If your low back pain sits mostly on one side, low down near the dimple above the buttock, and flares when you get up from a chair, climb stairs or turn over in bed — your sacroiliac joint may be the culprit. The sacroiliac joint is one of the most under-recognised sources of low back pain; many people are treated for their disc or their spine for months before anyone tests this joint. This is a companion to our main low back pain guide, focused on the SI joint.
Sacroiliac (SI) joint pain comes from the joint where the spine meets the pelvis, felt low in the back and to one side over the buttock, often worse with sitting, standing up and climbing stairs. It's confirmed with a diagnostic SI joint block and treated for the long term with sacroiliac denervation radiofrequency ablation (RFA) — which calms the joint's pain nerves without weakening the back or leg — alongside physiotherapy. Surgery is rarely needed.
What Is the Sacroiliac Joint?
At the base of your spine, the triangular sacrum connects to the pelvis on each side at the sacroiliac joints. These are strong, relatively stiff joints held by thick ligaments; their job is to transfer the load of your upper body into your legs and absorb shock while you walk. Like any joint, they can become strained, inflamed or dysfunctional — after pregnancy, injury, altered walking patterns, leg-length differences, or previous spine surgery — and then they hurt.
In plain terms: the SI joints are the sturdy connectors between your spine and your pelvis, like the joint between a mast and the deck of a boat. When one becomes irritated, you feel a deep, one-sided ache low in the back and buttock — and because it's not in the spine itself, it's easily blamed on the discs and missed.
Typical symptoms of sacroiliac joint pain
- Pain low in the back and buttock, usually on one side
- Worse with sitting for long periods, standing up, climbing stairs or turning in bed
- Pain that can spread into the groin or back of the thigh, usually not below the knee
- A feeling of the pelvis being "stuck" or unstable
- Tenderness right over the joint (near the dimple above the buttock)
How Sacroiliac Joint Pain Is Diagnosed
Because SI joint pain overlaps with disc, facet and hip problems, diagnosis matters. We combine specific examination tests (provocation manoeuvres that stress the joint) with the interventional pain specialist's key tool: a diagnostic block.
A diagnostic sacroiliac joint block is a small, image-guided injection of local anaesthetic into or around the joint. In plain terms: we temporarily numb the joint. If your usual pain substantially disappears while the anaesthetic is working, we have strong confirmation that the SI joint is the source — and that you're likely to benefit from denervation RFA.
Sacroiliac Denervation Radiofrequency Ablation (RFA)
Once a diagnostic block confirms the SI joint, sacroiliac denervation RFA offers lasting relief.
The back of the sacroiliac joint is supplied by small sensory nerves called the lateral branches. In plain terms: using image guidance to place the needle accurately, we apply controlled radiofrequency heat to calm these specific pain-carrying nerves — quietening the pain signal from the joint. Because these are sensory nerves, this relieves pain without weakening your back or leg. Relief commonly lasts many months, and because nerves slowly regenerate, the procedure can be safely repeated if pain returns.
1. Confirm the source
A diagnostic SI joint block confirms the joint is causing your pain.
2. Image-guided RFA
Under ultrasound and C-arm guidance, the radiofrequency needle is placed to treat the lateral branch nerves; the area is numbed first.
3. Same-day discharge
The procedure takes about 30–45 minutes and you go home the same day.
4. Rehabilitation
Pelvic and core stabilisation exercises support the joint and help relief last.
Sacroiliac denervation RFA is done under local anaesthesia; most patients feel pressure rather than pain and go home the same day. Relief commonly lasts several months up to a year or more, and the procedure can be repeated safely if pain returns.
Why Our Approach Is Different
Every SI joint procedure we perform is image-guided (ultrasound and C-arm) to an international standard, and we always confirm the diagnosis with a diagnostic block before denervation — because the SI joint is so often blamed wrongly or missed entirely. And every procedure is paired with pelvic and core stabilisation rehabilitation, which addresses the mechanics that overloaded the joint in the first place.
Image-Guided Precision
Ultrasound and C-arm guidance place the needle accurately on the joint and its nerves.
Confirmed Before Treated
We prove the SI joint is the source with a diagnostic block before offering RFA.
Lasting, Repeatable Relief
Denervation calms only sensory pain nerves; relief lasts months and can be repeated.
Rehabilitation Built In
Pelvic and core stabilisation addresses the mechanics behind the pain.
Doctor's advice
If your back pain is one-sided and low, and months of disc-focused treatment haven't helped, ask specifically whether your sacroiliac joint has been tested. A simple diagnostic block can settle the question — and if the SI joint is the culprit, denervation RFA with rehabilitation often provides the relief that eluded every treatment aimed at the wrong target.
Key takeaways
- Sacroiliac joint pain is a commonly missed cause of one-sided low back and buttock pain.
- It's confirmed with a diagnostic SI joint block, not just a scan.
- Sacroiliac denervation RFA gives lasting relief without weakening the back or leg.
- Relief lasts months and the procedure can be safely repeated.
- Pelvic and core rehabilitation makes results durable; surgery is rarely needed.
Summary
The sacroiliac joint is a frequently overlooked source of low back pain, and identifying it can be the turning point for people who've been treated for the wrong thing for months. Confirmed with a diagnostic block and treated with image-guided sacroiliac denervation RFA plus pelvic and core rehabilitation, most patients get substantial, lasting relief without surgery.
Frequently Asked Questions About Sacroiliac Joint Pain
What is sacroiliac joint pain?
Pain from the joint where the spine meets the pelvis, felt low in the back and to one side, often worse with sitting, standing up and climbing stairs.
How is sacroiliac joint pain diagnosed?
Through specific examination tests and a diagnostic image-guided SI joint block. Good relief from the numbing injection confirms the joint as the source.
What is sacroiliac denervation RFA?
A procedure using controlled heat to calm the lateral branch nerves carrying SI joint pain, giving lasting relief without weakening the back or leg.
How long does sacroiliac joint RFA last?
Commonly several months up to a year or more. As the nerves slowly regenerate, it can be repeated safely.
Is sacroiliac RFA painful?
It's done under local anaesthesia; most patients feel pressure rather than pain and go home the same day.
What causes sacroiliac joint dysfunction?
Strain, injury, pregnancy, altered walking patterns, leg-length differences, and sometimes previous spine surgery.
Is sacroiliac joint pain the same as sciatica?
No, though they can feel similar. SI joint pain is usually felt in the back and buttock and rarely travels below the knee, unlike nerve-driven sciatica from a disc.
Does sacroiliac joint pain need surgery?
Rarely. Most is managed with physiotherapy, SI joint injections and denervation RFA. Fusion surgery is reserved for select severe, refractory cases.
Can sacroiliac joint pain be cured?
It can be brought under lasting control, especially when RFA is combined with pelvic and core stabilisation exercises.
Where can I get sacroiliac joint pain treatment in Delhi?
At PainClinix, Punjabi Bagh, interventional pain specialist Dr. Titiksha Goyal offers image-guided SI joint injections and sacroiliac denervation RFA for patients across West Delhi and Delhi NCR.
Medical disclaimer
This article is for general education and does not replace a personal medical consultation. Sacroiliac joint pain should be diagnosed and treated after individual assessment. Please consult a qualified pain physician before making decisions about your care.