Sacroiliac Joint (SIJ) Pain & Sacroiliitis
If you have ongoing pain in your lower back, buttocks, or hips that hasn’t improved with standard care, like exercises or simple medications your sacroiliac joint (SIJ) may be the cause.
Walking on the beach with lower back discomfort from sacroiliac joint pain
This small but powerful joint connects your spine to your pelvis. It helps transfer weight between the upper body and legs while absorbing shock during movement.
When the SIJ becomes inflamed or unstable, it can cause severe discomfort that disrupts daily life.
At Pain Specialists Australia, our fellowship-trained pain physicians are leaders in advanced SIJ treatments. From accurate diagnosis to minimally invasive procedures, we help patients across Melbourne and Australia regain comfort and mobility.
What is Sacroiliac Joint Pain (Sacroiliitis)?
The sacroiliac joints sit where your sacrum (bottom of your spine) meets your hip bones. They transfer weight from your upper body into your legs and act as shock absorbers.
When these joints become irritated or inflamed, the condition is known as sacroiliitis. It often feels like a deep ache in the buttock, hip, or lower back. Pain may radiate into the thigh, making it easy to mistake for sciatica or a slipped disc.
Common Symptoms
Patients with sacroiliac joint pain often report:
Pain in the lower back, buttocks, hips, or groin
Pain that worsens with sitting, climbing stairs, standing for long periods, or rolling over in bed
A feeling of stiffness in the lower back or pelvis
Pain that spreads into the thigh, but rarely below the knee
Temporary relief when lying on the back
The sacroiliac joint (SIJ) connects the spine to the pelvis and helps transfer weight between the upper body and legs while absorbing shock during movement.
Causes of Sacroiliac Joint Pain and Why Pain Often Gets Misdiagnosed
Common causes include:
Trauma or injury (falls, car accidents, heavy lifting)
Pregnancy and childbirth (ligaments loosen, joint becomes unstable)
Arthritis or inflammation in the joint
Post-surgical stress (e.g. after lumbar fusion or hip replacement)
Repetitive strain from standing, running, or manual work
Because SIJ pain can mimic sciatica or hip arthritis, it is often misdiagnosed.
Accurate diagnosis is key to choosing the right treatment. We see you - not just your symptoms. Our migraine specialist treatment plans are tailored to people who feel stuck, worn down, and ready for something that actually helps.
How We Diagnose SIJ Pain at Pain Specialists Australia
Because SIJ pain mimics other back and hip conditions, a careful diagnostic process is essential.
At our Melbourne clinics, we use:
Clinical assessment – a detailed history, physical examination, and pain mapping
Imaging – X-ray, CT, or MRI where appropriate
Diagnostic SIJ injections – a small amount of anaesthetic injected into the joint under X-ray or ultrasound guidance. If pain improves, the SIJ is confirmed as the source and then further treatment can be planned.
Treatment Options for Sacroiliac Joint Pain
We provide evidence-based, tailored care, focusing on both symptom relief and long-term management.
Image-Guided SIJ Injections
A targeted injection of local anaesthetic and corticosteroid into the sacroiliac joint can provide fast pain relief and confirm the diagnosis. Performed under X-ray or ultrasound, this procedure is safe, precise, and effective and can provide significant relief.
Radiofrequency Ablation (RFA)
For patients with recurring SIJ pain, radiofrequency ablation offers longer-lasting relief. Using specialised equipment and needles, we carefully disrupt the nerves that transmit pain signals from the joint. Many patients experience months to years of reduced pain.
Physiotherapy & Rehabilitation
Rehabilitation focuses on stabilising the pelvis with core and hip strengthening exercises. When combined with interventional procedures, physiotherapy enhances outcomes and helps prevent recurrence.
Lifestyle & Supportive Care
Pain management often includes weight management, posture correction, and ergonomic advice. Our team works with you and your team to reduce strain on the SI joints and improve your overall mobility.
Surgery
In severe cases where all other options fail, surgical fusion may be considered. We work with some of the most experienced spine and neurosurgeons in Melbourne and the wider afield.
Right-sided sacroiliac joint injection to target inflammation and pain
X-ray image of SI joint radiofrequency neurotomy to relieve nerve pain
Stretches that help reduce SI joint pain and improve mobility
Why Choose Pain Specialists Australia?
National leaders in interventional pain medicine – all specialists are appropriately qualified and selected. Our specialists have decades of expertise in diagnosing and treating this and many other complex pain conditions.
Expertise in complex pain – trusted by GPs, surgeons, and allied health professionals for more than a decade.
Cutting-edge procedures – including advanced radiofrequency ablation and image-guided injections
Patient-centred care – we listen, believe, and tailor treatments to your needs
Convenient Melbourne locations – providing care across Melbourne. We have access to telehealth.
What Patients Tell Us
Patients living with SIJ pain often say they feel unheard and misunderstood. Many have tried medication or generic therapies without success.
Many patients say they:
Lived with pain rolling over in bed or sitting too long
Were told it was “just sciatica” but treatments didn’t help
Tried medication or physiotherapy with only temporary relief
Found long-lasting relief after injections or radiofrequency
The injection gave them relief I hadn’t felt in years.
They could finally walk without constant pain.
Frequently Asked Questions (FAQ)
1. How do I know if my back pain is coming from the sacroiliac joint?
Many patients describe SIJ pain as a deep ache or sharp pain in the lower back, buttock, or hip. It often flares when climbing stairs, standing up from sitting, or rolling over in bed. Because SIJ pain mimics other back problems, proper diagnosis usually involves a physical exam and sometimes an image-guided injection to confirm the joint is the pain source.
2. What happens during a sacroiliac joint injection?
An SIJ injection is a short outpatient procedure. A specialist uses X-ray or ultrasound to guide a fine needle into the joint. A small amount of anaesthetic and anti-inflammatory medicine is injected. This can provide both diagnosis (if pain improves, it confirms the SIJ as the source) and relief. Most patients can go home the same day and resume normal activity within 24 hours.
3. How long does pain relief from an SIJ injection or radiofrequency treatment last?
Pain relief duration varies between patients. Some feel better for weeks, others for several months or longer. Injections often provide short- to medium-term relief, while radiofrequency ablation can give longer-lasting results by targeting the nerves carrying pain signals from the joint. Your specialist will recommend the best approach based on your symptoms and response to earlier treatments.
4. Can physiotherapy really help with sacroiliac joint pain?
Yes. Targeted physiotherapy strengthens the muscles that support your pelvis and spine, helping to stabilise the joint. Simple exercises, guided by a physiotherapist, may reduce pain and improve movement. Many patients benefit from combining physiotherapy with interventional treatments such as injections or radiofrequency for longer-term relief.
If physiotherapy and simple medications are not helping, then you should consider having your diagnosis updated and consider a specialist assessing you thoroughly and whether pain procedures are an option.
5. When should I see a pain specialist about my SIJ pain?
If your lower back or hip pain has persisted for more than a few weeks, affects sleep, or limits daily life, it’s worth seeing a specialist. Pain specialists can confirm whether the SI joint is the problem and offer advanced treatments beyond basic medications or general advice. Seeking help early can prevent the pain from becoming long-term and harder to manage.
6. Can sacroiliac joint pain cause pain in my leg?
Yes, SIJ pain can sometimes radiate into the buttock, groin, or thigh. While it usually does not extend past the knee, some patients feel a deep ache that mimics sciatica. If your pain is spreading down the leg, it’s important to get checked so your specialist can rule out disc or nerve-related causes and recommend the right treatment.
7. Is sacroiliac joint pain permanent?
Not always. Some people experience temporary SIJ pain after injury, pregnancy, or strain, and it improves with rest and physiotherapy. Others may have ongoing SIJ dysfunction that requires specialist treatment such as injections or radiofrequency ablation. The good news is, with the right care, many patients achieve long-term relief and return to daily activities without constant pain.
Get Your Diagnosis by Our Melbourne SIJ Specialists
Don’t let sacroiliac joint pain limit your lifestyle.
Whether you’ve had pain for weeks or years, our team at Pain Specialists Australia can provide answers, advanced treatments, and renewed hope.
References
Further Reading and References on SIJ Pain:
1. Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005;101(5):1440–53.
- This landmark review outlines the complex anatomy of the SI joint, reasons it is often misdiagnosed, and the evidence behind different treatment options including injections. It remains one of the most cited papers in SIJ pain research.
https://pubmed.ncbi.nlm.nih.gov/16244008/
2. Vanelderen P, Szadek K, Cohen SP, et al. Sacroiliac joint pain. Pain Pract. 2010;10(5):470–8.
- An evidence-based overview covering the challenges of diagnosing SI joint pain and reviewing both conservative and interventional treatment options, including physiotherapy, injections, and radiofrequency ablation.
https://pubmed.ncbi.nlm.nih.gov/20667026/
3. Simopoulos TT, Manchikanti L, Gupta S, et al. Systematic review of diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. Pain Physician. 2015;18(5):E713–56.
- A high-quality systematic review that evaluates the accuracy of diagnostic injections and the effectiveness of interventional treatments such as steroid injections and radiofrequency ablation for SIJ pain.
https://pubmed.ncbi.nlm.nih.gov/26431129/
4. Chou LH, Slipman CW, Bhagia SM, et al. Inciting events initiating injection-proven sacroiliac joint syndrome. Pain Med. 2004;5(1):26–32.
- This clinical study highlights common triggers of sacroiliac joint pain confirmed by diagnostic injections, including trauma, repetitive strain, and post-surgical stress.
https://pubmed.ncbi.nlm.nih.gov/14996234/
5. Mayo Clinic. Sacroiliitis – Symptoms and Causes
- An authoritative summary from the Mayo Clinic explaining sacroiliitis symptoms, causes, and treatment options, written for both patients and healthcare professionals.
https://www.mayoclinic.org/diseases-conditions/sacroiliitis/symptoms-causes/syc-20350747
