Pelvic and Hip Pain: SI Joint Dysfunction and Treatment Options

January 14, 2026

Pelvic and hip pain can be frustrating, limiting, and difficult to pinpoint. Many patients assume hip arthritis or a lumbar spine issue is the cause, but the true source of pain is often the sacroiliac (SI) joint. SI joint dysfunction is a common yet frequently overlooked contributor to lower back, buttock, hip, and pelvic pain.

What Is the SI Joint?

The sacroiliac joints sit at the base of the spine where the sacrum meets the iliac bones of the pelvis. These joints help transfer weight and forces between the upper body and the legs while providing stability during everyday movement.

What Is SI Joint Dysfunction?

SI joint dysfunction occurs when the joint becomes inflamed or moves abnormally. Even small disruptions in joint mechanics can lead to significant pain and mobility issues.

Common Causes of SI Joint Pain

  • Injury or trauma
  • Pregnancy-related ligament changes
  • Degenerative arthritis
  • Leg length discrepancies
  • Prior lumbar spine surgery
  • Repetitive stress or overuse

Symptoms of SI Joint Dysfunction

  • Lower back or buttock pain
  • Hip or groin discomfort
  • Pelvic pain or pressure
  • Pain when standing, walking, or climbing stairs
  • Difficulty sitting or transitioning positions

How SI Joint Dysfunction Is Diagnosed

Diagnosis involves a thorough history, physical examination, imaging studies, and sometimes diagnostic SI joint injections to confirm the source of pain.

Non-Surgical Treatment Options

  • Targeted physical therapy
  • Activity modification
  • SI joint bracing
  • Inflammation-focused lifestyle strategies

Interventional Pain Management Options

  • Image-guided SI joint injections
  • Radiofrequency ablation (RFA)
  • Advanced regenerative injection therapies

When Is Surgery Considered?

Surgical intervention is rarely needed and reserved for severe cases that fail conservative and interventional care.

Living With SI Joint Dysfunction

With accurate diagnosis and a personalized treatment plan, most patients can manage SI joint pain successfully and maintain an active lifestyle.

Final Thoughts

SI joint dysfunction is a common but often underdiagnosed cause of pelvic and hip pain. Early evaluation and comprehensive treatment can lead to lasting relief and improved quality of life.

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