Is Sacroiliac (SI) Joint Pain Causing Your Lower Back, Buttock or Hip Pain?

H2 SUBHEADING IN THE FORM OF A QUESTION

Do you have lower back pain that sits just off to one side, near the dimple of your low back or buttock? Does it hurt to stand up from a chair, roll over in bed, walk, or climb stairs? If so, your pain may be coming from the SI joint. Luckily, there are safe and effective non-surgical treatments that can provide long term relief.

What Is the SI Joint?

The sacroiliac (SI) joints connect the sacrum (base of the spine) to the pelvic bones (ilium) on each side. These joints are small but powerful, carrying the weight of the upper body into the hips and legs. They are stabilized by strong ligaments and muscles and work together with the
spine to support every step you take.

When the SI joint becomes inflamed, irritated, or unstable, it can cause deep lower back and buttock pain that can mimic disc, muscle or sciatica pain.

Resolve Neck, Back, and Sciatica Pain and Regain Your Function

Why Does the SI Joint Become Painful?

SI joint pain can develop due to:

  • Joint instability from injured, stretched or weak ligaments
  • Inflammation from overuse, arthritis, or trauma
  • Pelvic asymmetry from leg length differences or posture imbalance
  • Pregnancy or childbirth (ligaments naturally loosen)
  • Compensation from spine problems such as degenerative discs
  • Lumbar fusion surgery (extra stress shifts to the SI joints)

When the SI joint becomes irritated, surrounding muscles tighten, contributing to chronic pain and stiffness. The nearby spinal nerves can also become inflamed, causing symptoms of sciatica (leg pain and numbness).

Common Symptoms of SI Joint Pain

Patients often describe SI joint pain as:

  • Pain on one side of the lower back or buttock
  • Pain that may radiate into the hip, thigh, or groin
  • Pain worse with standing, walking, stairs, or getting out of a car
  • Sharp pain when rolling in bed or standing from sitting
  • Stiffness in the lower back or pelvis
  • Feeling like the back or pelvis is “misaligned”, unstable or weak
  • Sciatica – pain and numbness down the leg

How Is SI Joint Pain Diagnosed?

Diagnosis begins with a detailed history and physical exam. A spine and SI joint pain specialist performs specific stress tests on the SI joint (such as Gaenslen, FABER, compression, and thigh-thrust tests) to reproduce pain from the joint.

Imaging may include:

  • X-ray or MRI – to assess joint degeneration or inflammation
  • Diagnostic SI joint injection – may be used to identify if the SI joint is a pain source

Treatment Options for SI Joint Pain

We treat SI pain by restoring stability, reducing inflammation, and addressing the root cause—not just masking pain.

Non-Surgical SI Joint Treatments (Offered in Estero, SW Florida):

  • Ultrasound and X-ray Guided Injections – of biologics and other regenerative medicine solutions
  • Prolotherapy – strengthens loose SI ligaments to stabilize the SI joint and supporting structure
  • Platelet-Rich Plasma (PRP) Injections – reduces SI joint inflammation and repairs the supporting ligaments. In clinical studies, PRP has been shown to be more effective than steroids at treating SI joint pain and providing long term results. (will need the reference)
  • Bone Marrow Stem Cell Therapy – promotes deeper ligament and joint healing
  • Pelvic stabilization rehabilitation – strengthens glutes, core, and pelvic muscles for long-term results (works best when combined with regenerative injections)

Resolve Neck, Back, and Sciatica Pain and Regain Your Function

Frequently Asked Questions

SI joint pain is usually felt low in the back, near the pelvis or the “dimples” at the base of the spine. It can also radiate into the buttock or thigh. Pain often worsens when standing up from a seated position or after prolonged sitting.

A detailed physical exam by a spine specialist—and sometimes diagnostic injections—can help confirm whether the SI joint is the true source of pain.

SI joint pain can be short-term if caused by a mild strain or irritation, but it may become chronic if the joint or supporting ligaments are unstable or inflamed. Without proper treatment, symptoms can last for months or even years.

Non-surgical options can be very effective for SI joint pain.

Physical therapy to strengthen and stabilize the hips, pelvis, and core is a great starting point.

Regenerative treatments such as prolotherapy or PRP (platelet-rich plasma) injections can strengthen the ligaments that support the SI joint, reduce inflammation, and provide long-term pain relief—helping many patients avoid surgery.

Yes. Prolonged standing, walking, or sitting—especially on one side—can aggravate SI joint pain. Pain often flares when transitioning from sitting to standing or after remaining in one position for too long. Taking frequent breaks to stretch or move can help reduce stress on the joint.

Sacroiliitis refers to inflammation of the sacroiliac (SI) joint. It can result from trauma, repetitive stress, or autoimmune conditions such as ankylosing spondylitis.

While all sacroiliitis causes SI joint pain, not all SI joint pain is due to sacroiliitis—some may stem from ligament laxity, instability, or degeneration.

To prevent SI joint pain from recurring, focus on strengthening the muscles around your hips, pelvis, and lower back, and maintaining flexibility in the hip joints.

Treating and strengthening the supporting ligaments through prolotherapy or PRP can restore joint stability and help prevent future flare-ups.

Yes. After a lumbar spine fusion—especially at L4-L5 or L5-S1—the SI joints often take on extra stress to compensate for lost motion in the fused segments. Over time, this can lead to SI joint degeneration, inflammation, and pain.

An MRI is not always needed to diagnose SI joint pain. Diagnosis is typically based on a detailed physical exam and specific movement tests that reproduce symptoms.

In some cases, X-rays or diagnostic SI joint injections may be used to confirm the diagnosis.

Yes. A leg length difference or hip imbalance can increase stress on one or both SI joints, leading to inflammation and degeneration.

When the hips or pelvis move unevenly, the SI joint must absorb more load, which can cause chronic pain. Correcting alignment and strengthening supporting muscles can help restore balance and reduce symptoms.

Resolve Neck, Back, and Sciatica Pain and Regain Your Function

Why Choose Integrative Rehab Medicine for your SI Joint Treatment?

At Integrative Rehab Medicine in Estero, FL (serving Southwest Florida), we do more than mask pain—we fix the root cause of SI joint pain.

✅ Non-Surgical, Long-Term Relief from SI Joint Pain

Steroid injections only mask pain temporarily. Our regenerative treatments repair and stabilize the SI joint by targeting inflammation and ligament damage—without surgery.

We treat the entire SI joint complex, not just the joint space, including:

  • Joint capsule
  • Supporting ligaments
  • Pelvic stabilizers

This restores true joint stability and delivers lasting pain relief.

✅ Whole-Body Evaluation for Better Results

SI joint pain rarely exists alone. We identify why your SI joint became painful in the first place by treating related regions that overload it:

  • Hip joint (arthritis, mobility loss)
  • Lumbar spine (degenerative discs, facet pain)
  • Pelvis & core (weak stability)
  • Knee & ankle alignment (gait problems)

Correcting these imbalances prevents flare-ups and improves long-term outcomes.

✅ Precision-Guided Injections + Highest Quality Regenerative Medicine

All treatments are done with ultrasound and fluoroscopy (X-ray) guidance for precise and safe injection placement—no blind injections ever.

We also process all PRP and regenerative biologics in our on-site sterile lab, allowing us to:

  • Create high-concentration PRP
  • Customize treatments for discs, joints, and ligaments
  • Maintain strict quality and sterility
  • Deliver consistent, superior results

Better accuracy + better biologics = better outcomes.

For the best non-surgical treatments of Sacroiliac (SI) Joint Pain offered in Estero FL (southwest FL), contact our clinic and schedule a consultation.

Fantastic alternative to shoulder surgery. My torn tendon is now completely healed. Thank you Floyd, Kristine and your entire team.
Dr. Sebastian and Floyd helped me resolve my arthritic hip issue. I am able to run, sprint, lift weights and exercise intensely on the stair master. At our first meeting we developed a plan and then executed the plan. Everything fell into place from the first of two capsular distension shots. The third shot, a PRP injection just enhanced mobility and made stretching easier while providing a greater range of motion.

I can't thank the IRM Team enough. If you have any type of physical injury, they are the best. They embrace helping athletes!

Thanks again!
I had my Discseel and PRP procedure with Dr. Sebastian at Integrative Rehab Medicine in Estero, Florida, and I truly couldn’t be more grateful for the care I received. From the consultation to the procedure itself, everything was explained clearly and thoroughly. He is extremely knowledgeable and takes a thoughtful, patient-centered approach. He answered all of my questions and made me feel completely comfortable and confident in my decision.

Procedure day went very smoothly. I took a very nice nap thanks to the anesthesia and woke up feeling well cared for by the nurse and supported by the entire team.

I also appreciated how clearly Dr. Sebastian explained the recovery process and set realistic expectations. The office runs efficiently, and you can truly tell they care about their patients and outcomes.

I’m so thankful I found this practice and would highly recommend Dr. Sebastian to anyone considering regenerative treatment options. 🙌🏻
Kris is great 🙂
I want to share my experience not as a patient but as an executive assistant making arrangements for my boss's consultations, procedures and follow up appointments. I dealt with Amanda on a vast array of issues and quite frankly I don't know what I would have done without her. My boss traveled from out of state to Florida so there were a lot of balls in the air to coordinate everything successfully. Amanda always advised me what we needed to do, and she consistently followed up with me to ensure a wonderful experience. She is a true professional and a great asset to the practice.
In June of 2024 I was treated by Dr. Klisiewicz for lumbar degenerative disc disease. Initially, I had a phone consult with the PA and everything went great. We scheduled a date for an epidural PRP and I flew to Florida. Once I arrived is when the problems began. Dr. Klisiewicz said the epidural PRP wouldn't be sufficient and I needed intra-discal -and- epidural PRP, which doubled the cost. Then, he suggested the "gold standard" stem cells, which would then double the price again. It all felt like an upsell. I went with intra-discal and epidural PRP. The only sedation I had was Nitrous and a low dose valium. The procedure was torture. This isn't just me saying it. The web is full of people saying the same thing, including injured combat vets. When I tell other doctors about it, they're astounded. This really should be done under IV sedation. Dr. Klisiewicz also suggested that for the best possible outcome I should do 4 days of the Giga-laser, which I agreed to, mostly to prove a point. I reviewed the PubMed literature. It's a big stretch to claim this laser any effect on low back pain. This is an 18 watt laser, and at the wavelengths used, it will only effect a few millimeters of tissue. This is far far less than necessary to effect tissues as deep as the lumbar spine. PubMed data on the Giga-laser is mixed, at best. When I asked Dr. Klisiewicz about this, he had a deer in the headlight look and deflected the conversation. That was the second big red flag. My Giga-laser appointments were every morning at 8am EDT, because I had work commitments at 8am CDT and only had one hour. On one of the days, Dr. Klisiewicz suggested I do PT with them every morning. Again, it felt like another upsell that wasn't discussed prior to me flying to Florida. When I said I couldn't, he commented "well if those are your priorities". Excuse me!! This comment was extremely insulting. There's a difference between 'commitments' and 'priorities'. I'm sure he'd rather spend his day with his family, but he has -commitments- to his patients and staff. Similarly, I had -commitments-. That comment was red flag number 3 and really what motivated me to leave a poor review.

While there are some studies that show PRP does work for some people, I had no benefit. Some studies do show that multiple treatments are more beneficial, but I refused to return. For me, this experience was a waste of time and money.

Lastly, I understand Dr. Klisiewicz is doing Discseel combined with PRP. This hasn't been studied in clinical trials. This is just inventing medicine and can be dangerous. That's not my opinion. That's the comment of several doctors familiar with the procedures. Even Discseel only works in 1/2 the patients. This data comes from the doctor who created the procedure. "At the 12-month follow-up, 50% of patients achieved minimal clinically important differences...".

The only reason I gave 2 stars is because of his nursing staff. They're great. If it weren't for them, this would be a zero star review.
I have never left a review regarding a phone call, but there is always a first. I have called this office multiple times asking every question that comes to mind for my husband with back issues. And every time I called I have spoken to Amanda Nagle. She took all of my calls so patiently and kind answering all my questions. I was never rushed most importantly she put me at ease. I have called multiple offices finding a good fit for my husband. And I’m comfortable enough just speaking to, Amanda that this is the right place for him. If the front office “the face of the office” is like this, I know that the rest is amazing.
Anybody going through chronic pain knows the frustration. What did PRP do for me? Pain went from a 9 to a 2 and sometimes 0. Activity? Before I couldn't do anything and was in pain. After, some limitations but no lasting pain. For example, I'm jump roping and running but no load bearing above 30 pounds. It's a learning pain. PRP improved my health. At Integrative Rehab Med. they are absolutely 100% caring and professional. I am thankful for Dr. Sebastian and his professional staff!
I have seen spinal surgeons, orthopedic surgeons, neurologists, and gotten trigger point injections. Nothing made my chronic low back pain better. Once I went to Dr. Sebastian and his clinic, they reviewed my MRIs and X-Rays, did a physical assessment, and quickly identified my issue in the first visit. I was hesitant to continue with the PRP procedure in my pelvis and low back, since I have been in constant pain for 11 months and had many failures with injections. I am now a little over 2 months post-PRP procedure, back to running and lifting with no pain. I am extremely grateful for Dr. Sebastian and his entire staff, who were welcoming and supportive every day I came into the clinic!
Response from the owner:Thank you for trusting Integrative Rehab Medicine in Estero, Florida with your back pain care. We understand how discouraging chronic low back pain can be after seeing multiple specialists without relief. We’re glad that a comprehensive assessment allowed Dr. Sebastian Klisiewicz to identify the source of your, and better yet, an effective back pain treatment with PRP injections and specific rehabilitation. Hearing that you’re back to running and lifting pain-free just over two months after your PRP procedure is incredibly rewarding. Our team is committed to providing care in a safe environment while supporting our patients every step of the way. We’re grateful to be part of your recovery and wish you continued health and strength.
I am currently one month removed from my procedure from Dr. Sabastian and his staff. All of my consistent pain stop. Physical therapy is continuing under there direction.

With more positive improvement coming long term my advice why wait call or visit them. Integrative Rehab Medicine is the very best non-surgical treatment of the spinal discs.

I excited about my future living without pain. Make this appointment your health will Thank you later.

Chris Drikakis
A fellow golfer and Vietnam veteran
Response from the owner:Thank you so much, Chris, for taking the time to share your experience—and for your service as a Vietnam veteran. We’re truly honored to be part of your healing journey.

We’re thrilled to hear that just one month after your non-surgical spinal disc procedure, your consistent pain has resolved and that you’re continuing to make progress. At Integrative Rehab Medicine, our mission is to help patients avoid unnecessary spine surgery by offering advanced, evidence-based treatments for chronic back and neck pain, including non-surgical disc repair options such as Discseel® and PRP.

Your story highlights exactly why we focus on treating the underlying cause of disc-related pain—not just masking symptoms—and why so many active patients, including golfers and veterans, seek out non-operative spine care with us. We’re excited about your continued improvement and long-term recovery.

https://irehabmed.com/va

Thank you again for your kind words.