Sacroiliac Joint Symptoms:

  • Buttock pain on one side
  • Sitting on affected buttock is painful
  • Falls asleep OK, but wakes up when rolling over in bed
  • A sense of instability in the leg – knee gives out
  • Some have L5 or S1 dermatome tingling or ache (pseudo-sciatica)

Pain Patterns Can Include:

  • Buttock are especially tender over the SIJ Sulcus
  • Groin (mimics hip problems)
  • Hamstring (mimics sciatica)
  • Foot

Physical Examination For SIJ Clues:

  • Patients elevates the affected side when sitting
  • Patient often limps and hip hikes affected side
  • Points to SIJ Sulcus when asked where it hurts
  • Pain on passive movement of the hip (pain in the butt)
  • Palpation of the SIJ Sulcus is especially tender
  • Neurological exam is negative

The single most important diagnostic test is the SIJ anthrogram and block. If a patient has been sent to pain management that resulted in hours, days or weeks of relief after an SIJ block, the pain generator is likely the joint. When the pain returns, patients often believe the treatment failed. To the contrary, a diagnosis has been made and the patient should now be given non-operative and operative solutions to permanently treat the cause of the pain.