The sacrum region is located at the base of the spine, just above the coccyx, and articulates with the hip bones via the sacroiliac joints.

When this region hurts, the discomfort is usually deep, located near the 'dimples' on the back, and is often confused with lower back or hip pain.

Understanding whether the pain comes from the lumbar spine, the sacroiliac joint, or another structure is essential for effective treatment.

What is Sacroiliac Origin Pain Like?

Sacroiliac joint pain typically:

is located on one or both sides of the base of the spine, near the hip;

worsens when standing for a long time, walking long distances, or carrying weight;

sometimes radiates slightly to the buttock or back of the thigh;

improves when lying down in certain positions.

It may arise after:

false step (lifting something heavy, twisting the trunk);
pregnancy and postpartum (due to hormonal and mechanical changes in the pelvis);
gait changes and impact (due to leg length difference, for example).

Common Causes of Sacroiliac Pain

Mechanical Overload

imbalances in how weight is distributed between the legs and pelvis;
weakness of glutes and deep muscles that stabilize the pelvis.

Pregnancy and Postpartum

hormonal changes that loosen ligaments;
change in center of gravity;
overload in the lumbopelvic region.

Changes in Lumbar Spine or Hips

arthrosis, hernias, or misalignments can modify walking patterns and overload the sacroiliac joints.

Treatment: How to Care for Sacrum Pain

Treatment generally involves:

Conservative Measures

strengthening of glutes, core, and pelvic stabilizing muscles;
correction of gait imbalances, when present;
postural guidelines for daily activities;
physiotherapy focused on lumbopelvic stabilization.

Medical Acupuncture

can contribute to reducing pain and muscle tension in the region;
integrated into a plan that considers the entire lumbopelvic chain.

Interventional Treatments

In cases of intense, chronic pain or pain refractory to conservative measures, the pain doctor may evaluate:

diagnostic and therapeutic blocks of the sacroiliac joint;
radiofrequency procedures on specific structures, when well indicated.

In Summary

Pain in the sacrum and sacroiliac joints is often underdiagnosed and confused with nonspecific low back pain.

Careful evaluation helps identify the exact origin of the problem and direct a care plan that includes pelvic stabilization, strengthening, possible interventions, and strategies to resume routine with less pain.

Schedule your Evaluation

If you have pain at the base of the spine or near the 'dimples' on your back, our team can evaluate if the origin is in the sacroiliac joint and propose the best treatment.

Sacrum Pain: When the Base of the Spine Hurts