Are Your SI Joints Causing Your Chronic Low Back Pain?

Many people have lived with chronic back pain for years. Whether merely a nagging inconvenience or a debilitating pain, chronic back pain at its least decreases quality of life and at its worse can be disabling. In fact, some impressive statistics concerning lower back pain include that it is the most significant cause of disability in the entire world and it is one of the leading reasons for lost work hours.

The more severe back pain sufferers may have undergone a medical workup to try to find the cause of their pain, or perhaps even low back surgery, but still have not had satisfactory relief of their pain.  The recent war on use of Opioids to treat chronic pain complicates the situation for many.  For those people, it is apparent that the cause of their pain was not adequately identified or addressed. But, there may be hope, and another treatment avenue yet to be explored involving the sacroiliac joints (SI Joints).

What are the SI Joints?

The SI joints are the joints between your pelvis and your lower back. There are two of them, a left and a right, and their main job is to carry and transfer the weight of your upper body to your pelvis and on to your legs when you stand or walk. The entire weight of your upper body is resting on your two SI Joints.

Can the SI Joints be Injured?

Yes, they can. SI joint problems frequently occur after a fall on the buttocks or hips. It doesn’t have to be a fall to disrupt them. In fact, any mechanism of injury that creates a significant blow to the joints could be responsible for an SI joint injury. Any trauma that causes a shearing force between the spine and the pelvis can be responsible for causing instability in the SI joint. And, for the most part, injuries to the SI joints can cause symptoms that mimic a low back injury including back pain and pain running down into the hip and leg.

Are My SI Joints Causing My Back Pain?

When your low back hurts, you look for a problem in the low back. But it is becoming more apparent that you can’t just stop there. We are finding more and more that you have to also consider the SI joints as being a possible cause for the pain. Some statistics recently state that an injured SI joint may be responsible for upwards of 25 percent of chronic low back pain patients.

SI joint dysfunction won’t normally show up on an X-ray, MRI, or other radiology exams. But, there is a series of physical examination tests that can be done to focus on the SI Joints and determine whether they are the cause of your pain. If the examination suggests the SI Joints are involved, a set of injections can then be done to confirm whether the SI joint is truly causing the pain. These same injections may actually help resolve the pain. Surgery isn’t always needed to achieve pain relief.

If you do need surgery, doctors usually use a process that fuses the SI joint to eliminate movement. It is a relatively minor procedure and has a very high success rate of resolving SI joint dysfunction.

Did My Doctor Look at My SI Joint as a Possible Cause of My Pain?

Obviously, we can’t answer that question. But in decades past, doctors rarely considered the SI joint as a possible low back pain generator. Back pain, without an obvious cause like a fracture, was often attributed to some inflammatory process in the back itself. Even if your doctor did suspect your SI joints were the source of your pain, there were no recognized testing criteria to make a diagnosis and no realistic treatment options existed. So it was unlikely that your doctor would consider the SI joints as the cause of your low back pain.

In more recent years, your doctor may have been more aware of the possibility the SI joints were to blame. But, the continued inability to adequately treat an SI Joint injury likely resulted in only a few rounds of physical therapy. If you got better, great. If you didn’t, your doctor probably told you to learn to live with the problem. In the present day, testing criteria exist to accurately diagnose SI joint problems, and there are medical procedures to stop the pain.

The important point to understand is that in order to determine whether a problem exists with the SI joints, one has to specifically look for it. A work-up for low back pain in the past likely overlooked the SI joints as a possible cause. Even in the current medical system, it is rare to find a doctor that will actually test for SI joint dysfunction. Unless they do, they aren’t likely to find out whether the SI joints are causing your problems.


If you meet the criteria for surgical treatment of this condition, the success rate is very high. Over the past couple of years, our law firm has handled cases for several clients who have had a confirmed diagnosis of SI joint dysfunction. All of them involved substantial fights with the workers’ compensation insurance carrier. However, we were able to convince the insurance company to authorize and pay for the surgery. All of them had the surgery described in this article. And all of them have reported complete or near (95%) complete relief of their symptoms.

If you or a loved one suffer from chronic back pain, regardless of how long it has been going on, it may be worthwhile for you to look into whether the pain is a result of an SI joint problem. Treatment is now available and quite successful.