Could an SI joint problem cause your low back pain?


Lower back pain can be caused by many disorders including degenerative disease, osteoarthritis, trauma (eg, motor vehicle accident), pregnancy, hip problems, and sacroiliac joint disorders. According to published scientific literature, it is common for pain from the SI joint to feel like disc or lower back pain. One study reports that SI joint problems are a challenging condition affecting upwards of 25% of patients with axial low back pain.1


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Non-surgical treatment may include physical therapy, oral medications, and/or injection therapy. Some patients’ symptoms are not adequately relieved by non-operative therapies and they may require surgery. Until now, traditional SI joint surgery usually involved instrumentation (eg, screws) with bone graft in an invasive surgical procedure.

The purpose of the Patients’ Guide to Sacroiliac Joint Problems is to help you understand SI joint disorders and provide you with information about the iFuse Implant System®. Use the information provided in this Guide to help learn about SI joint disorders and talk with your doctor who can help you make informed decisions about your healthcare.

What are the SI joints?  

Figure 1

Your sacroiliac joints are part of your pelvis and located between the ilium and sacrum (Figure 1). The pelvis acts as a central base through which large forces are transferred and dispersed. The SI joints transfer weight and forces back and forth between your upper body, pelvis and legs.  The primary role of the SI joints is to provide pelvic stability and support the weight of the upper body. 

Like other joints in the body, the SI joints can be injured and are susceptible to wear and tear. When this happens symptoms can develop and be felt anywhere from the lower buttocks to the lower spine. SI joint problems may co-exist with lumbar spine or hip conditions. 

How are SI joint disorders diagnosed?

SI joint disorders are challenging to diagnose because they can feel like and/or co-exist with different spine problems such as a slipped or degenerated disc, or pain originating from the hips.  However, your doctor can compare findings from your physical examination, X-rays, CT scans, or MRI as well as perform a diagnostic spinal injection. 

The injection is performed using fluoroscopic or CT guidance to verify accurate needle placement into the SI joint.  If your symptoms are decreased significantly, it may be concluded that the SI joint is either the source or a major contributor to your low back pain.2

Once the SI joint is confirmed as the source of your symptoms, treatment can begin.  Many patients respond favorably to physical therapy, oral medications, and/or injection therapy.  However in some cases these treatments are less effective over time.  In those instances, surgical fusion may be recommended.


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This information is not intended to take the place of a doctor's advice. Please keep in mind that treatment and outcome results vary among patients. The iFuse Implant System® is intended for sacroiliac fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruption and degenerative sacroiliitis. This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted postpartum for more than 6 months. There are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit. For information about the risks, read the Important Safety Information.

Steven R. Garfin, MD is a paid consultant of and has an ownership interest in SI-BONE Inc.