Sacroiliac Joint Mobility Dysfunction Causes

Sacroiliac Joint Dysfunction

Sacroiliac joint seen from above.
Sacroiliac joint seen from above. Images

Sacroiliac Joint Dysfunction 

When your SI joint – (SI is an acronym for sacroiliac joint) “goes out on you” it can be a devastating experience.  I know because it’s happened to me numerous times. 

The sad fact is that SIJD (sacroiliac joint derangement or sacroiliac dysfunction) is a major - but under diagnosed - cause of lowest back pain, buttock pain and sciatica.  Those affected often find themselves on lengthy medical odysseys that yield varying results.  Many spend years in pain and dysfunction and sometimes undergo one or more surgeries that either do nothing, or make things worse.

In this article, I present a way to understand SI joint dysfunction for those with no medical background, followed by a discussion of causes.

For treatment information, check out: 7 Treatments for Sacroiliac Joint Pain and Dysfunction

Sacroiliac Joint Mobility

An x-ray like image of an inflamed sacroiliac joint.
An x-ray like image of an inflamed sacroiliac joint. SCIEPRO / Science Photo Library / Getty Images

Sacroiliac Joint Mobility – Too Much, Not Enough, or None At All?

Sacroiliac joint dysfunction can, in general, be divided into two camps:  Excessive joint motion or reduced joint motion.

Hypermobile Sacroiliac Joint

A hypermobile sacroiliac is one that moves too much.  Unlike many of the body’s joints (for example shoulders and hips) the snug fit of the SI is one that allows for little, if any movement.   But when the ligaments at the back of the joint are sprained, whether by trauma, due to pregnancy or for some other reason the integrity of the fit, and therefore stability of the joint, may be compromised. Over time, this reduced stability can lead to deterioration at the joint surfaces.

By the way, some doctors don’t believe any movement is possible at the SI joint, or that if it is, it is not the source of pain in this area.  But other doctors - as well as many SI patients (myself included) – strongly disagree.

Hypomobile Sacroiliac Joint

A hypomobile SI joint, on the other hand, is one that does not have enough movement.  Generally caused by arthritis, a hypomobile SI joint is often affected by inflammation.

Related:  Sacroilitis 


Adam Goode, Eric J Hegedus, Philip Sizer, Jr, Jean-Michel Brismee, Alison Linberg, and Chad E Cook. Three-Dimensional Movements of the Sacroiliac Joint: A Systematic Review of the Literature and Assessment of Clinical Utility. J Man Manip Ther. 2008; 16(1): 25–38.

Sacroiliac Joint Dysfunction Causes

X-ray of spine with instrumentation
Spinal fusions do not always form enough bone to make a union. plepraisaeng

Sacroiliac Joint Dysfunction Causes

Common causes of SIJD include:

  • Degenerative arthritis
  • Inflammatory arthritis
  • Trauma
  • Leg length inequality
  • Previous lumbar or lumbosacral spinal fusion
  • Infection
  • Hip arthritis
  • Neoplasms (neoplasm is new tissue growth, often characteristic of cancer.)

Sacroiliac Joint Pain and Lumbar Spinal Fusion

Note from the list above that if you’ve had a lumbar spinal fusion, you may be at a higher risk of sacroiliac joint pain. 

According to Yoshihara, in his article entitled "Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge," which was published in the September 2012 issue of the European Spine Journal, films of patients who have had lumbar and/or lumbosacral spinal fusion frequently show more degeneration at the sacroiliac joints than do films of patients who have not had this surgery.

Yoshihara also reports that injection tests reveal that in a considerable number of patients who undergo fusion surgery, SIJ pain is the cause of persistent symptoms.

This may be due to adjacent segment degeneration, where joints above and below a fusion get more than their fair share of movement as they accommodate the lack of motion in the nearby fused area.


Hancock MJ, Maher CG, Latimer J, Spindler MF, McAuley JH, Laslett, M, Bogduk N: Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. Eur Spine J 16:1539–1550, 2007. Epub 2007 Jun 14

Liliang PC1, Lu K, Liang CL, Tsai YD, Wang KW, Chen HJ. Sacroiliac joint pain after lumbar and lumbosacral fusion: findings using dual sacroiliac joint blocks. Pain Med. 2011 Apr;12(4):565-70. doi: 10.1111/j.1526-4637.2011.01087.x. Epub 2011 Apr 4.

Yoshihara H1. Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge. Eur Spine J. 2012 Sep;21(9):1788-96. Epub 2012 May 13.

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