Sacrum Pain or Sacroiliac Joint Pain: Causes, Symptoms, and Treatments

Sacrum Pain and Low Back Pain

Sacrum pain causes aches and sharp pains in the low back and buttocks. Sacrum pain comes from dysfunction in the sacroiliac (SI) joint which is between the base of your spine and your hip bone. Diagnosing sacrum pain can be a challenge because there are many other reasons for low back pain. The pain and irritation that sacrum pain causes in the lumbar region can feel like a herniated disc or problem with your hip.

Irritation and inflammation caused by wear and tear, injury, or strenuous physical activity can cause pain in your sacral area. Pain from the sacroiliac joint can also radiate to the groin, upper thigh, or hip. Heat therapy, massaging the lower back, and stretching exercises are excellent natural ways to treat the symptoms of sacroiliac joint pain.

In this article, you will find out what can be causing sacrum pain and how it is related to lower back pain, and how to spot the symptoms of SI joint dysfunction. You will also get some effective pain relief treatments to help get rid of the pain in your low back and buttocks.

Sacrum Pain, Sacroiliac Joint Pain, SI Joint Pain: What Is It?

Your sacrum is a large, triangular-shaped bone at the base of your spine. On either side of your sacrum are your iliac bones, or hip bones and the join between the two bones is called the sacroiliac joint. According to doctors on MedicineNet, the sacrum forms the back of the pelvic bone and the sacrum in women is wider than in men.1

Your sacrum is located just where you have two dimples on your lower back.

Pain in the sacrum occurs when the ligaments and muscles that support the sacroiliac joints weaken causing the sacrum and iliac bones to rub together. According to doctors from the Mayfield Clinic, the aging process means that conditions like arthritis can stiffen back muscles and ligaments and cause SI joint strain in the pelvic area resulting in pain when moving.2

Another cause of sacrum pain is the fact that there are many nerve endings at the base of your spinal cord. Joint dysfunction can cause SI joint inflammation if movement between the bones is too much or if joint degeneration presses or rubs on nerves.

The intensity of sacrum pain can range from mild occasional aches to severe stabbing pain in your lower back. An injury to your abdomen, pelvic area, or lower back could cause acute sharp pain above your waist that may take a few weeks to heal. Joint degeneration can result in chronic pain in the lumbar region and buttocks which may be constant, or the aches and pains could come and go.

Sacrum Pain, SI Joint Pain, Sacroiliac Joint Pain: Why it Causes Lower Back Pain

SI joint syndrome is one of the major causes of low back pain; in fact, according to a report in the journal Anesthesia & Analgesia, SI joint dysfunction is to blame for up to 25% of all cases of low back pain. The report also stated that sacrum pain can also be a reason for pain in the upper thigh and can radiate to the buttocks.3

However, it seems that many doctors fail to diagnose the connection between the sacroiliac joint and lumbar pain. In many cases, doctors attribute low back pain to spinal problems without taking into consideration SI joint dysfunction. The journal Spine reported that many patients who have undergone spinal surgery for low back pain still have pain afterward. However, the real reason for their lumbago (low back pain) was pain coming from the SI joint.4

Therefore, to relieve low back pain and tension, it’s important to take into consideration SI joint dysfunction because the pain could be coming from the sacrum joints. That is why the journal ClinicoEconomics and Outcomes Research reports that dysfunction in the joints between the sacrum and hip bone should be evaluated when looking for the underlying cause of low back pain.5

Symptoms of Sacrum, SI Joint Pain and How It Affects Your Lower Back

Sacroiliitis is the medical name given to pain that comes from inflammation in the SI joint. This usually results in pain on just the left side of the lower back or pain in the right side of the lower back.

According to Dr. Tyler Wheeler on WebMD, sacrum pain can range from a dull ache to sharp intense pain that gets worse when you move. For some people, the pain may be worse in the morning and gradually ease throughout the day.

Doctors from the Virginia Spine Institute say that severe sacrum pain can also be a reason for groin pain in women and men, hip pain, aches in the buttocks, and soreness at the top of the thigh. Sometimes, even simple daily activities like walking or standing up can aggravate the SI joint and cause more pain.7

Si joint syndrome can also cause shooting pains that go from your lower back down the length of your leg. The European Spine Journal reported that sacrum joint dysfunction can cause symptoms similar to sciatica. This can cause tingling down one leg, weakness in the leg muscle, or debilitating pain that makes walking difficult.8

The Virginia Spine Institute also reports that painful symptoms caused by problems with the joint between the iliac bones and the sacrum can be similar to a degenerative hip disease, herniated lumbar disc, inflammation of the hip, or pinched nerves in the lower back.7

Causes of Sacrum Pain or Sacroiliac Joint Pain

Let’s look at some of the causes of sacrum pain that may be to blame for stiffness, discomfort, and pain in your lower back.

Injury to the sacrum

Injury or a traumatic blow to your sacral area at the base of your spine will result in sacrum pain as well as pelvic bone pain. The injury to the SI joint could just be as a result of aging where the muscles and ligaments around the bone stiffen. Or, the pain in the sacrum could be caused by an injury from falling, being in a car accident, or playing sports.

For example, the website reports that common causes of a sacral fracture include intense activities like running, old age, falling, or osteoporosis. The stress on your SI joint that can cause a sacral fracture resulting in back and buttock pain could even result from wearing incorrect footwear.9

Strenuous physical activity

Putting your back or spine under regular stress from strenuous physical activity can also result in sacrum pain.

The journal Current Sports Medicine Report says that SI joint dysfunction is very common among athletes. Although injury can be a source of sacrum pain, the study found that repetitive micro-trauma from strenuous physical activity was the most common reason for dysfunction and pain of the sacroiliac joint. The result from SI joint problems is an “achy” back that gets worse at night.10

The journal also pointed out that repetitive strain on the sacrum joints can also cause lower abdominal pain, groin discomforts, and pain at the top of the thigh.

Abnormalities of the spine

Abnormalities of the spine can put undue stress and tension on the SI joints causing pain in the lower back that radiates to the groin. The Spine Journal reported that certain spine problems can cause low back pain.11

Also, Dr. Tyler Wheeler on WebMD says that ankylosing spondylitis caused by arthritis can affect the spine and, over time, can damage the sacroiliac joint that will hurt when you move.6

One type of abnormality of the spine is Bertolotti’s syndrome. This is when vertebrae at the lower part of the spine fuse together and cause lower back pain. According to the journal Malaysian Family Physician, this type of spine abnormality can cause low back pain in children as the vertebrae start to fuse as bones grow.12

Pelvic floor disorder

Pelvic floor disorder can also cause sacrum pain in many women. The sacrum bone forms part of the pelvic bone and any dysfunction of the pelvic area can increase tension and stress in the sacroiliac joints. Pelvic floor disorder is common in middle-aged or older women and may also result in incontinence and pelvic pain without a period.

According to the journal Manual Therapy, pelvic floor dysfunction is also associated with low back pain. Doctors usually recommend exercises to strengthen the pelvis and prevent symptoms of pelvic floor disorder.


Another reason for low back pain in women that is caused by problems with the sacroiliac joint is endometriosis. Endometriosis is a condition where endometrial tissue grows outside the womb in the tissue lining of the pelvis. It can cause spotting before your period, pain during sexual intercourse, and pain when passing a bowel movement, as well as cramping pelvic pain.

The Journal of Clinical Research reported that deep endometriosis can affect the sacral ligaments. This can result in pain and discomfort in the lower back and abdominal area. The abnormal tissue growth in the pelvic area can also affect nerve endings and also cause severe chronic pain.13

Sacrum pain during pregnancy – pelvic girdle pain (PGP)

Many pregnant women suffer from lower back pain and pain in the sacral region that becomes more intense as the pregnancy progresses. This condition is called symphysis pubis dysfunction (SPD) or pelvic girdle pain (PGP). It is very common during pregnancy and can cause a lot of discomfort as well as pelvic bone pain when walking, standing, or bending over.

Most of the times the pain usually disappears within several weeks after delivery, however in some cases one of the sacroiliac joints becomes sprained, and the result is chronic sacrum pain.

The reason for the sacrum pain is that during the later stages of pregnancy, there are hormonal changes that cause increased motion to allow the pelvis and the muscles around it to enlarge in preparation to delivery. This causes over-mobility of the SI joints, and with the additional weight gain of the pregnancy these may cause strain on the sacroiliac joints which may cause pain and inflammation.

Hodgkin’s disease

A rare cause of sacrum pain is Hodgkin’s disease. According to the Journal of Cancer Research and Therapeutics, in rare cases, bone cancer can show up as lesions on the sacral bone without other symptoms.14

However, it is good to remember, that this is a rare occurrence and in the majority of cases, pain in the lower back is due to wear and tear or an injury to your spine or sacroiliac joints.

How to Treat Sacrum Pain (SI Joint Dysfunction) or Lower Back Pain Naturally

Most methods for treating sacrum pain involve getting symptomatic relief from discomfort and pain that SI joint dysfunction causes.

Cold therapy for SI joint dysfunction

If you have damaged your pelvic bone from an injury and you have low back pain, applying an ice pack can help to relieve inflammation, swelling, and pain in your sacroiliac joints.

Dr. Linda Vorvick on MedlinePlus says that applying ice to a joint or muscle immediately after an injury helps to reduce blood flow to the area and reduces swelling. The effect of cold also helps to calm damaged nerve endings in the sacrum.15

How to use ice for relieving sacrum pain (sacroiliac joint pain):

You can make an ice pack at home to treat acute low back pain by putting ice in a sealable plastic bag or using a bag of frozen vegetables. This is what you should do:

  1. Wrap the ice pack in a thin towel and hold to your lower back where you feel the pain.
  2. Keep the ice pack held for up to 15 minutes at a time to relieve sacrum pain or back/hip joint pain.
  3. For the first day – apply ice for 15 minutes every hour.
  4. For the second day – apply ice for 15 minutes every 3 or 4 hours.

If you still have pain in your lower back, groin, or abdomen from an SI joint dysfunction in the third day, you should change to heat therapy for pain relief.

Heat therapy for treating sacroiliac joint pain

Once any swelling has gone away, you can use heat therapy to get rid of acute or chronic pain from your lumbar region. Heat helps to boost blood flow to the muscles and tendons around the SI joint and helps to get rid of the pain.

Dr. William Blahd on WebMD says that heat can be applied to get rid of joint pain, muscle pain, and other general aches. Applying a heat pack to a sore area on your lower back will help to remove tension from muscles and help to boost the healing process.16

How to use heat packs for alleviating sacrum pain:

You can easily make your own heat pack to treat sacroiliac joint dysfunction symptoms at home. Here is the simple method:

  1. Fill an old clean sock with rice leaving a few inches clear at the top.
  2. Tie the sock and place in a microwave on full power for 2 minutes.
  3. Carefully remove the heat pack, making sure not to burn your fingers.
  4. Wrap the hot rice-filled sock in a warm moist towel and hold on your lower back for 10-15 minutes to relieve SI joint pain.
  5. Apply every 3-4 hours during the day to relieve pain from your lumbar region and sacroiliac joint to treat sacrum pain.
  6. Continue using daily until you don’t have low back pain when walking or moving.

Alternate cold and heat treatment for sacrum pain

Using a combination of hot and cold treatment for joint pain is a great way to treat sacrum pain in your lower back.

Dr. David Zelman on WebMD says that heat and cold therapy dilates and constricts the blood vessels to stimulate circulation. The cold also acts as an anesthetic to numb the pain and heat acts as an analgesic to relieve inflammation in irritated joints and muscles.16

How to use:

It is very easy to use heat and cold therapy to treat lower back sacrum pain or pain in the buttocks. This is what you should do:

  1. Start off by applying the ice pack (see above) for 10 minutes to numb the sacrum pain.
  2. Then apply the heat pack for 15 minutes to help relax the muscles.
  3. Wait for 30 minutes then repeat the cold and heat treatment.
  4. Repeat for up to 3 hours – alternating between heat and cold with a 30-minute break to help relieve SI joint pain and restore movement to your pelvic and groin area.

Epsom salt bath to relieve sacrum pain

One way to relax stiff SI joints and ease sacrum pain is to take a warm bath of Epsom salt.

Dr. Carol DerSarkissian on WebMD says that an Epsom salt bath can help to heal strained or pulled muscle and ease many aches and pains. It is thought that magnesium and sulfate from the salts penetrate the skin and help relax stiff muscles.20

How to use Epsom salt for sacrum pain:

Here is what you should do to make a healing bath with Epsom salt to get rid of pain in your sacral region:

  1. Fill your bathtub with very warm (but not hot) water and add 1 to 2 cups Epsom salt.
  2. Soak in the bath water for 20 minutes to allow the salts and minerals ease sacrum pain and stiffness in your lower back.
  3. Rinse off in the shower and dry yourself.
  4. Take the bath up to three times per week until your lower back pain is healed and is no longer sore.

Massage to ease lower back pain or sacrum pain

Massaging your lower back and the area at the base of your spine is an effective way to make your sacrum hurt less. Massage techniques help to increase blood circulation to the lower back. You can also make your own massage oil with essential oils that have pain relief properties.

For example, the journal Current Reviews in Musculoskeletal Medicine reports that massage can help to repair mild to moderate muscle injuries. Massaging can help to relax the muscles that surround irritated joins and can provide better muscular support if joints are irritated.17

Scientific research into essential oils has shown that they help to reduce pain and inflammation. For example, research in 2015 found that lavender oil has anti-inflammatory effects as well as analgesic properties.18 Also, peppermint oil has been shown to have a cooling effect when applied to the skin and has pain-relieving properties.19

How to make your own massage oil for sacrum pain:

This is how to make a massage oil at home to help relieve tension in your lower back and get rid of the symptoms of SI joint pain:

  1. Mix 10-12 drops of peppermint oil, lavender oil, and rosemary oil with 1 oz. (30 ml) carrier oil such as sweet almond oil.
  2. Take a little of the oil and rub between your palms and massage into your lower back and buttocks.
  3. Apply the essential oil treatment 2 times a day.
  4. Use daily for chronic sacrum pain to help reduce pain and discomfort in the sacrum.

Exercises to Treat Sacroiliac Joint Pain or Sacrum Pain

If you suffer from recurring sacroiliac joint pain or you have to deal with chronic sacrum pain every day, exercises can help treat the lower back and buttock pain.

The Journal of Physical Therapy Science reported that exercising the lower back area and pelvic region can help to strengthen the sacroiliac joints. This can help relieve pain if you have chronic SI joint pain from a sedentary job or age-related groin and hip pain.

Exercises for sacrum pain:

Here are some specific exercises that can help to strengthen your pelvic area and reduce symptoms of SI joint dysfunction such as low back pain and sciatica.

Pelvic twist. Help keep your lower back muscles nimble with pelvic twist exercises. This is what you should do:

  1. Lie on your back and pull your knees to your chest.
  2. Turning at the hip, gently twist your legs to the right until they touch the floor.
  3. Hold for 5 seconds and return your knees to the starting position.
  4. Repeat to the left side.
  5. Do the exercises 5 times to help increase flexibility and strength in your lower back and pelvic area.

Thigh exercise. If SI joint dysfunction also causes sciatica-like symptoms, then this thigh exercise is great to release nerve pain and strengthen your lower back.

  1. Lie on your back and pull one leg to your chest. You should feel your buttock and back of your thigh muscles getting stretched.
  2. Hold in position for 30 seconds and then release.
  3. Repeat 2 or 3 times in the day to help ease the pain in your back and get rid of sciatica pain in your leg.

There are many more effective exercises that can help to reduce low back pain and nerve pain in your back. For example, you can strengthen your low back muscles with a foam roller or you can use a tennis ball to ease nerve pain from your lumbar region.

Sacrum Pain, Sacroiliac Joint Pain, SI Joint Pain – When to See a Doctor

It is usually possible to get symptomatic relief from sacrum pain and ease SI joint dysfunction symptoms if they flare up. However, in some instances, you should see a doctor for SI joint pain. Dr. Tyler Wheeler on WebMD recommends visiting a doctor or chiropractor if you can’t get rid of joint pain and it interferes with your daily activities.

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