Signs and Symptoms

The most common manifestation of sacroiliac joint dysfunction is acute pain in the low back, in the area of the Posterior Superior Iliac Spine (PSIS) positioned approximately 2 inches from the midline and very deep-seated. Usually, tenderness is found near the lumbo-sacral promontory and in the PSIS area, one more pronounced than the other. Radiating pain into the buttock, hip, groin and thigh is often experienced. The pain is frequently increased by prolonged positions such as sitting, standing, walking or lying. The patient reports that frequent position changes are needed to maintain any degree of comfort.

Common symptoms of sacroiliac joint dysfunction:

  • Lumbosacral pain
  • Buttock Pain
  • Pain radiating to the leg
  • Hip pain
  • Groin pain
  • Urinary frequency
  • Iliac crest pain
  • Transient numbness, prickling or tingling
  • Increased pain with menstruation
  • Increased pain with sexual intercourse
  • Increased pain with stair climbing
  • Increased pain with sustained positions (i.e., sitting, walking, lying)

Patient self-evaluation of symptoms revealed the following:

  • 96% Increased discomfort with sustained positions (i.e., standing, sitting, lying)
  • 66% Radiating buttock pain
  • 39% Discomfort with stair climbing and/or hill climbing
  • 26% Groin pain
  • 23% Radiating leg pain
  • 20% Pain with forward flexion
  • 15% Loss of strength in the legs
  • 10% Urinary frequency

The most commonly reported position of comfort by patients in the study was side lying (left or right), with a pillow between the knees.

The most frequent complaint from patients with sacroiliac joint dysfunction is increased discomfort with sustained positions such as standing, sitting and lying, with the inability to attain a position of comfort. A disc patient can often find a position of comfort, especially when lying down. Sacroiliac joint symptoms will intensify with activity and decrease with rest, while disc symptoms will usually be worse upon rising in the morning.

The second most common symptom of sacroiliac joint dysfunction is radiating buttock pain. This is reported as a generalized distribution of “achiness” which can radiate into the thigh.

The third most common symptom is increased discomfort with stair or hill climbing. This is a result of increased demands on the skeletal and soft tissue system of the pelvic girdle during these activities. This symptom may also be present in disc pathologies, but is primarily reported as increased discomfort with forward trunk flexion.