Degenerative & Arthritic
Sacroiliac Degeneration
Understanding Arthritis of the Sacroiliac (SI) Joint
The sacroiliac (SI) joints connect the spine to the pelvis. They play an essential role in absorbing shock, transferring weight between the upper body and legs, and stabilizing the spine during movement. Like other joints, the SI joints can undergo wear and tear over time, leading to sacroiliac degeneration — a form of arthritis that causes lower back, buttock, and sometimes leg pain. At Desert Spine and Pain, we frequently see patients with SI joint pain that mimics other conditions such as lumbar strain or herniated disc. Accurate diagnosis by a neurosurgeon like Dr. David L. Greenwald, M.D., FAANS, FACS is essential to avoid misdiagnosis and get effective treatment.
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What Is Sacroiliac Degeneration?
Sacroiliac degeneration occurs when the cartilage in the SI joints wears down. This can lead to:
Inflammation and swelling of the joint
Abnormal joint motion (too much or too little)
Pain that radiates to the lower back, buttocks, or thighs
Bone spurs and narrowing of joint space
Causes and Risk Factors
Aging – Natural wear and tear
Pregnancy – Hormonal changes can loosen ligaments around the SI joint
Trauma or injury – Falls, car accidents, or sports injuries
Spinal fusion surgery – May increase stress on the SI joints
Unequal leg length – Even slight imbalances can stress the SI joint
Arthritis – Osteoarthritis or inflammatory arthritis may accelerate degeneration
Symptoms of Sacroiliac Degeneration
Pain in the lower back, buttocks, hips, or thighs
Pain that worsens when standing, climbing stairs, or walking long distances
Stiffness in the lower back or pelvis
Discomfort when rolling over in bed or rising from a chair
Rarely: numbness or tingling if nearby nerves are irritated
Diagnosis
At Desert Spine and Pain, diagnosis includes:
Physical exam – Special maneuvers (e.g., FABER test) to reproduce SI joint pain
Imaging – X-rays, MRI, or CT scans to assess degeneration and rule out other causes
Diagnostic injection – A numbing injection into the SI joint; pain relief confirms diagnosis
Treatment Options
Non-Surgical Care
Medications for pain and inflammation
Physical Therapy for posture, stability, and strengthening of the core and hips
SI joint belts or braces for stabilization
Activity modification to reduce stress on the joint
Interventional Pain Management
SI joint injections – Steroid injections for pain relief
Radiofrequency ablation (RFA) – Disables small pain nerves around the SI joint for longer-term relief
Surgical Options
If conservative treatments fail, minimally invasive SI joint fusion may be recommended. This procedure stabilizes the joint with small implants, reducing painful movement and restoring function.
Recovery Timeline
Conservative care – Many patients improve within weeks to months
Injections or RFA – Relief may last several months to over a year
SI joint fusion – Minimally invasive; patients often resume light activity within weeks and full recovery in 6–12 weeks
Why Choose Desert Spine and Pain?
Expertise in SI joint disorders – Dr. Greenwald ensures accurate diagnosis and avoids mislabeling pain as lumbar-only
Comprehensive care – Conservative-first approach with advanced interventional and surgical options when needed
National reputation – Patients across Phoenix trust our team for spine and joint conditions
Compassionate support – We make complex spine care understandable and reassuring
Frequently Asked Questions
How is sacroiliac degeneration different from sacroiliac joint dysfunction?
Degeneration refers to cartilage breakdown and arthritis, while dysfunction refers to abnormal movement (too much or too little). They often overlap.
Can SI joint degeneration be treated without surgery?
Yes. Many patients improve with therapy, injections, and lifestyle adjustments.
How long does SI joint fusion take to recover?
Most patients return to light activity within weeks and fully recover in 6–12 weeks.
Does SI joint degeneration always cause symptoms?
Not always. Some people show arthritis on imaging but remain pain-free.
How does Desert Spine and Pain approach SI joint degeneration differently?
We provide precise diagnosis, conservative-first care, and minimally invasive fusion options when necessary.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If sacroiliac degeneration is causing persistent lower back or hip pain, you don’t have to live with the discomfort. Dr. Greenwald and his compassionate team will help identify the root cause of your symptoms and create a personalized treatment plan to restore your comfort and function. Every step you take toward better spine and joint health brings you closer to lasting relief. Schedule your consultation today and let us help you move forward with greater ease and less pain.
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Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon specializing in the diagnosis and treatment of sacroiliac (SI) joint degeneration, a condition that occurs when the cartilage in the SI joints—located between the sacrum and the pelvis—breaks down over time. This degeneration can cause chronic lower back pain, hip pain, and discomfort when standing, walking, or sitting for long periods. Dr. Greenwald uses advanced imaging and diagnostic injections to accurately determine whether the SI joint is the source of pain. He offers both non-surgical and minimally invasive surgical treatments, including SI joint fusion when appropriate, to relieve pain and restore stability. His patient-focused approach helps individuals throughout South Florida regain comfort, mobility, and confidence in their daily lives.
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