There may be many reasons for buttock pain. Muscles, joint, ligaments or other soft tissue damage or disorder can cause buttock pain. buttock pain is related to or as a result of an injury elsewhere such as the lower back. Pain usually develops gradually over time, but can also occur suddenly in the case of muscle strains or sciatic nerve-related injuries. Finding the cause and treating it appropriately could help your butt pain. Sacro-iliac joint seem to be a significant source of butt pain. Inflammation of the Sacroiliac joint causes pain in the lower back and buttocks.

The Sacroiliac joints are located at the very bottom of the back, one either side of the spine and help make up the rear part of the pelvic girdle. They sit between the sacrum bone and the Ilia or hip bones. SIJ dysfunction is a term which is commonly used when talking about sacroiliac injuries. This dysfunction refers to either hypo or hypermobility (low or high respectively). In other words, the joint can become ‘locked’ or be too mobile. This can then lead to problems with surrounding structures such as ligaments (e.g. Iliolumbar ligament) and muscles, which means SIJ problems can cause a wide range of symptoms throughout the lower back and buttocks, or even the thigh or groin.

The function of the SI joints is to allow torsional or twisting movements when we move our legs. The legs act like long levers and without the sacroiliac joints and the pubic symphysis (at the front of the pelvis) which allow these small movements, the pelvis would be at higher risk of a fracture.

The concept of the SIJ causing lower back pain is now pretty well understood. However, due to the complex anatomy and movement patterns at the joints and area in general, evaluation and treatment of sacroiliac dysfunctions are still controversial.

A sacroiliac joint injection (SIJ injection) is an injection of local anesthetic and a steroid medication into the sacroiliac joint. Due to the numbing medicine used during this procedure, you may experience temporary pain relief afterwards that may last several hours. The steroid medication may give longer lasting pain relief and usually begins working after 24-48 hours.

We perform our SIJ injection under x ray guidance. After the doctor examines you and goes over the risks and benefits of the procedure, he will ask you to sign a consent form. Then, you will be assisted to the X-ray table and made as comfortable as possible lying on your stomach. Your injection site is cleansed with an antiseptic solution and then covered by sterile drapes. The skin is numbed with local anesthetic (numbing medicine). Using X-ray guidance, a needle is advanced into the sacroiliac joint. X-ray dye will be injected to confirm proper placement. Local anesthetic (numbing medicine) and steroid are then injected into the joint, and the needle is removed. The injection site will be washed and a Band-Aid will be applied. You will be monitored for an appropriate time in the recovery area (usually 15 minutes). You will be given verbal and written discharge instructions, and may go home with your driver after your doctor authorizes discharge.

If the therapeutic sacroiliac joint injection is successful in reducing or eliminating the patient's pain for a longer duration, it may be repeated up to three times per year, in conjunction with physical therapy and rehabilitation program, to help the patient maintain normal function.