Lower back pain is not always caused by the spine. Many people experience pain because of irritation or inflammation in the sacroiliac (SI) joint, which connects the spine to the pelvis. This condition may develop after an injury, arthritis, pregnancy, repetitive movements, or uneven pressure on the joints. SI joint pain can make walking, sitting, standing, climbing stairs, and sleeping difficult. In the United States, lower back pain affects millions of adults every year, and studies estimate that 15% to 30% of chronic low back pain cases are related to the sacroiliac joint. SI joint pain can make walking, working, exercising, and even resting uncomfortable over time. Dr. Rao K. Ali, Best Pain Doctor in Dallas, can evaluate the source of your symptoms and create a treatment plan focused on relieving pain, improving mobility, and helping you return to your normal daily activities. The sacroiliac joints sit where the sacrum connects with the iliac bones of the pelvis. These two joints help transfer body weight from the upper body to the legs when supporting balance and stability during walking, bending, standing, and other everyday movements. The SI joints allow only limited movement, yet they absorb repeated pressure throughout the day. Stretched ligaments, cartilage wear, inflammation, injury, or uneven stress may cause pain in the lower back, buttocks, hips, or upper legs. Symptoms often worsen during prolonged standing, stair climbing, walking, or rising after sitting for an extended period. SI joint pain may result from arthritis, injury, pregnancy, uneven movement, or inflammation. Identifying the cause supports effective lower back pain treatment in Dallas. Some of the most common causes include: Osteoarthritis slowly wears down the protective cartilage within the SI joint, increasing friction and inflammation. As the joint surfaces become less smooth, everyday movements such as walking, standing, or climbing stairs may become increasingly painful. Falls, car accidents, sports injuries, or lifting heavy objects can strain the ligaments that stabilize the SI joint. Even a single injury may lead to lingering pain if the joint does not heal properly. Hormonal changes during pregnancy naturally loosen the pelvic ligaments to prepare for childbirth. Combined with added body weight, these changes place greater stress on the sacroiliac joints and may cause pain during pregnancy or after delivery. Differences in leg length, foot conditions, hip disorders, or previous knee injuries can change the way body weight is distributed. Over time, uneven pressure on one SI joint may lead to irritation, inflammation, and chronic pain. Some patients experience SI joint pain after lumbar fusion surgery because the pelvis absorbs more stress when movement in the lower spine becomes limited. This additional pressure can slowly irritate the joint. Inflammatory diseases such as ankylosing spondylitis and other forms of inflammatory arthritis may affect the sacroiliac joints. Ongoing inflammation can lead to stiffness, reduced mobility, and lower back pain if left untreated. SI joint pain can closely resemble a herniated disc or sciatica, making it difficult to identify the exact source without a proper evaluation. Identifying the symptoms early can help guide the best treatment. Common warning signs include: Pain in the lower back Buttock pain on one or both sides Pain when standing for long periods Increased pain when climbing stairs Difficulty turning over in bed Pain after sitting too long Tenderness over the pelvic area Stiffness in the lower back Pain that improves after changing positions SI joint pain often resembles sciatica, a herniated disc, hip problems, or other lower back conditions, so diagnosis usually involves several steps. A careful evaluation helps identify the true source of pain and prevents treatment from being directed at the wrong condition. The physician reviews when the pain started, where it is located, and which movements make it better or worse. Previous injuries, spine surgery, pregnancy, work activities, and existing medical conditions may also help reveal what is placing stress on the SI joint. During the examination, the doctor may press around the lower back, hips, and pelvis to locate tender areas. Specific movement and pressure tests are also used to determine if stressing the SI joint reproduces the patient’s usual pain. X-rays, MRI scans, or CT scans may be recommended to check for arthritis, fractures, spinal disorders, inflammation, or hip conditions. Imaging alone may not confirm sacroiliac joint dysfunction, but it helps rule out other possible causes of lower back pain. A small amount of local anesthetic is injected directly into the SI joint under imaging guidance. Significant pain relief after the injection suggests that the sacroiliac joint is the main source of pain. This test is one of the most reliable methods for confirming SI joint pain. Treatment for SI joint pain depends on the cause, severity, and impact on daily movement. Care often begins with non-surgical methods, when injections or minimally invasive procedures may be recommended when pain continues despite initial treatment. Physical therapy strengthens the core, hips, pelvis, and lower back muscles that support the SI joint. Guided stretching and movement exercises can also improve flexibility, correct uneven movement patterns, and reduce pressure on the painful joint. Anti-inflammatory medications may help reduce swelling, stiffness, and pain around the SI joint. These medicines are often used alongside physical therapy and activity changes to improve movement during painful flare-ups. An SI joint brace or pelvic belt provides additional support around the pelvis and limits excessive joint movement. It may be particularly helpful for patients experiencing instability after pregnancy, injury, or ligament weakness. SI joint injections deliver a local anesthetic and corticosteroid directly into the painful joint under imaging guidance. The injection can reduce inflammation, provide temporary pain relief, and help confirm if the SI joint is causing the symptoms. Radiofrequency ablation uses controlled heat to reduce pain signals from the small nerves surrounding the SI joint. This procedure may provide longer-lasting relief for patients who experienced improvement after a diagnostic injection. Severe joint instability or persistent pain that does not improve with other treatments may require minimally invasive SI joint fusion. Small implants stabilize the joint, limit painful movement, and help improve long-term function. Lower back, hip, or buttock pain should not be ignored when it begins affecting sleep, movement, work, or daily activities. A pain specialist in Dallas can identify the source of your symptoms and recommend the best treatment before the condition becomes more difficult to manage. Pain lasts longer than several weeks Walking becomes increasingly difficult Pain interrupts sleep Home treatments no longer help Pain spreads into the buttocks or hips Daily activities become limited Previous back treatments have not improved symptoms Lower back pain repeatedly returns Dr. Rao K. Ali is a Double Board-Certified Interventional Pain Management Specialist who focuses on finding the true source of SI joint pain. His treatment approach is designed to reduce pain, improve movement, and help patients return to normal daily activities. Double Board-Certified pain specialist Detailed evaluation of lower back and pelvic pain Accurate diagnosis of SI joint dysfunction Personalized treatment plans for each patient Non-surgical pain relief options Image-guided SI joint injections Advanced interventional pain procedures Focus on mobility and long-term pain relief Sacroiliac joint pain can affect movement, sleep, work, and daily comfort. Finding the underlying cause is the first step toward lasting relief. Dr. Rao K. Ali, Best Pain Doctor in Dallas, can provide a detailed evaluation and recommend treatment options based on your symptoms and mobility needs. Schedule an appointment with Dr. Rao K. Ali for expert sacroiliac joint pain care. Call +1 469-562-4188 to discuss your symptoms and take the next step toward improved movement and long-term pain relief.Why the Sacroiliac Joint Can Become a Hidden Source of Pain
Common Causes of Sacroiliac Joint Pain
Arthritis
Injury or Trauma
Pregnancy
Uneven Walking Patterns
Previous Spine Surgery
Inflammatory Conditions
Signs that Sacroiliac Joint Pain May Be the Problem
How Doctors Diagnose Sacroiliac Joint Pain
Medical History
Physical Examination
Imaging Studies
Diagnostic SI Joint Injection
Treatments for Sacroiliac Joint Pain Relief
Physical Therapy
Anti-Inflammatory Medication
SI Joint Brace
Image-Guided SI Joint Injections
Radiofrequency Ablation
Minimally Invasive SI Joint Fusion
When Should You See a Pain Specialist?
Why Choose Dr. Rao K. Ali for Sacroiliac Joint Pain Treatment?
Regain Comfortable Movement Before Pain Becomes Chronic