OpenHealth Q&A

Understanding Sacroiliac Joint Dysfunction: What Steps to Consider Next?

I’m a 33-year-old female, weighing 70 kg and standing 170 cm tall, with a background of being an ex-smoker and an occasional drinker while on holiday. My medical history is quite extensive, which I’ll summarize with my medications later, although most of it may not be particularly relevant. I also experience moderate levels of joint hypermobility. Back in 2014, I was heavily involved in long-distance running until I started experiencing a piercing pain in my right buttock. This discomfort intensified whenever I bent down or carried something on that side, leading to sharp sensations with each step. An X-ray showed no abnormalities, and the physiotherapist attributed my issue to weakness in the glutes, but unfortunately, this problem has persisted. The pain is particularly acute during my menstrual cycle, gradually lessening afterward. Just before my period, it feels more like sharp jabs, and at other times, the sensation resembles IT band discomfort, extending from the outer thigh down to the ankle, with additional sharpness in the hamstring and knee areas. - While imaging never pinpointed any specific problems, anti-inflammatory medications tend to alleviate the symptoms. - Orthopedic specialists ruled out any hip-related issues but identified FAI (femoroacetabular impingement), which explained some of my hip pain. - A gynecologist dismissed the possibility of endometriosis, stating that even if it were present, there would be little that could be done—a disappointing revelation. - I was referred to a sports medicine doctor who diagnosed me with sacroiliac joint dysfunction and recommended strengthening my glutes, along with considering a cortisone injection. - A podiatrist fitted me with orthotics, which provided some relief, though they are not a definitive solution. - Symptoms have been manageable on birth control, but I can no longer use hormonal contraceptives. - Since 2022, I have been engaging in Pilates and strength training supervised by both a physiotherapist and an exercise physiologist. - Both X-rays from 2014 and 2024 returned normal results. - An MRI of my lumbar spine conducted in 2024 revealed mild kissing spine, although only the S1 vertebra was examined, leading me to believe the real source of discomfort lies further down. - An MRI of my hip in 2024 mentioned FAI and some bone spurs, but the area of concern was not adequately captured in the imaging. - A laparoscopy performed in 2021 discovered deep bowel endometriosis. - Stretching occasionally alleviates IT band discomfort, but the acute stabbing sensation can only be managed through anti-inflammatory medication and patience. - Ponstan has proven to be the most effective, and I recently noticed that ibuprofen sodium dihydrate has been significantly more beneficial than regular ibuprofen—I’m perplexed by this improvement, yet the symptoms persist. After enduring a challenging five years with my health, I am finally regaining my sense of normalcy, and I’m eager to move forward with my life. This persistent pain is hindering my progress. **What should my next steps be?**

Answers (1)

2/9/2026, 10:00:46 AM

OpenHealth AI

It sounds like you've been navigating a complex and challenging situation with your health, particularly regarding sacroiliac joint dysfunction and associated issues. It's important that we address the pain and help you regain a sense of normalcy in your activities. Here’s a condensed view of the key points and recommended next steps.

Key Points

1. Sacroiliac Joint Dysfunction Diagnosis: You have been diagnosed and treated for this, which is often linked to glute weakness and can cause pain in the buttock and radiating sensations.
2. Pain Management: Anti-inflammatory medications have been effective, but the pain persists despite various treatments.
3. Physical Therapy and Exercises: You've been engaged in targeted exercises, which is promising for strength development and pain management.

Next Steps

1. Strengthening Exercises:

   • Continue focusing on glute strengthening exercises, such as bridges, clamshells, and single-leg deadlifts. These can enhance stability in the sacroiliac joint.
   • Work with your physiotherapist to ensure your technique is correct; they may also suggest variations or new exercises as you progress.

2. Manual Therapy:

   • Consider regular sessions with a manual therapist skilled in treating sacroiliac dysfunction. Techniques such as mobilization, massage, or manipulation may provide additional relief.

3. Focus on Core Stability:

   • Incorporate core strengthening exercises into your routine, such as planks and side planks, as a strong core supports your lower back and pelvis.

4. Pain Management Alternatives:

   • If anti-inflammatories are your primary method of pain relief, discuss potential non-steroidal anti-inflammatory drugs (NSAIDs) options and dosages with your healthcare provider. Ensure that the use of ibuprofen sodium dihydrate is monitored properly to avoid side effects.

5. Consider Non-Medical Pain Management Options:

   • Explore options such as acupuncture, dry needling, or transcutaneous electrical nerve stimulation (TENS), which have shown benefits in managing chronic pain.

6. Lifestyle and Activity Modifications:

   • Pay attention to body mechanics during activities. Use proper lifting techniques and avoid prolonged sitting or standing, which could aggravate the joint.

7. Monitor Your Cycle:

   • Since you've noticed an increase in pain around your menstrual cycle, keep a log of your symptoms and discuss potential non-hormonal management strategies for pain relief with your healthcare provider.

8. Educate Yourself Further:

   • Seek reputable resources on managing sacroiliac dysfunction. Understanding your condition better can empower you and help you communicate effectively with your healthcare team.

9. Support System:

   • Engage in support groups or forums where individuals with chronic pain share their experiences and strategies—this can help you feel less isolated and provide new coping mechanisms.

With dedication to these steps, you may find more significant relief and regain control over your daily activities. Please remember that progress can take time, and it's essential to remain patient and persistent. Keep tracking your symptoms and celebrate the small victories along the way.