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SI Joint Pain Symptoms & Natural Treatments


SI joint pain - Dr. Axe

Sacroiliac joint dysfunction, also commonly called SI joint pain, is a condition that causes upper leg and lower back pain. Studies show that low back and/or upper leg pains due to conditions like disc diseases, overuse, age-related degeneration of joints and inflammation are very common, affecting millions of people every year. In fact, in people over 45, low back pain is now the leading cause of disability and the second leading cause of doctor’s visits in the U.S.

Of all people with radiating back pain (the kind that runs down spinal nerves from the low back to the legs), between 15 percent to 30 percent experience symptoms due to sacroiliac dysfunctions. (1) Something unique about SI joint pain is that it commonly affects young and middle-aged women more than any other group. Onset of back and leg pain usually starts during someone’s 30s or 40s and can come and go for a the remainder of a person’s lifetime if he or she doesn’t take steps to resolve its underlying causes.

It’s often difficult for doctors to diagnose the exact cause of a patient’s back pain — for example, many people with sacroiliac joint problems are misdiagnosed with a herniated disc — because oftentimes the causes are multifactorial. However, in a high percentage of patients, disc degeneration and changes in the lower lumbar region of the back are contributing causes of  low back/upper thigh pain, since this causes other joint compensations and postural problems.

If you’re suffering from low back/leg pain, here’s the good news: With treatment, up to 80 percent of all people with low back pain experience significant improvements in symptoms within about four to six weeks after diagnoses. What types of things can you do to help improve healing and treat discomfort caused by SI joint dysfunction? Natural remedies like stretching, resting, applying heat, prolotherapy and improving your posture can all offer relief.

What Is the Sacroiliac Joint?

Every person has two sacroiliac joints, which are located at the bottom of the spine right near the pelvis, sacrum, tailbone and hips. The lower part of the spine located down the back is known as the lumbar region, and the SI joints sit just below this area. (2) The SI joints connect the pelvis bone (iliac bone) and sacrum (lowest part of the spine), absorbing shock and providing cushion between the bones, which allows for the hips to move.

Normally the SI joints only move a small amount, so overuse can be one reason why pain occurs. When these joints become inflamed or degenerated over time for various reasons, triggering sensitivity and pain, a patient is then diagnosed with the condition called sacroiliitis.

SI Joint Pain Symptoms, Causes and Risk Factors

Although some people experience pain in both legs or hips, most with SI dysfunction have symptoms in only one leg along with the low back. The most common signs and symptoms of SI joint pain include:

  • Low back pain
  • Pain in the hips, butt or upper thighs — sometimes pain radiates down the legs, especially when moving, but usually stays above the knees
  • Throbbing when exercising, bending, squatting, standing up from a sitting position, running or walking
  • Reduced range of motion and limited flexibility
  • Discomfort when sleeping on the painful side/hip or pain in certain lying positions
  • Loss of balance/stability (some people feel like a leg is “giving out”)
  • At times numbing, tingling or muscle weakness in the lower extremities

SI joint pain is primarily caused by: (3)

  • Hyperactivity (moving the joints too much, especially in repetitive ways)
  • Joint degeneration, sometimes caused by degernative joint diseases, such as osteoarthritis
  • Inflammation of the joint
  • Hypomobility (loss of normal range of motion and movement)
  • Poor posture, improper form and the SI joints overcompensating for other joints/body parts, which increases the amount of stress placed on them. For example, people with injuries to the lumbar region of the spine can lose normal range of motion in their backs, so the body then starts to compensate by placing more weight and pressure on the sacroiliac joints. This can also happen in those who haven’t healed well after lumbar surgery.

What sort of medical conditions or lifestyle factors make you more susceptible to developing SI joint pain? Risk factors for sacroiliac joint dysfunction include:

  • Being a woman: Women have broader pelvises, greater curvature of the lumbar spine and usually shorter limb lengths.  Women also experience widening of the pelvis during pregnancy and increased pressure on the lower body (4)
  • A history of other spinal diseases, arthritis, osteoarthritis or osteoporosis
  • Major trauma or impact that causes injury to the ligaments and joints near the spine
  • Smoking or using recreational drugs
  • Long-term use of medications, including corticosteroids, or use of immunosuppresion drugs and chemotherapy
  • Suffering from bacterial infections that affect the spine
  • A history of cancer
  • Pregnancy, which adds weight and pressure to the low back
  • Being over the age of 50 makes you more likely to deal with spinal problems, such as a pinched nerve, due to the degenerative effects of aging. However, surveys show that young to middle-aged women frequently suffer from SI joint problems due to factors like postural problems, overuse and even pregnancy.


SI joint pain stats and facts - Dr. Axe

Diagnoses and Conventional Treatments for Sacroiliac Joint Dysfunction

If you suspect the cause of your symptoms is a problem affecting the SI joint, visit your doctor for a physical examination. After ruling out “red flag” symptoms that suggest another type of disease could be to blame for your pain (such as bowel dysfunction or infection), you’ll likely receive a physical exam to test your range of motion, strength, flexibility, posture and symptoms when standing or sitting in different positions.

Because SI dysfunction can be hard to distinguish from other problems, your doctor might also choose to inject the SI joint with an anesthetic blocking drug in order to test your response and symptom improvements. (5)

NSAID pain relievers, and sometimes anesthetic injections or corticosteroids, remain the first-line treatment for most forms of spinal problems and disc diseases.

NSAIDs help control inflammation and dull throbbing, but they usually don’t address the root cause of the problem and can cause side effects when used long term. For patients with severe pain, NSAIDs might need to be taken for long durations of time, or else symptoms will return. Problems associated with long-term NSAID use can include digestive discomfort, such as acid reflux, stomach ulcers, blood pressure changes, kidney problems and fluid retention. (6)

Natural Treatments for SI Joint Pain

1. Collagen Repair Diet

What is collagen, and how can it help you overcome joint pains? Collagen is the most abundant natural protein found within our bodies and an important building block of all tissue, including joints and ligaments. It can be found inside of joints and is one of the first things lost due to aging, overuse and inflammation.

The best natural source of collagen is real bone broth. Bone broth is high not only in collagen, but other beneficial substances like glucosamine, chondroitin, hyaluronic acid and amino acids, which help heal joint injuries.

Another way to help heal joints is to eat omega-3 foods (EPA/DHA). The best sources are wild-caught fish like salmon, mackerel and sardines, as well as other omega-3 foods like grass-fed beef, chia and flaxseeds. All of these are beneficial for fighting inflammation and many different age-related problems.

Consume more antioxidants and anti-inflammatory foods, which support tissue repair. These include organic vegetables, organic fruits, and herbs like turmeric, ginger, garlic, etc.

2. Posture Correction Exercises and Physical Therapy 

Proper posture when standing or sitting/working along with using the right form when exercising are both crucial for keeping unwanted stress off of joints. It’s possible that your sacroiliac pain is caused due to muscular/joint compensations, especially those stemming from abnormalities in the lower lumbar region.

To help overcome this, I recommend seeing a physical therapist, an Egoscue posture therapist and/or a spinal correction chiropractic doctor from the Clear Institute (especially if you suffer from conditions like scoliosis). These professionals can help correct poor postural problems, such as forward head posture, and reteach you how to position your weight correctly.

These treatments are especially helpful if your SI joint is “stuck” in an abnormal position or hypermobile and unable to move normally. The types of chiropractic adjustments you can expect to receive for SI joint pain include side-posture manipulation, drop technique, blocking techniques and instrument guided methods. (7)

3. Prolotherapy (PRP) Treatments

Prolotherapy is a cutting-edge form of regenerative medicine that’s leading the way in helping both acute and chronic injuries. Studies have found that prolotherapy is one of the most useful and effective forms of treatment in SI joint pain patients because not only does it improve tissue healing, but it can help boost effectiveness of exercises/stretches that balance the trunk and lower extremities. (8)

Many elite athletes are now even turning to PRP treatments (those using platelet-rich plasma) to manage painful symptoms due to arthritis, a torn ligament, tendonitis, bulging disc, or pain in any joint, such as the neck, low back, knee or shoulders. What is prolotherapy exactly, and and how does PRP work?

Prolotherapy uses your body’s own natural platelets and growth factors to heal damaged tissues. A form of stem cell therapy, this is quickly becoming viewed as one of the most advanced forms of regenerative medicine for treating inflammatory conditions or overuse/trauma injuries. I recommend the brand Regenexx, which I personally use, as has my wife for past injuries.

4. Soft Tissue Therapy

By helping you overcome compensations, poor posture/form when exercising and overuse, soft tissue practitioners can aid in eliminating muscular pain. I’ve used active release technique (ART) practitioners for years to help me overcome a number of muscle- and joint-related injuries. What does soft tissue therapy do to resolve pain? It can relieve tight muscles, scar tissue that has formed in myofascial tissue and painful trigger points in order to reduce joint stress.

Consider visiting a specialist in ART, Graston Techniqudry needling and neurokinetic therapy.

5. Supplements to Reduce Inflammation

Because many people are low in nutrients that help preserve joint health and prevent deterioration of the musculoskeletal system, taking certain supplements can be very helpful. In order to heal damaged tissues, you need nutrients that help reduce inflammation, support tissue repair and increase growth factors.

The following supplements are useful for overcoming SI joint pain:

  • Turmeric
  • Ginger
  • Bromelain
  • Omega-3 supplements
  • Protein powder made from bone broth: contains type 2 collagen, glucosamine, chondroitin and hyaluronic acid. These can aid in tissue repair, as can bovine collagen powder, which has type 1 and 3 collagen.
  • Antioxidant-boosting compounds: These include resveratrol, green tea, cordyceps and berry extracts. Antioxidants can help support the body’s own stem-cell production and initiate tissue regeneration.

6. Rest and Apply Heat/Ice to Reduce Pain

To help dull pain, apply heat (or ice if you’ve experienced an injury) to the affected area for 15—20 minutes at a time, up to several times daily. Icing the area is best during the first two days to two weeks following trauma or an injury, but during this time avoid heating, which can make inflammation worse.

7. Exercise to Improve Hip and Back Strength 

Once your condition has healed enough for you exercise, get clearance from your doctor and work on strengthening the muscles near the SI joint. This can include doing low-impact bodyweight exercises, gentler exercise like tai chi, brisk walking or water aerobics. Low-impact exercise is part of ongoing maintenance for healthy joints, since it helps bring blood to the damaged area, controls inflammation, and improves balance and flexibility. Exercises that bring the knees toward the chest and rotate the lumbar region are especially important for stretching the SI joint.


SI joint pain vs. other joint diseases - Dr. Axe

Sacroiliac Joint Pain Statistics and Facts

  • Low back pain is an extremely common problem among adults, affecting somewhere between 15 percent to 45 percent of all people over 40 (especially women).
  • Low back pain is considered the No. 1 type of disability that people are most likely to live with for years, especially during the end of their lifetimes.
  • SI joint pain accounts for up to 30 percent of all radiating low back pain cases. (9)
  • Women are more likely than men to have SI joint pain. The age group most affected by SI dysfunction is those 30–60 years old.
  • Some surveys found that around 20 percent of college-age adults with back pain have SI joint dysfunction. (10)
  • Between 8 percent and 16 percent of people with sacroiliac dysfunction or abnormalities don’t experience any symptoms.

SI Joint Pain vs. Other Spinal Disk or Joint Diseases

What makes sacroiliac pain different from other common causes of back pain, like arthritis or sciatica, for example?

  • Sacroiliac dysfunction remains difficult to diagnose in many cases and has a lot of overlap with disc herniation and radiculopathy (pain that runs down the back along the sciatic nerve). The good news is that although SI pain can falsely be attributed to a herniated disc in some patients, treatments for both conditions are similar.
  • Common joint disorders, such as rheumatoid arthritis, usually affect the cervical part of some joints (mostly in the knees, hands or feet) and don’t commonly impact the SI joint.
  • Other health problems that can contribute to spinal disc problems might also cause bowel/digestive dysfunction, morning stiffness and skin inflammation, which aren’t common in sacroiliitis.
  • If your back/leg pain feels the worst when you wake up in the morning but gets better when you move more, it likely isn’t the sacroiliitis causing your problems, but possibly arthritis, an infection or another inflammatory disorder.
  • If you feel pain running down the back of your legs that extends to your ankle or foot, you might have sciatic nerve pain. SI joint pain is similar to sciatica, but the two have different causes (sciatica pain radiates down the sciatic nerve located in the lower back).

Precautions When Treating SI Joint Pain

SI joint dysfunction is certainly not the only reason you might be feeling lower back or leg pain, so it’s always best to get a proper diagnosis from a doctor before taking any steps to treat your condition. If you developed back pain prior to being 30 years old and experience other symptoms — such as morning stiffness, unexplained weight loss, bowel problems, fever, rashes, pain that lasts for more than six weeks and pain that improves with activity — it’s possible that the real cause for your pain is another disorder or disk disease.

Final Thoughts on the Sacroiliac Joint and SI Joint Pain

  • The sacroiliac joint (SI joint) is located at the bottom of the spine right near the pelvis, sacrum, tailbone and hips.
  • Dysfunction of the SI joint can cause pain and limited range of motion in the lower half of the body, especially the low back, hips, buttocks and upper thighs.
  • Causes of SI pain include degenerative joint diseases, poor posture, added pressure due to pregnancy, overuses and other injuries affecting the spine.
  • Natural treatment for SI joint pain include prolotherapy, a diet rich in collagen, soft tissue therapies, physical therapy, low-impact exercise and chiropractic adjustments.

Read Next: 6 Natural Ways to Relieve Sciatic Nerve Pain

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