Sacroilitis / Buttock pain

The sacroiliac joints are located where the sacrum meets the pelvic bones. These joints provide foundational support and absorb impact between the upper and lower body. Though they do not move much, inflammation in these joints—called sacroiliitis—or excessive joint movement can trigger pain.

Common symptoms may include:

• Pain in the lower back, buttocks, or groin
• Discomfort that radiates down the back of the thigh
• Difficulty sitting on one side or lying comfortably
• Stiffness when rising from a seated position
• Soreness during climbing stairs, walking, or sleeping
  

It is common for patients to confuse this discomfort with hip, lumbar spine, or muscular issues, which is why accurate diagnosis matters.

There are multiple causes of sacroiliac joint dysfunction. Some cases follow a traumatic injury such as a fall. Others develop gradually due to wear and tear. In women, pregnancy and childbirth can greatly affect the alignment and flexibility of these joints.

Other risk factors and contributing conditions include:

• Inflammatory conditions such as ankylosing spondylitis
• Progressive degeneration of joint surfaces
• Trauma from falls or accidents
• Uneven gait due to previous surgery or joint injury
• Weak pelvic or gluteal muscles
• Stress following lumbar spinal fusion surgery
  

Consider an example: someone wears a walking boot following ankle surgery. The shift in weight-bearing demands causes strain on one side, leading to irritation in the SI joint. Many patients are unaware of this domino effect until the pain becomes persistent.

Sacroiliac joint pain in Northern Virginia often goes underdiagnosed since it resembles symptoms from other musculoskeletal conditions. Recognizing activity-specific triggers and consulting a specialist can make a major difference in effective recovery.

Accurate diagnosis typically begins with a discussion about the onset, pattern, and triggers of your pain. A physical exam often includes targeted tests such as:

• The FABER test
• Gaenslen test
• Sacral thrust
• Yeoman’s test
  

When necessary, imaging like X-rays, CT scans, and MRIs may be used to rule out comparable issues such as disc degeneration or hip joint pathology. The gold standard for confirming SI-related pain is often a diagnostic injection. If the pain improves after a local anesthetic is placed into the SI joint, this confirms the diagnosis.

Once a diagnosis is made, the next step is creating a plan that reduces pain and supports joint stability. Every case of sacroiliac joint pain in Northern Virginia is different, which is why a personalized approach is key.

Treatment plans may include:

• Physical therapy to strengthen the core, pelvis, and glutes
• At-home stretching routines for stabilization
• Rest along with hot or cold therapy as appropriate
• Over-the-counter anti-inflammatories or acetaminophen
• Targeted sacroiliac joint steroid injections
• Radiofrequency ablation for long-term nerve pain relief
• Surgical SI joint fusion in rare or severe cases
  

Most patients benefit significantly from conservative therapies, avoiding the need for surgery. A structured treatment plan that supports strength and alignment is often enough to manage symptoms effectively.

Reducing the risk of future SI joint flare-ups is an important part of long-term health. A few simple strategies can go a long way:

• Practice proper posture when sitting, standing, or sleeping
• Avoid lifting heavy items with poor form
• Incorporate low-impact exercises to build core strength
• Maintain a healthy weight to reduce load on joints
• Avoid smoking, which slows healing and impacts tissue repair