Explore SI joint pain treatment options that may help patients regain function, reduce pain, and support a return to daily activities.
SI Joint Pain Treatment Approaches to Support Recovery
Sacrum and iliac joint (SI joint) pain can significantly impact daily life. This discomfort may affect activity levels and overall well-being, often making it difficult to perform daily tasks such as sitting, standing, walking, or sleeping comfortably.
This page provides an overview of SI joint dysfunction and outlines non-surgical and interventional treatment options. These approaches can help provide relief and support a return to daily activities. For those exploring alternatives to surgery, understanding these proprietary methods is an important step toward making an informed decision.
Understanding SI Joint Pain and Its Causes
The SI joints connect the base of the spine to the pelvic bones.[1] These joints are strong and stable, helping to support upper body weight while standing or walking. They act as a bridge that transfers weight between the upper body and the legs. While these joints are designed to move only a small amount, any change in functionality can cause discomfort and may affect activity levels and overall well-being.
The sections below provide more information on how SI joint pain often presents and common factors that may contribute to the condition.
Signs and Symptoms
SI joint pain can present in different ways, and symptoms often vary. Common signs may include:
- Pain located in the lower back, buttocks, hips, or groin.
- Discomfort that can worsen with prolonged standing, walking, climbing stairs, or other weight-bearing activities.
- Occasionally, mild pain that radiates into the leg.
Because these symptoms often overlap with other causes of lower back pain, a thorough evaluation by physicians in the licensed Regenexx network is important for determining if the SI joint is the cause of pain.
Causes and Risk Factors
SI joint pain may result from various underlying issues that affect how the joint moves or functions. Common causes and risk factors include:
- Inflammation: Conditions such as sacroiliitis or other inflammatory disorders may irritate the joint.
- Abnormal Movement: Too much or too little motion in the SI joint can place strain on surrounding tissues.
- Injury or Trauma: Falls, accidents, or repetitive stress from daily activities may disrupt joint stability.
- Pregnancy: Hormonal changes and increased joint mobility can affect the alignment and support of the SI joints.
- Arthritis: Degenerative changes in the joint over time, including osteoarthritis, may contribute to pain and stiffness.
Why Early Care May Help SI Joint Pain
Addressing SI joint pain early may help reduce discomfort and limit changes in joint function. If the SI joint is not moving correctly, the body may change how it moves to compensate. This can increase strain on surrounding joints and muscles and may affect activity levels and overall well-being.
Seeking a timely and thorough evaluation may help identify contributing factors. This allows for customized, non-surgical procedures using Regenexx processes. Early care does not just support relief—it may also help maintain mobility and support the body’s natural healing agents.
The following section outlines available treatment options that may help manage SI joint pain and support recovery.
Conservative and Non-Invasive Approaches
For many individuals, conservative treatments are the first step in managing SI joint pain. These approaches focus on relieving discomfort, improving joint stability, and supporting mobility. Depending on the symptoms and underlying causes, one or more of the following options may be recommended as part of a care plan.
Physical Therapy
Customized physical therapy may help improve joint function by strengthening the muscles that support the pelvis and lower back. A licensed physical therapist can provide exercises designed to improve stability, flexibility, and posture. This may also help identify and avoid movements that can worsen the joint discomfort.
Consistent participation in a program can support long-term improvement and help reduce strain on the SI joint.
Recommended Medications
Over-the-counter or prescription medications are often recommended to help manage inflammation and discomfort related to SI joint dysfunction. These may include nonsteroidal anti-inflammatory drugs (NSAIDs) or other pain-relieving medications.
Medications are typically used as part of a broader treatment plan to help manage symptoms, while other methods address the mechanical causes of joint pain.
Supportive Devices
In some cases, a supportive device such as an SI belt may be recommended. These belts are designed to provide stability by compressing the pelvic region. This can help reduce excessive joint movement and improve comfort during daily activities.
Supportive devices are generally used with other treatments, such as physical therapy, and may be most helpful during periods of increased activity.
Interventional Treatment Options
When conservative treatments do not provide sufficient relief from SI joint pain, interventional options may be considered. These procedures are typically non-surgical. They are designed to help manage pain and improve function by addressing the source of discomfort.
Depending on the underlying cause of the symptoms, physicians in the licensed Regenexx network may recommend one or more of the following image-guided techniques as part of a customized care plan:
Injections
Image-guided injections may be used to deliver medication directly into or around the SI joint. These injections typically contain a combination of an anti-inflammatory agent and a local anesthetic. They may help reduce inflammation and provide temporary relief. This may allow for better engagement in rehabilitation activities like physical therapy. In some cases, diagnostic injections may also be used to help confirm the SI joint as the cause of pain.
Radiofrequency Ablation (RFA)
RFA is a non-surgical procedure that uses heat to interrupt nerve signals. This can help stop the nerves from sending pain signals from the SI joint to the brain. This technique targets specific nerves and may provide longer-lasting relief when symptoms are linked to nerve irritation. The procedure is typically performed using image guidance and may be considered when injections offer only limited benefits.
Nerve Blocks
Nerve blocks involve the injection of anesthetic medication near the nerves that supply the SI joint. This can help temporarily disrupt pain signals. Physicians usually use these for both diagnostic and therapeutic purposes. In some cases, nerve blocks are a preliminary step before considering other treatments.
Surgical Options for Complex SI Joint Pain
Surgery is rarely necessary for SI joint pain and is considered only in severe cases when other treatments have not worked. This option is typically reserved for instances where symptoms continue to affect daily activities despite conservative or interventional care.
One surgical procedure is SI joint fusion.[2] This involves stabilizing the joint by placing implants that join the sacrum and iliac bones. This may help reduce joint movement, which can relieve stress on surrounding tissues and potentially alleviate pain.
While some surgical methods are less invasive than traditional open surgery, they still involve significant recovery. Individual outcomes vary, but some patients may experience improved function and relief after this procedure.
A thorough evaluation, including diagnostic testing and a review of previous treatment, is essential to determine if surgery is the recommended next step.
Complementary and Alternative Approaches
In addition to conventional treatments, some individuals explore complementary therapies to support recovery and overall well-being. While these approaches are not intended to replace medical care, they can be used alongside other treatments to help manage symptoms and improve mobility.
The options below are commonly considered as part of a broader, customized approach to managing SI joint pain.
Acupuncture
Acupuncture involves the placement of thin needles at specific points on the body. This practice is believed to stimulate nerves and muscles, which may help promote natural pain-relieving responses. It can also help improve circulation in the affected area.
Chiropractic Care
Chiropractic care typically involves manual adjustments to the spine and joints. The goal is to improve alignment and reduce muscle tension. For those experiencing SI joint pain, certain techniques may help address contributing factors such as posture, joint mobility, or muscle imbalances.
Yoga and Pilates
Yoga and Pilates are low-impact movement practices that focus on strength and flexibility. These practices may help support core stability and improve posture. When used correctly, they can help reduce strain on the lower back and pelvis.
Exploring A Non-Surgical Approach For SI Joint Pain
For individuals seeking alternatives to surgery, physicians in the licensed Regenexx network offer non-surgical, image-guided procedures. These use the individual’s own healing agents and Regenexx processing to target areas of inflammation or instability.
A key difference in the Regenexx approach is the method of processing. While typical providers use a basic, automated bedside centrifuge, Regenexx injectates are processed by a technician in a flexible lab environment. This enables a significantly higher level of customization.
By focusing on joint stability and supporting the body’s natural repair processes, these regenerative therapeutics may offer an alternative for those who wish to avoid invasive surgical intervention.
Bone Marrow Aspirate Concentrate (BMAC) Injectate
Regenexx SD procedures involve collecting a small sample of bone marrow—typically from the back of the hip. This sample is processed into a customized concentration of healing agents and reintroduced into the SI joint using precise, image-guided techniques.
This procedure may be recommended for those with chronic SI joint pain related to instability or degeneration, especially when other treatments have not provided sufficient relief.
Platelet‑Rich Plasma (PRP) Injectates
PRP injectates are prepared by drawing a small amount of blood and processing it to isolate healing agents. Using the Regenexx approach, these concentrations are customized specifically for each patient and their condition.
This procedure supports the body’s natural healing agents and may help reduce inflammation or irritation in the joint. PRP is often recommended for mild to moderate cases where conservative therapies alone have not reached the desired goal.
Supporting and Maintaining Joint Health With The Regenexx Approach
SI joint pain can significantly affect comfort, mobility, and overall well-being. While early conservative care may help manage symptoms, some individuals benefit from non-surgical options when other treatments aren’t enough.
The Regenexx approach focuses on providing patients with image-guided, non-surgical procedures that may support joint stability and the body’s natural healing response. Using an individual’s own healing agents and Regenexx processing, these procedures are designed to help reduce pain and improve function. This approach may support joint health and mobility without the need for invasive surgery.
For those exploring alternatives to surgery, physicians in the licensed Regenexx network may offer a treatment path customized to the specific condition and recovery goals.
Looking for a non-surgical treatment for SI joint pain? Explore Regenexx non-surgical procedures to help regain function.
References:
- Wong M, Sinkler MA, Kiel J. Anatomy, Abdomen and Pelvis, Sacroiliac Joint. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507801/
- Martin CT, Haase L, Lender PA, Polly DW. Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence. Int J Spine Surg. 2020 Feb 10;14(Suppl 1):20-29. doi: 10.14444/6072. PMID: 32123654; PMCID: PMC7041666. https://pmc.ncbi.nlm.nih.gov/articles/PMC7041666/
