Understanding Sacroiliac (SI) Joint Dysfunction and Injection Therapy
&srotate=0)
Published in The Ospina Orthopedic Blog ~ 5 min read ~ Last Updated: November 16, 2025
Is It Your Back or Your SI Joint?
Low back pain is one of the most common complaints in medicine, but for many patients, the spine isn't the culprit. If you experience pain that sits low on one side of your back, feels worse when standing up from a chair, or radiates into your buttock, you may be dealing with Sacroiliac (SI) Joint Dysfunction.
Because the SI joint is located so close to the lumbar spine, it is frequently misdiagnosed. Patients often undergo MRI scans of their discs and receive treatments for "sciatica" that provide little relief. At Ospina Medical, we specialize in the precise diagnosis of pelvic and spinal conditions, utilizing specific provocation tests to ensure we treat the right joint with the right therapy.
The Role of the Sacroiliac Joint
The SI joints connect your sacrum (the triangular bone at the base of your spine) to your ilium (pelvis). Unlike the knee or elbow, these joints aren't designed for much movement. Their primary job is to act as shock absorbers, transferring the weight of your upper body to your legs.
To do this, the SI joint relies on a massive network of strong ligaments (dorsal and interosseous ligaments). When these ligaments become loose or damaged—due to a fall, car accident, or the hormonal changes of pregnancy—the joint becomes unstable. This extra motion creates inflammation and pain, a condition known as SI joint dysfunction.
Why Steroids and Fusion May Not Be the Answer
The traditional medical route often begins with steroid injections. While these can reduce inflammation temporarily, studies show they have a failure rate of up to 26% and diminishing returns over time. In severe cases, surgeons may recommend SI joint fusion, where the joint is permanently screwed together. While this stops the motion, it also removes the joint’s shock-absorbing ability, which can transfer stress to your hips or lower back (adjacent segment disease), potentially causing new problems down the road.
A Stabilizing Solution: SI Joint Injection Therapy
Our approach at Ospina Medical focuses on restoring the stability of the joint naturally. By strengthening the supporting ligaments, we can reduce the excess motion that causes pain.
Diagnostic Precision:
The first step is confirming the diagnosis. Dr. Matthew Kohler uses fluoroscopy (real-time X-ray) to perform a diagnostic block. If numbing the SI joint temporarily eliminates more than 50-75% of your pain, we know we have found the source.
Therapeutic Injection:
Once confirmed, we utilize SI joint injection therapies tailored to your needs. This often involves PRP by Regenexx or Bone Marrow Concentrate. These injectates are placed precisely into the joint (intra-articular) and the surrounding ligaments (peri-articular).
- Repair: The growth factors stimulate the repair of lax ligaments, making them tighter and stronger.
- Stability: As the ligaments strengthen, the joint becomes more stable, reducing pain and improving your ability to stand, walk, and move. Comparative studies show that PRP provides statistically significant pain reduction that is more durable than steroids.
Holistic and Functional Wellness
Treating the SI joint is about more than just the injection. It involves looking at how your body moves. Dr. Kohler and the team consider your posture, muscle balance, and biomechanics to ensure long-term relief.
If you are tired of chasing "back pain" treatments that don’t work, it is time to look lower. Schedule a comprehensive evaluation at Ospina Medical to see if SI joint injection therapy can provide the stability and relief you need.
A Riley Publication ~ Branded Thought Leadership by Riley Partners and Publications, Inc.
Medically Reviewed by: Matthew Kohler, MD