Sacroiliac Joint Syndrome (ISG Syndrome) 101

Sacroiliac Joint Syndrome (ISG Syndrome) is the name given to low back pain that occurs in the lower back area. The sacroiliac joint connects the hip bones to the sacrum with ligaments. Sacroiliac joint syndrome can occur in both the young and the elderly.

What is Sacroiliac Joint Syndrome?

Severe low back pain can be an indication of sacroiliac joint syndrome.

According to abbreviationfinder, Sacroiliac Joint Syndrome (SIJ Syndrome) is a painful condition affecting the lower back. The sacroiliac joint is not a movable joint like e.g. B. the knee. It serves as a connection between the sacrum and the hip bones. The mobility of the SI joint is severely restricted due to the rigid fixation with ligaments.

The sacrum is located between the lumbar vertebrae and the coccyx and consists of five vertebrae that are fused together. In sacroiliac joint syndrome, the joint surfaces shift against each other. This is often associated with very severe pain and restricted movement.

Since the lower part of the spine in particular is subject to a great deal of stress, pain and degenerative changes in this area often occur. Sacroiliac joint syndrome (SIJ syndrome) is one of the most common forms of back pain.


Sacroiliac joint syndrome can have many causes. Above all, incorrect posture and incorrect strain in sports and work often lead to signs of wear and tear and thus to back pain. Lack of exercise and thus underdeveloped muscles also promote the development of sacroiliac joint syndrome.

Another cause can be diseases. Bechterew’s disease, rheumatoid arthritis or osteoporosis can trigger sacroiliac joint syndrome. Bacterial infections, often e.g. B. in Lyme disease, can cause inflammation in the sacroiliac joint.

Sacroiliac joint syndrome often occurs during pregnancy, as the muscles and ligaments in the lower spine are heavily stressed during this time.

In the case of low back pain, the psychological factor must not be ignored. Stress and other psychological strains often manifest themselves in the form of sacroiliac joint syndrome.

Symptoms, Ailments & Signs

One possible symptom that suggests a dislocation of the sacroiliac joint is diffuse low back pain. These are usually accompanied by a sharp pain in the ISB, which can radiate to the legs, abdomen and lumbar region. The feeling of limping or jamming in the hip joint is also typical, often associated with restricted movement.

In general, the pelvis and lower back appear unstable and painful when bending forward or backward heavily. The pain mainly occurs when the person has stayed in one posture for a long time. After lying, standing or sitting, there is persistent pain and muscle stiffness, which only subsides slowly.

When lying on the back, extreme pain usually occurs, which radiates from the joint to the surrounding body regions. The typical pain can affect the entire pelvic area. If the disease is not treated, serious complications can develop. If left untreated, the pain develops into a chronic condition that also occurs at night and during periods of rest.

In addition, severe inflammation can set in, which significantly restricts the mobility of the affected joints. This is usually accompanied by emotional upset and irritability.

Diagnosis & History

The sacroiliac joint syndrome is usually diagnosed by an orthopedist. The doctor uses various examination methods. In addition to a detailed anamnesis (collecting the medical history, description of the symptoms), tests are carried out both standing and lying down.

The so-called advance phenomenon and the reverse phenomenon are tested. These tests check the mobility of the sacroiliac joint. In addition to the physical examination, imaging methods are also used. However, x-rays cannot detect sacroiliac joint syndrome. X-rays, magnetic resonance imaging and CT are used to rule out other diseases and injuries to the spine and intervertebral discs.

A blood test can be used to determine whether there is an infection. A bone scintigram can be used to visualize the inflammation in the area of ​​the SI joint. If sacroiliac joint syndrome is diagnosed, the disease is usually not limited to the SI joint, but the hip and lumbar spine are also affected over time.

The course of sacroiliac joint syndrome must be assessed differently, as it depends on the cause and the treatment. The symptoms often only occur for a short period of time and improve with the help of medication and physiotherapy. In about 30 percent of all those affected, the sacroiliac joint syndrome develops into a chronic disease.


Due to the sacroiliac joint syndrome, the patient suffers from severe pain in different regions of the body. In most cases, however, the back and hips are affected. The pain often leads to restricted mobility and thus to psychological problems. Muscle tension and knee pain can also occur.

The everyday life of those affected is restricted by the sacroiliac joint syndrome and many physical activities or sporting activities can no longer be carried out. If the pain also occurs at night in the form of rest pain, this can lead to sleep disturbances. Long-term treatment of the pain with the help of painkillers is not recommended, as these have a negative effect on the stomach.

In the case of inflammation, antibiotics and other medications can be used to stop it. There are no further complications. However, the affected person is dependent on physiotherapy to treat the symptoms. However, this does not always lead to a positive course of the disease, so that the affected person may suffer from restrictions throughout his life. Life expectancy is not affected by sacroiliac joint syndrome.

When should you go to the doctor?

Unusual lower back, back or buttock pain should always be examined by your family doctor or an orthopaedist. If there is already a concrete suspicion of a serious illness, rapid clarification is required. Affected patients should talk to their general practitioner or go to a specialist clinic with their symptoms. Since sacroiliac joint syndrome is usually chronic, close monitoring is indicated. If side effects and interactions occur during treatment, the responsible doctor must be informed.

The same applies if the pain increases in intensity or new symptoms appear. Typical warning signs that must be clarified immediately are restricted movement or signs of paralysis in the area of ​​the back and buttocks. People suffering from Bechterew’s disease or osteoporosis are particularly susceptible to the development of sacroiliac joint syndrome. Rheumatoid arthritis or a bacterial infection can also trigger the disease. People suffering from any of these diseases should speak to their doctor if they experience the above symptoms and conditions.

Treatment & Therapy

There are several treatment options for sacroiliac joint syndrome . The therapy plan begins with physiotherapy and pain therapy. The cause of the symptoms must then be found and treated appropriately.

If there is an infection, it is treated with antibiotics. As a consequence of a rheumatic disease, cortisone preparations are usually administered in conjunction with painkillers, as these are the most effective.

If the pain is very severe, an anesthetic can be injected into the joint space. This relieves the discomfort and mobility is also improved because the joint surfaces no longer rub against each other due to the injection of liquid.

Physiotherapy is used both as an immediate measure and as long-term therapy. Electrostimulation treatments, heat applications, physiotherapeutic and ergotherapeutic exercises, underwater gymnastics, etc. have proven particularly effective here. The aim of physiotherapy is to relieve pain, restore mobility and correct poor posture. Since the joint is blocked in sacroiliac joint syndrome, manual therapy can be used to try to release the blockage.

So-called alternative treatment methods have also proven effective for sacroiliac joint syndrome. Yoga, progressive muscle relaxation and acupuncture offer a good alternative to conventional medicine.

Outlook & Forecast

The prognosis for SI joint syndrome differs from patient to patient. Among other things, the age of those affected, the severity of the disease and the selected therapeutic measures play a decisive role in the course of the disease. ISG syndrome that has not existed for long has the best prognosis. It can usually be treated with physiotherapy and targeted exercise. Spontaneous improvements are also more common in this form of ISG syndrome.

On the other hand, an ISG syndrome that has existed for a longer period of time is difficult to treat. Despite physical activity, massages or physiotherapy, the patients continue to suffer from pain. However, there are also differences in terms of pain quality and pain quantity. While some patients only feel pain in the SI joint area when they are overexerted, others complain of pain even when they are at rest. The quality of pain varies from barely noticeable to very severe.

Especially in younger patients between the ages of 15 and 40, the SIJ syndrome shows little improvement despite appropriate treatment. The quality of life and everyday life of those affected suffer greatly. It is not uncommon for them to depend on taking pain medication for life in order to cope with their everyday life. In some cases, however, the usual pain medication for SI joint syndrome is only very weakly effective, so that patients have to learn to live with the pain.


There are several ways to prevent sacroiliac joint syndrome. Physical activity is a must, as is avoiding obesity. Furthermore, it makes sense to attend a so -called back school. This is offered by all health insurance companies or you can learn it from a physiotherapist.

These are special exercises for the back. With their help, you learn to recognize and avoid bad posture and strain. Important: If you are already in pain, you should move slightly, because resting can aggravate sacroiliac joint syndrome (SIJ syndrome).


Follow-up care for sacroiliac joint syndrome depends on the degree of the disease and the age of the patient. With an early diagnosis, the symptoms can be relieved quite well. The follow-up treatment is primarily about targeted physiotherapy. With the right movements, this helps to make the joint flexible on the one hand and to stabilize it on the other.

Sporting activities are irreplaceable for those affected, also to avoid becoming overweight. Depending on the problem, the doctor may recommend attending a back school. Some of these are offered by health insurance companies, but individual physiotherapy is also helpful. With the health-promoting exercises, those affected strengthen their backs and learn the ideal posture.

A conscious approach to your own body prevents further incorrect stress and has a correspondingly positive effect on the quality of life. Even if patients feel pain, they should exercise enough and not take long-term painkillers. At rest, the affected joint may get worse. For aftercare, doctors often recommend heat applications or special relaxation methods such as yoga. Gentle exercise also improves the back muscles, after which the symptoms decrease. After an intensive introduction, the exercises are also suitable for use at home.

You can do that yourself

In the case of sacroiliac joint syndrome, the patient has various options for self-help that can significantly alleviate the symptoms of this disease.

First and foremost, various heat applications have a very positive effect on the symptoms and can relieve the pain. Relaxing exercises such as yoga or other light sports can also strengthen the back muscles and reduce the symptoms. Acupuncture can also have a positive effect on the course of the sacroiliac joint syndrome. Furthermore, many patients are also on physiotherapy or physiotherapyreliant. These exercises can often be done at home to restore movement. The patient should also note that long-term use of painkillers is not recommended as it can damage the stomach. The intake of painkillers should therefore always be coordinated with the doctor.

The symptoms of the sacroiliac joint syndrome can also be reduced by underwater aerobics. These exercises are usually done in a group, but can also be done alone. If the pain is severe, however, the patient should consult a doctor, as this can be relieved with an anesthetic. In most cases, the sacroiliac joint syndrome leads to a positive course of the disease.

Sacroiliac Joint Syndrome

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