Do you experience sharp, stabbing pain in your lower back that radiates to your buttocks or thighs? You may be dealing with sacroiliac joint pain, a condition affecting 25% of all lower back pain cases. The good news is that physical therapy for sacroiliac joint pain is highly effective, with over 90% of patients finding relief without surgery.
At New York Bone & Joint Specialists, our expert team provides comprehensive sacroiliac joint treatment, helping New Yorkers return to pain-free living through evidence-based care and personalized treatment plans.
What is Sacroiliac Joint Pain? Understanding the Condition
The sacroiliac joint is one of the largest joints in your body, connecting the bottom section of your spine (the triangle-shaped sacrum made of fused vertebrae) to the ilium, the top part of your pelvis. Strong ligaments hold these bones together, creating a joint that moves slightly with each step you take.
Every time you move your hips, walk, or change positions, you’re engaging your sacroiliac joints. When this joint becomes inflamed, injured, or dysfunctional, it can cause significant pain and mobility restrictions that impact your daily life.
Key Facts About Sacroiliac Joint Pain
- 25% of all lower back pain can be attributed to sacroiliac joint dysfunction
- More common in women due to pelvic anatomy and pregnancy-related changes
- Often misdiagnosed as other lower back conditions
- Highly treatable with conservative, non-surgical approaches
Sacroiliac Joint Pain Symptoms and Diagnosis
Sacroiliac joint pain often mimics other lower spine conditions, making an accurate diagnosis crucial. Watch for these distinct symptoms:
- Sharp, stabbing pain or constant dull ache in the lower back
- Pain that radiates from the lower back to the buttocks, hips, and thighs
- Worsening pain after sitting or standing in one position for extended periods
- Increased discomfort when turning or rotating your hip
- Morning stiffness in the hip lasting more than an hour
You may also experience pain when performing daily activities, like:
- Running or climbing stairs
- Getting in and out of cars
- Rolling over in bed
- Standing from a seated position
- Walking on uneven surfaces
What Causes Sacroiliac Joint Pain?
As mentioned previously, sacroiliac joint pain can be attributed to underlying conditions:
- Biomechanical. Mismatch in leg lengths; muscle tightness.
- Gait changes. Achilles tendonitis and ACL tears can alter how you walk and lead to hip pain.
- Pregnancy. The pelvis widens and stretches the ligaments before birth. The pain may ease after delivery.
- Arthritis and inflammatory conditions. Ankylosing spondylitis, a type of arthritis affecting the joints in the spine, is typically the first sign of sacroiliitis pain. Crohn’s disease and ulcerative colitis are other inflammatory conditions that could cause sacroiliac joint pain.
- Age-related factors. Arthritis due to wear and tear on the cartilage in our joints as we age.
- Injuries and traumas. Pelvic fractures due to accidents or falls.
- Post-surgical. Patients who have undergone a spinal fusion report higher instances of sacroiliac joint pain.
- Sports. Contact sports and activities with repetitive hip movements.
How sacroiliac joint pain is diagnosed
Because sacroiliac joint pain can be due to several underlying causes and show similar symptoms to other lower back conditions, you need to consult with a hip and back specialist for an accurate diagnosis to begin treatment
Physical exam
During the exam, your doctor will:
- Note when the pain started and what movements make it worse.
- Apply pressure on your hips and buttocks to locate the pain.
- Move your legs into different positions to see how it affects the joint and which causes pain.
Imaging tests. An X-ray and MRI can highlight the damage and inflammation in the joint.
Numbing shot. Numbing medicine is injected into the joint. If the pain stops, the problem is likely in the sacroiliac joint.
What is the Treatment for Sacroiliac Joint Pain? Comprehensive Approach
At New York Bone & Joint Specialists, we offer a comprehensive, evidence-based approach to treating sacroiliac joint pain, starting with conservative therapies that resolve over 90% of cases without surgery.
First-Line Conservative Treatments
Physical Therapy (Most Effective) Physical therapy for sacroiliac joint pain is the gold standard treatment, focusing on:
- Strengthening core, hip, and gluteal muscles
- Improving joint mobility and flexibility
- Correcting movement patterns and posture
- Teaching proper body mechanics
Medication Management
- Over-the-counter NSAIDs (ibuprofen, naproxen) for inflammation
- Prescription muscle relaxants for severe muscle spasm
- Short-term pain medications as needed
Manual Therapy
- Hands-on techniques to improve joint mobility
- Soft tissue massage to reduce muscle tension
- Chiropractic adjustments for joint alignment
“Sacroiliac joint dysfunction is often the hidden culprit behind chronic lower back pain that just won’t respond to traditional treatments. Our specialized injection therapies and targeted rehabilitation programs can provide the relief you’ve been searching for.” – Dr. Leon Popovitz, MD, Co-Founder of New York Bone & Joint.
Advanced Treatment Options for Chronic SI Joint Pain
In addition to physical therapy, the physicians at New York Bone & Joint Specialists offer advanced treatment options for sacroiliac joint pain. These minimally invasive therapies can be effective in treating pain when combined with traditional physical therapy.
Radiofrequency ablation. Radiofrequency ablation (RFA) sends radiofrequency waves to deaden the nerves near the sacroiliac joint to interrupt pain signals to the brain. Study results are mixed on how long RFA stops pain.
Regenerative medicine. Here are regenerative methods used for sacroiliac joint pain:
- PRP injections. Platelets are extracted from the patient’s blood and then injected into the joint and soft tissue to promote healing. Because the therapy uses the patient’s own blood, the risk of rejection is low.
- Prolotherapy. A concentrated solution of dextrose is injected into the damaged connective tissue to stimulate healing.
Minimally invasive procedures. Steroid injections can provide temporary pain relief from inflammation. Shots are limited to two to three a year.
Sacroiliac joint fusion surgery. A minimally invasive procedure to eliminate painful movement in the sacroiliac joint by fusing the ilium and sacrum with screws or a graft. Surgery is only recommended when non-surgical treatments have failed to bring relief within eight to 10 weeks. Recovery takes between three to six months. Over 90 percent of patients in one study reported a decrease in pain after the surgery.
Physical Therapy for Sacroiliac Joint Pain: Your Path to Recovery
Physical therapy for sacroiliac joint pain has proven highly effective as a first-line treatment. Our specialized physical therapists create personalized treatment plans based on your specific needs and goals.
Initial Assessment Process
Your physical therapist will:
- Analyze your posture, movement patterns, and body mechanics
- Identify activities or exercises that trigger your pain
- Assess muscle strength, flexibility, and joint mobility
- Develop a customized treatment plan
Sacroiliac Joint Pain Exercises
A physical therapist can model sacroiliac joint pain exercises for you. The exercises will become progressively more challenging as you go through the program.
Core strengthening
Modified plank
- Move to a pushup position on your hands and knees.
- Perform 10 pushups by lowering your chest to the ground and then pushing the ground away to return to the starting position
- Gradually increase the intensity of the move, slowly working your way up to the plank.
Bridge
- Lie on your back on a yoga mat or another soft surface.
- With your knees bent and your feet flat on the floor, push through your feet to raise your hips off the floor.
- Squeeze your butt muscles at the top of the move.
- Relax your hips back to the floor.
- To make it easier, space your feet further away from your hips and reduce how high you lift your hips.
Hip flexor and piriformis stretches
Side-lying hip flexor stretch
- Lie on the floor on your left side with your knees bent so they’re in line with your hips. Your thighs and shins should form a 90-degree angle.
- Move your right foot backward and gently grab the top of the ankle with your right hand.
- Slowly and gently pull your foot with your right hand, bringing your leg around behind you while keeping your pelvis tucked under and being careful not to arch your back.
- You should feel a stretch in the front of your thighs and your hip flexor on the right side.
- Repeat on the opposite side.
Outer hip piriformis stretch
- Lying on your back, bend your leg of the affected hip upward and place your foot close to the back of your other knee.
- Tuck your foot behind that knee and twist your leg to the opposite side. Your knee should be touching the ground (or as close as you can get).
- Place your hand on your opposite knee and raise your opposite arm in the air.
- Hold for 20 seconds.
- Switch to the other leg.
Pelvic stabilization exercises
Clamshell
- Lie on your side with your inner legs together, your spine straight.
- Bend your knees with your top hip stacked above your bottom hip.
- Keeping your feet together, squeeze your top gluteus muscles and slowly lift your top knee (resembling an open clamshell) without rolling back through your top hip.
Stretches for spinal mobility
Knee-to-chest stretch to relax the hips, thighs, and glutes
- Lie on your back with both knees bent and your feet flat on the floor.
- Keep your left knee bent, or extend it straight out along the floor.
- Draw your right knee into your chest, clasping your hands behind your thigh or at the top of your shinbone.
- Lengthen your spine down to your tailbone; avoid lifting your hips.
- Breathe deeply, releasing any tension.
- Hold for 30 seconds to 1 minute.
- Repeat with the other leg.
To make it easier, place a cushion under your head or wrap a towel around your leg if it’s hard for your arms to reach.
Seated spinal twist
- Sit on the floor with both legs extended out in front.
- Bend your left knee and place your foot outside your right thigh.
- Place your right arm on the outside of your left thigh.
- Place your left hand behind you for support.
- Starting at the base of your spine, slowly twist to the left side.
- Hold this pose for up to 1 minute.
- Repeat on the other side.
Keep both legs straight to make this exercise more comfortable
Preventing Sacroiliac Joint Pain Recurrence
Reduce your chance of sacroiliac joint pain by:
- Practicing good posture.
- Sitting with a straight but relaxed back and shoulders, keeping your knees at or below hip level with feet flat on the floor. Purchase an adjustable chair.
- Sleeping on your back with a pillow under your knees. Side sleepers can put a pillow between their legs.
- Managing your weight with a healthy diet.
- Exercising regularly, primarily low-impact activities (walking, swimming, elliptical training).
Why choose us for sacroiliac joint therapy in NYC?
New Yorkers have trusted us for sacroiliac joint therapy for decades. Our leadership in the field is a testament to:
- Comprehensive & Compassionate Care: Our world-class specialists provide expert, empathetic guidance from diagnosis through rehabilitation.
- Commitment to Joint Health: We prioritize your joint health and healing, understanding the vital role joints play in an active and fulfilling life.
- Effective Non-Surgical Solutions: We successfully resolve over 90% of sacroiliac joint pain cases with orthopedic treatments, often avoiding surgery.
- Dedication to Your Full Recovery: We are committed to your complete recovery, using conservative methods and only resorting to expert surgical intervention when necessary.
NYC’s top-rated sacroiliac joint therapy surgeons
At New York Bone & Joint Specialists, our philosophy is to preserve your body’s natural structures, especially for long-term sacroiliac joint therapy recovery. Our commitment to exceptional care means 90% of our patients recover without surgery, ensuring lasting health and function, and offering peace of mind.
Make an appointment today
Ready to take the first step toward relief? Schedule an appointment with New York Bone & Joint Specialists and start your personalized recovery plan today.
Frequently Asked Questions About Sacroiliac Joint Pain
How effective is physical therapy for sacroiliac joint pain?
Physical therapy for sacroiliac joint pain is highly effective, with studies showing significant improvement in 80-90% of patients. The combination of strengthening, flexibility, and movement training addresses the root causes of SI joint dysfunction. Most patients see improvement within 4-6 weeks of consistent therapy.
What exercises help sacroiliac joint pain?
The most effective sacroiliac joint pain exercises focus on core strengthening (modified planks, bridges), hip flexibility (piriformis stretches, hip flexor stretches), and pelvic stabilization (clamshells). These exercises improve muscle support around the joint and reduce stress on the SI joint.
What’s the best sleeping position for SI joint pain?
The best sleeping position for sacroiliac joint pain is lying on your back with a pillow under your knees. This maintains natural spine curves and reduces joint stress. If you prefer side sleeping, place a firm pillow between your legs and sleep on your less painful side.
What exercises should I avoid with sacroiliac joint pain?
Avoid high-impact activities (running, jumping), heavy lifting with poor form, aggressive twisting movements, and exercises requiring extreme hip flexibility. Also limit prolonged sitting or standing, and avoid sleeping on your stomach, as these positions can aggravate SI joint pain.
How long does sacroiliac joint pain take to heal?
Mild sacroiliac joint pain may resolve in days to weeks with proper treatment. More severe cases typically improve within 4-8 weeks with physical therapy and conservative care. Chronic cases may take 3-6 months for full recovery, depending on underlying causes and adherence to treatment.
When should I see a doctor for SI joint pain?
See a doctor if your pain persists beyond 2-3 weeks, interferes with sleep or daily activities, or is accompanied by numbness, weakness, or fever. Early professional intervention often leads to faster recovery and prevents chronic pain development.
Can pregnancy cause sacroiliac joint pain?
Yes, pregnancy commonly causes sacroiliac joint pain as hormones relax ligaments and the pelvis widens in preparation for childbirth. The added weight and shifted center of gravity also increase stress on the SI joints. Most pregnancy-related SI joint pain improves after delivery, though some women may need physical therapy.
Is sacroiliac joint pain the same as sciatica?
No, though they can feel similar. Sacroiliac joint pain typically stays in the lower back, buttocks, and upper thigh, while sciatica usually travels down the entire leg to the foot. SI joint pain is often worse with position changes, while sciatica may be worse with coughing or sneezing.
Can sacroiliac joint pain be cured permanently?
With proper treatment, most people achieve long-term relief from sacroiliac joint pain. While the joint may remain somewhat vulnerable, maintaining good posture, regular exercise, and healthy movement patterns can prevent recurrence. Some people may need occasional “tune-up” treatments.
How much does sacroiliac joint treatment cost?
Treatment costs vary depending on the specific therapies needed. Physical therapy is typically covered by insurance, as are most conservative treatments. Advanced procedures like PRP or radiofrequency ablation may have different coverage levels. We provide cost estimates and insurance verification before treatment begins.
