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5 Things To Know About The SI Joint

Authored by Dr. William Kemp, MD. November 15, 2022

If you feel like you’re hearing a lot lately about sacroiliac (SI) joint dysfunction – there’s a good reason for that. SI joints are the source of up to ¼ of all back pain. Even so  – they are not well understood by patients and diagnoses can be challenging when they’re the trigger of back pain. 

In the hopes of bringing clarity to those dealing with this common cause of back pain – here are the Top 5 questions patients ask me about SI joints. 

What is the SI Joint?

I generally pull out a model of the spine when talking about the SI joints because most people haven’t heard of them and aren’t sure where they are. The SI joints – you have two of them – sit between the sacrum and the pelvis, on either side of the lower part of your spine.

What Does SI Joint Pain Look Like?

SI joints are one of the more poorly understood areas in terms of being a pain generator. A lot of patients come to the clinic reporting generalized low back pain in the buttocks area. It’s often occurring in younger folks who are typically pretty physically active. The pain can be aching, can impact mobility and walking and some patients report that it feels like their joints are popping out of the socket.

skeleton of lower back and hip area. Red inflamed area of the SI Joints.

How Do You Get a Diagnosis of SI Joint Dysfunction?

This is often hard for patients – many of whom say they’ve been dealing with pain for a long time before they figure out the cause. Diagnoses can be hard to come by because there are a lot of other problems that may cause similar pain. We get to a diagnosis by starting with imaging such as an MRI or X-ray to confirm that the patient doesn’t have another issue in the spine or hip. We also do a physical exam to assess neurologic function. When these things are ruled out, we often laser in on SI joints as the cause of the pain.

What Treatments Are Available?

While SI joint pain can be debilitating for many – finding relief isn’t always easy. Countless offerings online promise to ‘cure’ your SI pain. But the best way to find relief is to meet with a spine doctor. I like to try conservative management first and for me, that’s usually physical therapy. Manipulative maneuvers from a trained PT, plus stretching can help patients employ a better range of motion and that can really help. PTs can also provide individualized exercise programs that can provide relief. If that doesn’t work, then it’s time to talk with your doctor about other options – perhaps medications, injections – or even regenerative medicine. You want to have a conversation with a doctor who is able to customize a treatment plan that best addresses your pain, the level of dysfunction and can get you back to doing what you love. SI joint fusion surgery is also available when nothing else fixes the problem.

Can Patients Recover From SI Joint Pain?

Absolutely. There are reasonable options for any patient that comes to see us. You don’t have to live with pain. You should not live with pain. Seek help. Look for answers. They’re out there and relief is absolutely possible.


Dr. William Kemp is a fellowship-trained spine neurosurgeon at Virginia Spine Institute. As a minimally invasive and complex spine neurosurgeon, Dr. Kemp takes pride in utilizing his extensive knowledge of the nervous system to find answers for his patients and provide operative and non-operative solutions to help them reach their goals. His genuine passion for helping others drives a commitment to the highest standard of care and helps patients get back to enjoying life. Learn more about Dr. Kemp.

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Reviewed by: Dr. William Kemp, MD.

Reviewed by: Dr. William Kemp, MD.

About The Author

Dr. William Kemp, MD

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