoms that closely resemble sciatica, including pain radiating down the back of the thigh or lower leg.

At San Antonio Pain Consultants, we emphasize careful and accurate diagnosis. While true sciatica is most commonly caused by conditions such as herniated lumbar discs or spinal stenosis, sacroiliitis can mimic these symptoms due to its proximity to the sciatic nerve. Our expert physicians utilize a comprehensive approach to diagnosis, including a detailed medical history, thorough physical examination, advanced imaging studies (such as X-rays or MRI scans), and specific clinical tests designed to evaluate the sacroiliac joint function and surrounding tissues.

Once an accurate diagnosis is established, our specialized team develops personalized treatment plans tailored to your specific needs. Treatment strategies may include targeted physical therapy, anti-inflammatory medications, minimally invasive injections, and lifestyle modifications—all aimed at reducing inflammation, alleviating pain, and restoring your mobility.

At San Antonio Pain Consultants, we understand that accurately diagnosing the source of your pain is essential in creating an effective and personalized treatment plan. Conditions such as sacroiliac joint pain and sciatica often present with similar symptoms, making it challenging to differentiate between them without professional evaluation.

Sacroiliac joint pain typically originates in the lower back or buttocks area and may radiate into the hips, groin, or upper thighs. Patients commonly describe it as a dull, aching pain that can become sharper during activities involving movement or weight-bearing, such as prolonged walking, sitting, or standing. Generally, this type of pain remains localized around the lower back, pelvis, and upper thighs, rarely extending below the knee.

Sciatica, on the other hand, involves irritation or compression of the sciatic nerve and often presents as sharp, shooting, or burning pain. This discomfort frequently radiates from the lower back, down through the buttocks and thigh, and sometimes into the calf or foot. Sciatica pain typically follows a defined nerve pathway and may be accompanied by neurological symptoms such as numbness, tingling, or muscle weakness in the affected leg or foot.

At San Antonio Pain Consultants, our team recognizes that diagnosing sacroiliitis requires a thorough evaluation due to the potential overlap with other conditions. Sacroiliitis, marked by inflammation in the sacroiliac joints, often causes pain in the lower back, buttocks, or hips. However, several other conditions can mimic these symptoms, making accurate diagnosis essential. Lumbar spine issues, such as degenerative disc disease, herniated discs, or facet joint arthritis, can result in pain in the lower back and buttocks, closely resembling sacroiliitis. We use advanced imaging and clinical expertise to distinguish these spinal issues from true sacroiliac joint inflammation.

Another condition that can be confused with sacroiliitis is piriformis syndrome, where the sciatic nerve is compressed by an inflamed piriformis muscle, causing pain in the buttocks and down the leg. At San Antonio Pain Consultants, we identify this through targeted physical exams and nerve studies. Hip joint problems, like osteoarthritis or labral tears, can also present similarly, causing pain in the groin, buttocks, or hip region. Our specialists perform comprehensive evaluations, including imaging, to accurately identify hip pathologies.

Ankylosing spondylitis, an inflammatory arthritis affecting the spine and sacroiliac joints, may initially resemble sacroiliitis. However, its systemic nature and spinal involvement set it apart. Our team carefully assesses patient histories, imaging, and lab tests to make the distinction. Additionally, gynecological conditions like pelvic inflammatory disease or endometriosis in women, as well as infections like osteomyelitis or septic arthritis, can produce pelvic pain that mimics sacroiliitis. We collaborate with specialists to ensure comprehensive diagnosis and effective treatment, using advanced diagnostic techniques to guarantee accurate, timely care.

Determining whether your back pain originates from the sacroiliac (SI) joint can be challenging because symptoms often overlap with other back-related conditions. At San Antonio Pain Consultants, our experienced specialists understand the complexities involved in diagnosing SI joint dysfunction and offer personalized evaluations to pinpoint the exact source of your discomfort.

The sacroiliac joints, located in the lower back, connect your pelvis to your spine and play a crucial role in absorbing shock and transferring weight during movement. Pain associated with SI joint dysfunction often presents as discomfort or aching in the lower back, buttocks, hips, or even down into the legs, sometimes mimicking conditions such as sciatica.

Typically, SI joint pain is felt on one side of the lower back, although it occasionally affects both sides. Patients frequently describe this pain as sharp or stabbing, which tends to worsen with certain movements or positions, including prolonged standing, climbing stairs, bending forward, or lying on the affected side.

At San Antonio Pain Consultants, our highly trained providers utilize specific physical examination techniques designed to stress or compress the SI joint to reproduce your symptoms and precisely identify the cause of your pain. Additionally, we may use diagnostic injections—where medication is injected directly into the SI joint—to confirm the diagnosis if your symptoms temporarily improve afterward.

If you suspect your back pain could be related to your sacroiliac joint, the dedicated team at San Antonio Pain Consultants is here to help. Our specialists will conduct a thorough evaluation, ensure an accurate diagnosis, and create a personalized treatment plan tailored specifically to your unique condition, helping you take meaningful steps toward pain relief and improved quality of life.

If you’re experiencing lower back or leg pain, it’s essential to understand whether sciatica or sacroiliitis is the cause. At San Antonio Pain Consultants, Dr. Darius Zagunis, M.D., offers expert diagnosis and effective treatment options for both conditions. 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.