Is It Lower Back Pain or Your SI Joint? How to Tell the Difference

Lower back pain can be frustrating, especially if you can’t quite pinpoint where it started. You might feel an ache near your spine, pain in one side of your lower back, or discomfort that seems to spread into your hip or buttock. 

The tricky thing about back pain is that several different conditions can cause similar symptoms. One possible source that often gets overlooked is the sacroiliac (SI) joint.

At Seattle Spine Institute in Seattle, Washington, our experienced spine specialists routinely diagnose and treat pain caused by a range of back ailments, including SI joint dysfunction. With a specialized surgery, we can fuse the SI joints and resolve serious cases of SI joint pain.

What SI joint pain is like

Your sacroiliac joints are located on either side where your lower spine meets your pelvis. These joints help transfer the weight of your upper body to your legs. When you walk, stand, sit, or change positions, irritation in or around one or both SI joints can cause distinct pain.

SI joint pain is usually one-sided, flaring in the lower back or buttock and spreading to the hip, groin, thigh, and leg. That can make SI joint pain look a lot like ordinary lower back pain, and misdiagnosis is common.

Unlike a herniated disc or sciatica, SI joint pain can be intractable. If conservative treatments don’t work, you may need a surgery called sacroiliac joint fusion.

How is SI joint pain different from lower back pain?

There is no single symptom that can tell you, “This is definitely your SI joint causing an issue.” That’s because muscles, discs, joints, or nerves can cause lower back pain. However, some signs can indicate SI joint issues:

• Pain concentrated around the lower back and buttock
• Pain that only appears on one side
• Pain that gets worse when shifting from sitting to standing or climbing stairs

If your pain is caused by a different problem located in your lower back, it can present differently. Nerve pain caused by a diagnosis like sciatica might show up with symptoms like:

• One-sided pain that travels from the hip far down the leg
• Pain accompanied by numbness or tingling
• Weakness in the affected leg

Many general medical practitioners can’t reliably diagnose the source of your back pain based on location or basic symptoms alone. If you haven’t been able to resolve your back pain, it might be time to see a specialist.

Resolving SI joint pain

Since SI joint problems can mimic other causes of back pain, determining the source can require a deeper dive into your condition. At Seattle Spine Institute, a spine specialist will review your symptoms and medical history and examine your back, hips, and pelvis. 

Applying pressure around the SI joint or moving the joint can help determine if it’s causing your pain. Scans like an MRI or CT scan can also help show if issues exist around your SI joints.

If your lower back or buttock pain keeps coming back, interferes with your daily activities, or does not improve with conservative care, Dr. Schwaegler may perform minimally invasive surgery using the advanced SImmetry® SI joint fusion system. This procedure includes preparing the joint, placing a bone graft, then inserting implants to stabilize the bones.

Want to know more about your options? Contact our Seattle, Washington, office to schedule an appointment today by calling 206-322-1765 or contact us online.