What Is the Best Treatment for Sacroiliac Joint Pain? A Complete Guide to Relief and Recovery

The sacroiliac (SI) joint plays a small but vital role in keeping your body stable and pain-free. Located where the spine meets the pelvis, it acts like a shock absorber—helping you walk, run, lift, and twist with ease. But when this joint gets inflamed or strained, it can lead to persistent lower back, hip, or leg pain that disrupts daily life.

In this blog, we’ll explore how the SI joint works, what causes pain, how to recognize the symptoms, and the most effective treatments—ranging from simple exercises and herbal remedies to advanced medical options.

How Does the Sacroiliac Joint Work?

The joint that connects, divides, or bridges the upper and lower body is the pelvic girdle, and tucked right inside this area is a small but mighty player- the sacroiliac joint. It links the end of the spine (sacrum) to the pelvis (ilium) on both sides. This joint bears the load of the entire upper body and distributes that mechanical weight evenly across the hips and legs while we walk, run, or jump. It acts as a buffer, absorbing shocks and protecting the spine from direct impact. Since its job is to stabilize the body during movement, it doesn’t allow too much wiggle room. But in order to be a great shock absorber, the SI joint does offer a tiny bit of flexibility — about 2 to 4 millimeters in both directions. Just enough to keep things moving smoothly.

• Think of it as your body’s internal shock absorber — so your spine doesn’t freak out every time you are walking, running, jumping or lifting.
• It keeps your upper body connected to your legs, making it possible to play, dance, and move with grace.
• It’s a stable joint with just the right amount of give — allowing you to stand tall and move freely without collapsing like a game of Jenga.
• Its movement is subtle, like a lazy hinge — minimal, but meaningful.
• It helps you stay balanced, so you don’t topple over doing the cha-cha or chasing a runaway auto.

In short: the spine and pelvis may be the stars, but the sacroiliac joint is the backstage crew making sure you or the human body runs like a well-oiled, beautifully choreographed machine.

What Causes Sacroiliac Joint Pain?

There are numerous ways by which the sacroiliac joint can get injured, inflamed, irritated, or misaligned, resulting in sacroiliac (SI) joint pain as per studies. There could be one or many underlying reasons—stress, injury, arthritis, pregnancy, a wrong mattress or sleeping posture, or even the way we carry ourselves, creating an imbalance in how the body moves.

Specific Causes:

• Trauma

Slips, falls or vehicular accidents that directly impacts could injure the sacroiliac joint (SI) causing pain. Repetitive stress from activities like running or certain sports could also contribute to injury. 

• Arthritis

Degenerative joint diseases like the wear-and-tear type, can affect the SI joint, causing pain and stiffness because of loss of cushioning and thus increased friction. Osteoarthritis and Ankylosing spondylitis, an inflammatory arthritis is the most common 

• Pregnancy

Hormonal changes during pregnancy loosen ligaments in the SI joint thus reducing the strong support system around this joint up causing laxity to hold the pregnancy and to deliver the baby, The increased weight and altered posture can put extra stress onthe joint, leading to pain. 

• Repetitive Stress

Activities that involve repetitive twisting or bending, or prolonged standing or sitting, can strain the SI joint and cause pain. 

• Muscle Weakness

Weak muscles surrounding the SI joint can reduce its stability, leading to pain and dysfunction. 

• Gait Problems

Conditions affecting how a person walks, like scoliosis or leg length discrepancies, can lead to uneven weight distribution on the SI joint, causing pain. 

• Infection:

Though less common, infections can also cause inflammation and pain in the SI joint. 

• Spinal Surgery

SI joint pain can sometimes develop after certain spinal surgeries. 

• Sleeping

Sleeping like a human origami project or in a yoga pose gone wrong could also tick this off

Sacroiliac Joint Pain Symptoms

A deep, dull ache or a sharp, stabbing pain in the lower back, buttocks, hip, groin, or even down the thighs are common symptoms of sacroiliac joint pain. Many times, as reported by people, pain is often more on one side, and usually it gets worse while changing postures, such as sitting to standing or climbing stairs, which is a series of continuously changing positions. Similarly, rolling in bed could be painful, and so could be standing or sitting for a long time. Normal day-to-day routine movements could be painful due to sacroiliac joint pain, which sometimes could also feel like leg weakness or instability. Patients and physicians can make an accurate diagnosis when they have a clear, pinpointed picture of symptoms. SI joint pain can appear in a multitude of ways, but most observed patterns include:

1. A deep, dull ache or sharp, stabbing sensation in the lower back, buttocks, groin, or thigh—often felt on just one side.
2. Pain that worsens with movement or changes in posture: stepping up stairs, shifting from sitting to standing, rolling over in bed, or remaining stationary for long periods.
3. A sensation of instability, weakness, or “giving way” in the leg or pelvis.
4. Discomfort that mimics sciatica, with pain radiating toward the hips, glutes, or legs, complicating diagnosis.

How Is Sacroiliac Joint Pain Diagnosed?

• Physical examination– a doctor will for the patient examine his or her scope of motion, discomfort trends or pain cycles, perform Provocative tests (these are basically a range of leg movements that creates stress on the hip joint) to acertain when and where the  pain starts basis of which the SI joint function can be established.
• Imaging– An X-ray of the pelvis can show signs of damage to the sacroiliac joint. An MRI can show whether the damage is the result of ankylosing spondylitis.
• Numbing Shots– For an accurate diagnosis, healthcare professionals may rely on numbing injection into the SI joint. A significant pain relief, following this injection, may strongly suggest the SI joint is the culprit .

What Is the Treatment for Sacroiliac Joint Pain?

Best Treatment for Sacroiliac Pain

The best treatment for sacroiliac pain depends on whether it is mild, moderate, or chronic:

• Mild to moderate pain – Lifestyle changes (posture correction, supportive mattress, avoiding long sitting/standing), physical therapy, topical herbal gels, and over-the-counter NSAIDs.
• Chronic or severe pain – Corticosteroid injections, radiofrequency ablation (RFA), or in rare cases, SI joint fusion surgery.
• Holistic support – Herbal tablets like Patanjali Lakshadi Guggul or Amvatari Ras, along with topical gels such as Himalaya Rumalaya Gel, provide natural anti-inflammatory relief.

A combination of physical therapy, medication, and lifestyle changes often gives the best long-term outcomes.

Non- Surgical treatments or Conservative Treatments: The go‑to first step for SI joint pain is usually conservative care, a mix of physical therapy, topical oils or gels like Himalaya Herbals Rumalaya Gel, herbal tablets like Patanjali Lakshadi Guggul and Patanjali Amvatari Ras are few of them which have been very effective.  OTC pain relief medications also give instant relief. But herbal tablets are safe and have no side effects and thus can be consumed for a longer period of time.

Topical Oils or gels: Done consistently, this approach is often both safe and highly effective.

Best Meds for SI Joint Pain

When people ask about the best meds for SI joint pain or the best medication for sacroiliac joint pain, doctors usually recommend:

1. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): Ibuprofen or naproxen are most common. They help reduce inflammation and provide pain relief.
2. Muscle Relaxants: Useful when muscle spasms are adding to the pain.
3. Topical Pain Relievers: Herbal gels and Ayurvedic formulations (Rumalaya Gel, Amvatari Ras) are safer long-term options with minimal side effects.
4. Prescription Options: In severe cases, stronger pain relievers or nerve-targeting medications may be prescribed under medical supervision.

⚠️ Note: Medications provide temporary relief — they don’t cure the underlying issue. Always combine them with strengthening exercises and lifestyle changes.

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Physical Therapy:

Exercises that toughen and stabilize core and hips work the best. A consistent and dedicated approach can reduce stiffness, enhance flexibility and strengthen the pelvic, thus easing discomfort. Physical therapy is at the heart of it. A  ysical therapist teaches sacroiliac joint pain exercises– which is usually a combination of mobility, flexibility and strengthening that ease tension in the muscles helping them to relax and build support around the joint by strengthening them through targeted sets of exercises and yoga asanas. Starting soon after the pain begins, it helps bring back balance and movement in the lower back, pelvis, and hips. The main goals are to

• Ease muscle tightness and improve flexibility
• Build strength in key muscles like the glutes, hamstrings, and deep core, so they better support the SI joint
• Improve balance and coordination to keep everything stable

Heat and Ice Therapy:

ice is used post activity to reduce inflammation. Heat helps relax tight muscles and prepare the body for stretching and exercise. Alternating this can give comfort during physical activity.

SI Belts or Braces:

Pelvic braces or SI belts provide gentle mechanical stabilization to ease movement, offering immediate but modest relief during daily activities or exercise.

Pain Relievers and Muscle Relaxants:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Oral NSAIDs and topical analgesics are both shown to be effective .

Injections and Minimal Invasive Procedures:

When conservative measures aren’t enough Advanced Interventions for patients who don’t find sufficient relief from conservative methods, the next tier involves targeted interventions.

CorticosteroidInjections

These anti-inflammatory injections are delivered under image guidance (fluoroscopy or CT) for accuracy. Many patients experience relief lasting weeks to several months. In general, 1–3 injections may provide significant benefit when combined with physical therapy While regarded as the gold standard, their effectiveness may diminish over time, and repeated injections pose potential risks including local cartilage damage or systemic side effects .

Radiofrequency Ablation (RFA)

When steroid injections fail, RFA offers a minimally invasive alternative. Radio waves heat small nerve fibers to disrupt pain signals, and clinical reviews show effectiveness lasting up to 12 months

Surgical options:

The Last Step If pain persists beyond six months despite exhaustive conservative efforts and specialist confirmation, surgical options may be considered. SI Joint Fusion Often performed using minimally invasive techniques with titanium implants, fusion aims to permanently stabilize the joint. Studies report significant pain reduction—averaging around 73% improvement after one year in selected cases Outcomes vary: 70–80% of patients report satisfaction, though some experience complications related to approach and hardware; fusion may also limit nearby joint mobility. Surgeons often proceed with lateral minimally invasive techniques or isolated fixation, balancing invasiveness against functional outcomes.

Home Remedies and Lifestyle Changes

When it comes to curing sacroiliac joint pain at home, ayurvedic gels, herbal tablets and small changes in routine habits can make a huge difference. Taking a timely break from long hours of sitting or walking, gentle stretching in the morning or before bed helps keep the joint from stiffening up, while short walks or targeted SI exercises keep the muscles around your hips and lower back strong and flexible. Applying a warm compress or an ice pack where it hurts can bring quick relief on tough days. Paying attention to correct posture- while walking, whilst lifting weight, sitting up straight and avoiding a hunch back- and choosing a supportive mattress or cushion can also take pressure off the joint. We can also take help of SI BELT or braces that provide gentle mechanical stabilization to ease movement, offering immediate but modest relief during daily activities or exercise. These are few suggestive exercises seen to have been quick to give relief in sacroiliac joint pain 

Pelvic Tilts: Engaging deep core stabilizers by gently pressing the lower back

into the floor while supine. (10–15 reps)

Bridge Pose: Lifting the hips from a supine position using glutes and

hamstrings. Core remains engaged. (10–15 reps)

Bird-Dog: From all-fours, extend opposite arm and leg, keeping a neutral

spine. (10 reps side)

Clamshell/Hip Abduction: Side-lying exercise targeting outer hip muscles.

(12–15 reps)

Knee-to-Chest Stretch: A supine stretch pulling one knee into the chest to

loosen hamstrings and glutes. (30 seconds, 2–3 reps each side)

Piriformis Stretch: Cross-leg seated or supine stretch to release the

piriformis muscle, which often aggravates SI pain.

Cat-Cow and Child’s Pose: Yoga-based moves to mobilize the spine and soothe tension.

Gentle consistency is crucial—avoiding pain flares that could worsen symptoms. Over time, these small steps — when turned into a consistent routine and combined with lifestyle, behavioral, and psychological changes — often add up, making daily life easier and movement more comfortable. 

How to Get Sacroiliac Joint Pain Relief Quickly

Targeted exercises, over the counter painkillers, muscle relaxant and anti-inflammatory drugs can help in sacroiliac joint pain relief. For more complicated cases however doctors may suggest interventional treatments such as corticosteroid injections- offering instant relief in sacroiliac joint pain as this targets inflammation at the source.

Can Sacroiliac Joint Pain Be Cured?

Now one might think, is there a cure for sacroiliac joint pain? The answer is yes for sure a long term respite is there. The ideal path would be a holistic approach and balanced overview of things. A thoughtful custom combination of targeted exercises, common OTC pain relief, smart use of heat/ice packs and professional care when needed, over time with consistent efforts all this helps in long term relief in sacroiliac joint pain without needing surgery. However in more serious cases, where pain lingers refuses to settle down and seriously limits life, sacroiliac joint pain treatment might expand to include surgery, commonly known as SI joint fusion.

Pros and Cons of Different Treatment Options

Sacroiliac (SI) joint pain treatment options range from conservative to surgical, each with its own set of pros and cons. Conservative treatments like physical therapy, pain relievers, and injections offer initial relief with minimal invasiveness, but may not provide long-term solutions. Surgical options like SI joint fusion can offer long-term pain relief and improved mobility, but carry risks associated with surgery and prolonged

Physical Therapy

• Pros: Strengthens surrounding muscles, improves flexibility, and can help stabilize the SI joint, promoting long-term pain relief and improved function. 
• Cons: May not be sufficient for all cases, requires consistent effort and adherence to the exercise program.A trained therapist may be needed. 

Pain Relievers and Muscle Relaxants

• Pros: Provide temporary pain relief, making it easier to engage in daily activities. Easy to use just pop a pill
• Cons: Do not address the underlying cause of the pain, only masks doesn’t fix and may have side effects with long-term use. 

SI Joint Injections

• Pros: Can provide rapid and targeted pain relief by reducing inflammation and blocking pain signals. May also help diagnose the source of pain. 
• Cons: Pain relief may be temporary and require repeat injections, potential side effects like infection, increased pain, or nerve damage. 

Heat and Ice Therapy

• Pros: Can help reduce pain and inflammation in the acute and chronic phases of SI joint pain. 
• Cons: Provides only temporary relief, not a long-term solution. 

Orthotics and Shoe Modifications

• Pros: Can help correct leg length discrepancies and improve weight-bearing mechanics, reducing stress on the SI joint. 
• Cons: May not be suitable for all cases and should be approached with caution, as improper use can lead to muscle imbalances. 

Surgical Treatments

SI Joint Fusion

• Pros: Can provide long-term pain relief and improved mobility by stabilizing the SI joint.
• Cons: invasive and expensive Involves surgery with potential risks like infection, nerve damage, or hardware complications. Requires a longer recovery period and rehabilitation. 

Faqs

• What is the best treatment for sacroiliac pain?
  The best treatment is usually a mix of physical therapy, posture correction, herbal or medical pain relievers, and in some cases, injections. Surgery is reserved for chronic severe cases.
• What are the best meds for SI joint pain?
  NSAIDs (ibuprofen, naproxen), muscle relaxants, and herbal formulations like Rumalaya Gel or Amvatari Ras are common. They reduce inflammation and ease pain, but must be combined with exercises for best results.
• Can sacroiliac joint pain be cured permanently?
  Yes, many cases are resolved with therapy, posture changes, and medications. Severe or recurring cases may need advanced treatments like injections or surgery for long-term relief.