You have sacroiliac joint pain which can be caused by any trauma or chronic condition and are wondering if the pain you are experiencing can completely go away after treatment.
I rely on my knowledge as a radiographer and of course on medical research on the subject matter to answer the most frequently asked questions.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: November, 2025. Written by Juliet Semakula, a diagnostic radiographer.
| Yes, Sacroiliac joint pain can go away, particularly for acute or traumatic injuries and those that respond well to conservative treatments like physical therapy. However, it depends on the cause, and chronic cases, especially those linked to underlying conditions like arthritis, may persist or become long-term challenges requiring ongoing management. Early intervention with appropriate treatment and lifestyle adjustments is key to improving outcomes and preventing long term pain. |
Let’s first learn a little bit of the anatomy of the sacroiliac joint before we delve deeper into the subject matter.
▶️Where do we find sacroiliac joints on the pelvis?
The sacroiliac (SI) joint is the joint that connects the sacrum (the triangular bone at the base of the spine) to the ilium (hip bones) on each side of the pelvis.
Sacroiliac joint x ray
Movement in the sacroiliac joint is very minimal, only limited to a few millimetres and is not meant for active motion. Its main purpose is to transfer weight from the upper body to the legs and to act as a shock absorber.
▶️What is sacroiliac joint pain which is also called sacroiliac dysfunction.
Sacroiliac (SI) joint pain is an ache or sharp pain in the lower back, buttock, hip, or groin.
People who have this kind of pain normally describe it as a dull and aching but can be sharp sometimes
It gets worse when standing, sitting for long periods and running, climbing or lying on the ipsilateral side of the pain.
Sacroiliac pain usually arises from damage, injury, or abnormal movement (too little or too much) in these joints.
It can mimic or be confused with other back pain issues like a herniated disc.
Note! due to the stability of sacroiliac joints, usually they are not a common cause for back pain. You normally need an assessment to rule out other conditions.
Dangerous onset of pain that is worse at night and associated with weight loss and night sweats should be evaluated for malignant potential. (Gartenberg,2021)
Because of the complex anatomic structures, nerve innervation, and functional biomechanisms of the sacroiliac region make it challenging to diagnose and treat the sacroiliac joint as a pain source
▶️What are the two main types of sacroiliac joint pain are:
Sacroiliac joints undergo various changes especially when we are aging. In early adulthood, the joint surfaces are smooth and allow for multi-directional gliding motions
Changes such as cartilage capsule becoming increasingly collagenous, extreme restriction of motion may occur as we age coupled with other factors.
Sacroiliac pain or dysfunction typically results from abnormal motion and malalignment of the joint.
▶️This can cause two types of sacroiliac joint pain:
1️⃣Sacroiliitis (inflammation): Sacroiliitis is typically caused by inflammatory conditions like ankylosing spondylitis or osteoarthritis
2️⃣Sacroiliac joint dysfunction (abnormal movement): pain can result from too little movement (hypomobility) or too much movement (hypermobility) due to factors like injury, leg length differences, or pregnancy
▶️The potential causes of sacroiliac joint pain can either be traumatic or atraumatic.
The traumatic causes of sacroiliac pain are:
♦️Pelvic ring fractures that can be caused by falls.
♦️ Soft tissue injury from fall onto the buttock
♦️ Indirect injury from motor vehicle collision
♦️ Sudden / repeated heavy lifting/strain or torsion.
The atraumatic causes of sacroiliac joint pain are:
♦️ Spondyloarthropathy or Inflammatory back pain
♦️ Enthesopathy
♦️ Osteoarthritis
♦️ Infection
♦️Previous lumbar fusion
♦️ Pregnancy: When you are pregnant your hormone changes and increased load can cause sacroiliac joint pain.
♦️ Leg length discrepancy
♦️ Having structural abnormalities such as scoliosis may develop pain in the sacroiliac joints.
Chuang,2019
▶️Diagnosis of sacroiliac joint pain.
Normally when you go to the doctor with SI joint pain:
A physical examination will be done, looking into your medical history as well.
On physical examination, provocation tests, for example:
♦️Distraction test
♦️Gaenslen’s Test distraction, the thigh thrust.
♦️Thigh thrust
♦️Lateral compression
♦️Sacral thrust
Sacroiliac joint dysfunction provocative tests. A positive test elicits pain in the SIJ region
All these tests are helpful to increase diagnostic accuracy of sacroiliac joint pain (image from Gartenberg,2021)
♦️An x-ray, MRI or CT will be requested to give clues as to the presence of SI joint disorder.
♦️x-ray image showing areas of pain of sacroiliac joint pain.
The initial pain usually starts below the level of L5 referring to the entire lower extremity.
♦️Image-guided injections are the gold standard to identify sacroiliac joint pain or dysfunction (Le Huec,2019)
▶️What treatments are recommended for Sacroiliac joint pain?
Sacroiliac joint pain or dysfunction is an under-recognized source of low back pain.
If not treated it can result from various clinical conditions, as well as abnormal motion or malalignment of the joint.
Non-operative treatment options are considered first-line of treatment due to high surgical complication rates.
Here are some of the conservative managements that are normally used, and these will depend on the cause of the pain.
🔵Chiropractic care for sacroiliac (SI) joint pain involves manual adjustments to the pelvis and spine to improve joint function and reduce pain, often combined with other therapies like:
♦️Massage.
♦️Stretching.
♦️Exercises.
The goal is to reduce inflammation, restore movement, and strengthen supporting muscles to prevent future flare-ups.
🔵Medical therapy.
Pain relief medication such as Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, are often the first line of treatment to reduce pain and inflammation.
🔵Injections such as:
♦️Corticosteroid injections: These deliver potent anti-inflammatory medication directly into the SI joint to reduce pain and swelling
♦️ PRP injections: These involve injecting a concentration of your own platelets, which contain growth factors to potentially promote healing.
♦️Prolotherapy: This treatment uses an injection of a solution, often containing dextrose, to stimulate the body’s natural healing response
🔵Physical therapy: Once pain relief is attained, physical therapy is crucial to prevent recurrence.
A physical therapist can teach you range-of-motion and stretching exercises to increase flexibility and relieve pain.
🔵Other therapies that are used if pelvic instability is noted:
♦️ A sacroiliac belt may be temporarily utilized for support to the joint.
Here is a simple on Amazon
♦️ Radiofrequency ablation: your doctor may recommend radiofrequency ablation to disable the nerve fibers that are transmitting pain signals from the joint.
Raj,2023
Radiofrequency treatment.
♦️Nerve blocks.
♦️Articular injections.
🔵Surgical option:
♦️Surgical management involves an open and percutaneous approach with the sacroiliac joint fusion, which stabilizes the joint by fusing the sacrum and the ilium together.
♦️Placement of Surgical implants (such as titanium rods or screws) and sometimes a bone graft are inserted across the joint to stabilize it.
▶️How long does it take for a sacroiliac joint to heal?
The healing you expect will depend on three factors
1️⃣What is causing the pain?
2️⃣How severe the injury or pain and how long it has been going on. For example chronic pain that lasts more than three months is considered long-term and may require more intensive management.
3️⃣The type of treatment you receive ,surgical or non-surgical and how adherence to it.
All will play a role in how long it takes to fully recover from a sacroiliac joint pain.
Healing time for the sacroiliac (SI) joint varies significantly, here are some of the proposed timelines of people who have been observed with SI pain
| Phase | Timeline |
| Initial improvement | You may start to experience pain reduction and improved function within the first 6 weeks of conservative therapy. |
| Average recovery | Many patients see significant improvement within 1 to 3 months, with an average recovery time of 4 to 6 weeks for many cases. |
| With acute injuries | In a few days to weeks |
| Post-surgical recovery | can take up to 3 to 6 months. |
| Full recovery | A complete return to normal function can take up to 3 to 6 months or more depending on the individual case. |
Research indicates that up to 95% of patients with SI joint pain respond well to non-surgical treatments with significant pain reduction within 1 to 3 months.
So, you may be one of the 95%, take heart and adore your doctor’s treatment instructions, be patient, look after yourself and talk to people who can help with your care.
▶️How sleeping positions can help relieve sacroiliac joint pain.
Sleeping on the side of the affected joint may worsen sacroiliac joint pain. So, it is important to adapt certain sleeping positions to help ease the pain.
According to research studies, sacroiliitis (inflammation) that affects sacroiliac joints is characterized by gradual onset and it is more typical prominence at night and associated stiffness upon awakening. (Slobodin, 2018)
▶️To help you ease the nighttime pain, here are some additional tips for better sleeping.
⚫ Avoid sudden movements for example getting up or turning too quickly can compress the joint space.
⚫Support your head and neck: Use pillows that keep your head, neck, and spine aligned with each other.
⚫Sleeping positions on your back: Place a thick pillow under the knees when sleeping on the back to keep your hips and spine in a neutral position.
⚫Place a pillow between the legs when sleeping on the side which does not have pain and keep your knees slightly bent. This can help to relieve pressure on the joints by keeping your hips and pelvis aligned.
⚫Consider a rolled-up towel or small pillow under your waist if there’s a gap between your body and the mattress
⚫ Avoid sleeping on your stomach because this position can cause your spine to arch excessively which can worsen the sacroiliac joint pain.
⚫Sleeping on a supportive mattress with adequate support that is not firm or soft may be beneficial for your back. A mattress that is too soft may not offer adequate joint support.
It is always important to listen to your body, try to experiment with pillows to find the right position for you, as comfort can vary from person to person
▶️How to sit comfortably with Sacroiliac joint pain
⚫Always choose a chair that keeps your spine in a neutral straight position. A chair with adjustable lumbar support can help maintain the spine’s natural curve.
You can buy one at any chair store in your area or see on Amazon for recommended simples by people who have used them.
⚫ Introduce gentle pelvic movements while sitting with your feet flat on the floor, gently rock your pelvis from side to side and forward and backward. This helps the nerve endings in the sacroiliac joints become stimulated and feel better.
⚫ Use a supporting cushion. If you have a hard chair, using a cushion can help distribute the weight evenly and reduce pressure on the SI joint.
You can get this in shops that sell cushions or see on Amazon for different samples made of memory foam.
⚫ Maintain good sitting posture, try to sit upright with your back supported by the chair and feet flat on the floor. You can use a lumbar cushion:
⚫Placing a lumbar cushion or a rolled towel behind your lower back helps to support the natural curve of your spine. You can see some samples on Amazon.
Caution! Avoid Sitting for long periods of time, this can take its toll on your sacroiliac joins.so when possible, find activities that get you off your sit to relieve pressure on the joints.
▶️Learning to manage pain if the pain you are experiencing is chronic.
If you have tried everything and you still leave with pain, I will give you three principles I always use when I am faced with any kind of pain.
1️⃣I assess where my pain is coming from for example:
♦️Does it get worse when I sit, lay down or stand up?
♦️Does pain prevent me from sleeping?
♦️Which activities hurt must.
♦️How do I rate my pain on a scale of 0-10
After asking these questions then I identify the main impact of my pain on my daily life, this helps me to set pain management goals.
2️⃣ I set smart and manageable goals.
♦️Change sleeping positions to improve my sleep.
♦️Change activities that are causing me more pain.
♦️Monitor my pain and then evolve from bad to better by principle 3.
3️⃣I document my functional self-assessment, objectives and I follow-up on any achievements.
♦️Keeping a pain diary can help you over the long term to observe how your pain varies, and this helps you during any assessment and follow-up.
| It’s important to know that isolated pain on palpation is not indicative of a problem that could worsen over time. It is therefore important to have some basic clinical knowledge and always consult your doctor for an assessment. |
We have come to the end of this article. I hope I have been able to give you some reassurance, wishing a quick recovery!🙋
Any questions in the comments section below, and here are sources of articles I used for this subject matter.
📚SOURCES:
Raj MA, Ampat G, Varacallo MA. Sacroiliac Joint Pain. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
Chuang CW, Hung SK, Pan PT, Kao MC. Diagnosis and interventional pain management options for sacroiliac joint pain. Tzu Chi Med J. 2019 Sep 16;31(4):207-210. doi: 10.4103/tcmj.tcmj_54_19. PMID: 31867247; PMCID: PMC6905244.
Gartenberg A, Nessim A, Cho W. Sacroiliac joint dysfunction: pathophysiology, diagnosis, and treatment. Eur Spine J. 2021 Oct;30(10):2936-2943. doi: 10.1007/s00586-021-06927-9. Epub 2021 Jul 16. PMID: 34272605.
Le Huec JC, Tsoupras A, Leglise A, Heraudet P, Celarier G, Sturresson B. The sacro-iliac joint: A potentially painful enigma. Update on the diagnosis and treatment of pain from micro-trauma. Orthop Traumatol Surg Res. 2019 Feb;105(1S):S31-S42. doi:10.1016/j.otsr.2018.05.019. Epub 2019 Jan 4. PMID: 30616942.
Gottlich C, Githens T, Drusch A, Jain N, Caroom C, Sizer PS. Vibration Energy Color Doppler Imaging (VECDI) in Evaluating the Effect of Screw Fixation on Sacroiliac Joint Stiffness: A Prospective Pilot Study. J Orthop Surg Res. 2025 Jan 10;20(1):36. doi: 10.1186/s13018-024-05331-5. PMID: 39794824; PMCID: PMC11724536.
Slobodin G, Hussein H, Rosner I, Eshed I. Sacroiliitis – early diagnosis is key. J Inflamm Res. 2018 Sep 10;11:339-344. doi: 10.2147/JIR.S149494. PMID: 30237730; PMCID: PMC6136407.