Sacroiliac Joint Pain Treatment
in Tulsa, Oklahoma
The sacroiliac (SI) joints connect the spine to the pelvis and can be a significant source of lower back and buttock pain. Dr. Bhakta offers targeted diagnostic and therapeutic injections to confirm and treat SI joint dysfunction.
Understanding Sacroiliac Joint Pain
The sacroiliac (SI) joints are the two large joints where the sacrum (the triangular bone at the base of the spine) meets the iliac bones of the pelvis. Unlike the highly mobile joints of the spine above, the SI joints move only a few millimeters. Their job is to transfer load between the upper body and the legs while absorbing the shock of walking and lifting. Thick ligaments normally keep them stable; when those ligaments become lax, inflamed, or unevenly loaded, the joint becomes a pain generator.
Studies estimate that the SI joint is the primary driver in a meaningful portion of chronic low back pain, by some reports roughly 15–30% of cases. Despite that, it is one of the most frequently missed diagnoses because its pain pattern overlaps so closely with sciatica and lumbar facet joint syndrome. Accurate diagnosis requires a clinician who specifically looks for it.
Common triggers include pregnancy and childbirth (where ligament loosening can persist for months), a fall directly onto the buttock, motor vehicle accidents, leg-length discrepancy, prior lumbar fusion that transfers load onto the pelvis, and inflammatory arthritis. Classic symptoms are pain on one side of the lower back just below the belt line, deep buttock pain, and referred pain into the back of the thigh that usually stops above the knee, although it can occasionally travel farther. Patients often describe that sitting, stair-climbing, and rolling over in bed are the worst provocations.
The natural history varies by cause. Postpartum and injury-related SI dysfunction often improves substantially over several months with targeted physical therapy and a structured interventional plan. Degenerative and inflammatory cases tend to be more persistent but respond well to a stepwise approach, the goal is to calm the joint, restore balanced pelvic mechanics, and keep you active.
Symptoms & When to Seek Care
Typical SI Joint Symptoms
- One-sided lower back pain just below the belt line, often pointed to with a single finger
- Deep ache in the buttock or upper-outer hip
- Pain that radiates into the back of the thigh but usually stops at the knee
- Worsening with sitting, stair-climbing, rolling in bed, or getting out of a car
- Relief from walking or shifting weight to the opposite leg
- Feeling of pelvic instability, especially postpartum
When to Seek Immediate Care
- Fever, chills, or night sweats paired with back or pelvic pain
- New bowel or bladder control changes
- Progressive leg weakness or numbness in the groin and inner thighs
- Severe pain after significant trauma (fall, motor vehicle accident)
- Unexplained weight loss alongside persistent pain
These findings are uncommon but benefit from same-day evaluation. If you notice any of them, an emergency department can quickly rule out serious causes so the right care plan can begin.
How SI Joint Pain Is Diagnosed at PDTC
Because SI joint pain mimics several other back conditions, Dr. Bhakta uses a deliberate, stepwise process to confirm it is the true source before recommending treatment.
History & Provocative Exam
Dr. Bhakta maps the pain pattern, asks about transitional movements and pregnancy history, and performs a battery of provocative maneuvers, FABER, Gaenslen's, thigh thrust, and compression tests. When three or more are positive, SI involvement becomes highly likely.
Imaging & Diagnostic Injection
X-rays, and in some cases MRI, help rule out lumbar disc or hip causes and screen for inflammatory arthritis. A fluoroscopically guided diagnostic SI joint injection remains the gold standard, a substantial reduction in your usual pain during the anesthetic window confirms the joint as the source.
Tailored Treatment Plan
Once the SI joint is confirmed, Dr. Bhakta builds a plan around your specific pattern. Options may include therapeutic SI joint injections, radiofrequency ablation of the lateral branch nerves for longer-lasting relief, or PRP therapy for ligamentous support, paired with pelvic-stabilization therapy.
Treatment Options at PDTC
Dr. Bhakta creates an individualized plan based on your specific diagnosis and symptoms.
Learn More from Trusted Medical Sources
These links are provided for educational purposes. They do not constitute medical advice. Always consult Dr. Bhakta for personalized treatment recommendations.
Frequently Asked Questions
Bhadresh L. Bhakta, M.D.
Board-Certified Interventional Pain Specialist
Fellowship trained in Pain Medicine at Vanderbilt University. Board Certified for decades. Formerly served as Associate Professor at OU School of Medicine. Serving Tulsa since 2000.
Full bio →Related Treatments
Dr. Bhakta may recommend one or more of the following interventional options based on your specific diagnosis and history.