Sacroiliitis vs Sciatica: How to Tell the Difference

Lower back pain can interrupt even the simplest parts of daily life, especially when the discomfort spreads into the hips or legs. Many people assume the cause is sciatica, but sacroiliitis can create almost identical symptoms. Knowing the difference between these conditions helps you understand what your body is telling you and which treatments may bring meaningful relief.

At Pacific Pain Medicine Consultants, our team has spent decades diagnosing complex back and pelvic pain. Since 1984, the practice has brought together specialists in anesthesiology, physical medicine, and neurosurgery to accurately evaluate complex symptoms. 

What Is Sacroiliitis?

Sacroiliitis occurs when one or both sacroiliac joints become inflamed. These joints sit at the base of the spine and connect it to the pelvis. When irritated, simple movements like standing, walking, or climbing stairs can trigger sharp or aching pain.

Symptoms often include:

• Lower back or buttock pain: Usually felt on one side but may affect both.
• Pain with walking: Hip motion puts pressure on the sacroiliac joints.
• Stiffness: Reduced mobility makes bending difficult.
• Radiating discomfort: Pain may travel into the thigh but rarely below the knee.

Sacroiliitis is often mistaken for other causes of back pain, which is why expert evaluation is important.

What Is Sciatica?

Sciatica involves irritation or compression of the sciatic nerve, usually from a herniated disc or spinal narrowing. This condition produces a distinct pattern of nerve pain that travels down the leg.

Common symptoms include:

• Sharp or burning pain: Often moves from the lower back into the leg.
• Numbness or tingling: Nerve involvement can change sensation.
• Weakness in the leg or foot: Severe compression affects muscle control.
• Pain that worsens when sitting: Pressure on the nerve increases discomfort.

Sciatica symptoms follow the nerve’s path, which helps distinguish it from sacroiliitis.

Sacroiliitis vs. Sciatica: Key Differences

Understanding the differences between these conditions helps guide patients toward the correct diagnosis and treatment plan. The differences include:

• Location of pain: Sacroiliitis centers around the pelvis, while sciatica travels down the leg.
• Type of discomfort: Sacroiliitis creates joint-based pain; sciatica produces nerve pain that may feel electric.
• Movement triggers: Walking often worsens sacroiliitis, while sitting can aggravate sciatica.
• Radiation pattern: Sciatica usually extends past the knee; sacroiliitis rarely does.

Understanding these conditions can feel confusing, especially when symptoms overlap. Adding clarity helps patients feel more confident as they navigate their pain and seek the right form of care.

Personalized Care for Back and Pelvic Pain

Back pain does not have to control your day. At Pacific Pain Medicine Consultants in Encinitas, CA, each diagnosis is approached with precision so patients receive treatment that truly fits their symptoms. Call 760-753-1104 to schedule an evaluation and learn more about your relief options. Our goal is to help you move with greater comfort and confidence.