The purpose of this current opinion on sacroiliac joint pain and dysfunction is to assist interventional pain physicians to apply appropriate treatment decisions and rationale to their patients in pain. Discussion of relevant scientific data and controversial positions will be provided. This review is intended to help characterize the sacroiliac joint as a pain generator, and explore its contribution to the differential diagnosis of low back pain. Historical, technical, and current treatment practice will be characterized against current evidence. Discussion will provoke support or criticism of the relevant scientific data, and general recommendations for interventional pain management physicians should be considered within the context of the individual practitioners skill and practice patterns. Current Opinion is not intended to provide a standard of care.