Sacroiliac Joint Pain Treatment in New Jersey

If you have lower back pain that shoots into your buttock or hip, which becomes worse when you stand up from a chair or roll over in bed, tends to be worse on one side, and imaging studies and prior treatments have not fully explained it, the sacroiliac joint may be the source.

SI joint dysfunction is one of the most frequently misdiagnosed causes of chronic lower back and buttock pain. It can mimic disc herniation or sciatica closely enough to fool many practitioners. Dr. Todd Koppel has been diagnosing and treating sacroiliac joint pain in New Jersey for nearly 30 years, using a diagnostic injection approach that confirms the joint as the source before any treatment is recommended.

What Is the Sacroiliac Joint?

You have two sacroiliac joints, one on each side of the lower back, where the sacrum (the triangular bone at the base of the spine) meets the ileum (the large flat bone of the pelvis). They transfer load between your upper body and legs and allow small amounts of movement during normal walking.

When these joints become inflamed, degenerated, or unstable, they cause pain felt in the lower back, the buttocks, and sometimes the upper leg or groin. It’s frequently one-sided but can occur on both sides.

Who Gets SI Joint Pain?

Sacroiliac joint dysfunction is more common in certain groups:

• Any activity or accident which can cause back pain can also cause SacroIliac joint pain
• Patients who have had prior lumbar fusion surgery have fusion transfers mechanical stress on the SI joint
• Patients who participate in exercises such as weight lifting or pounding exercises such as pickleball or tennis
• Patients who took a direct impact on the spine from a fall or accident
• Women who have experienced pregnancy-related pelvic ligament laxity
• Patients with inflammatory conditions such as ankylosing spondylitis

Symptoms of SI Joint Pain

• Deep lower back pain, typically just above the buttocks on one side
• Buttock pain that may radiate into the upper thigh or groin
• Pain that worsens with transitional movements; standing up from a chair, rolling over in bed, climbing stairs
• Discomfort with prolonged standing or walking
• Sometimes mistaken for hip pain or sciatica

How Is SI Joint Pain Diagnosed?

Because SI joint pain mimics disc and facet joint pain so closely, accurate diagnosis requires more than imaging, as it doesn’t show up well on standard MRI. Dr. Koppel uses physical examination maneuvers that stress the SI joint and reproduce the patient’s pain, combined with a diagnostic injection.

A diagnostic SI joint injection places a small amount of local anesthetic directly into the joint. If the patient experiences significant, immediate relief of their usual pain, that confirms the SI joint is the source. This information then guides treatment.

Your Treatment Options

Sacroiliac Joint Injection

Once confirmed as the pain source, a therapeutic injection with corticosteroid typically provides meaningful relief lasting several months. Many patients benefit from periodic repeat injections.

Radiofrequency Ablation of the SI Joint

For patients who respond well to SI joint injections but find the relief does not last long enough, RFA of the sacral lateral branch nerves provides relief lasting 12 months or longer, the same RFA technology used for facet joint pain, applied to the SI joint’s nerve supply.

Radiofrequency Ablation

PRP Therapy

For SI joint instability where ligament laxity is contributing to the pain, PRP injections help strengthen the supporting ligaments and reduce chronic inflammation.

PRP therapy

SacroIliac Joint Fusion

For patients with recurrent pain after an SI block or Radiofrequency Ablation, a final permanent solution, involving SI Joint fusion, can be performed. This involves placing a small grasping screw across the joint, to hold it together and relieve the movement which cases SI Joint pain.