One question patients may ask their physician when they first begin to explore their SI joint symptoms is: Why is there pain when I sit? The answer is straightforward: damage or inflammation in one of the SI joints from injury, age, arthritis, some other trauma or congenital abnormality can lead to pain while sitting because the body’s weight is concentrated on the joints in this position. Similar pain and discomfort can occur when trying to lie down or sleep on the painful side, which also concentrates force on the SI joint.

SI joint pain may occur “unilaterally” or bilaterally”. Unilateral means the symptoms are occurring only on one side of the body. On the other hand, if problems arise in both of the SI joints, this is referred to as “bilateral” SI Joint Dysfunction. Feeling pain while sitting can sometimes manifest on one side in the buttock, groin and thigh. Generally, the pain does not radiate below the knee, but on rare occasions it can extend down to the lower leg and foot.

Some other causes of pain when sitting on one side include muscle strain, sprains, and lower back and nerve inflammation or damage. Many people who experience this type of pain automatically presume that it is a problem associated with their hip, back or with the sciatic nerve. Certainly this can be the case for some patients, however; unilateral SI joint dysfunction is a much more common cause of pain while sitting on one side.

In order to properly treat and resolve the discomfort and pain experienced with difficulty sitting on one side, it is important for a trained medical provider to diagnose the actual source of the pain. Accomplishing this goal can be tricky because the type of pain reported by people suffering pain on one side while sitting as a result of SI joint dysfunction can vary from a dull ache to sharp stabbing pains. These pain descriptions also match the chief complaints of people suffering from sciatica and lower back problems, so diagnosing the real source of the pain is vital to receiving proper treatments.

Some approaches used to evaluate the SI joint as a possible explanation to the cause of pain on one side while sitting may include:

• Thorough discussion of health history
• Physical examination
• Palpation of the area suspected of causing pain (the provider will press on the area in question)
• Range of motion evaluation
• SI Joint Provocative Tests
• Diagnostic SI joint injection
• MRI
• CT
• X-rays

It takes a knowledgeable and skilled healthcare provider to accurately diagnose SI joint dysfunction and develop the best plan for treating it. Treatment depends specifically on what is causing your pain, if you suspect that your pain may be caused by the SI joint, ask your healthcare provider for more information.

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