The sacroiliac (SI) joints connect your sacrum to your pelvis on each side. They have very limited motion but absorb tremendous load with every step. When an SI joint becomes inflamed, hypermobile, or hypomobile, it produces a distinctive pattern of pain in the low back, buttock, hip, or even down the leg — frequently misdiagnosed as lumbar disc or sciatica problems.
Also known as: Sacroiliac joint dysfunction, SIJ pain, Sacroiliitis
Symptoms of si joint pain
- Pain in one buttock or low back, often pinpointable with one finger
- Pain with rolling over in bed or standing from sitting
- Pain referred into the groin, hip, or back of the thigh
- Worse on long walks or standing, better lying down
- Sometimes triggered by pregnancy, trauma, or a fall
Common causes
- Pregnancy-related ligament laxity
- Falls onto the buttock
- Auto accidents
- Leg-length discrepancy or gait abnormalities
- Hypermobility (Ehlers-Danlos and related conditions)
- Prior lumbar fusion that overloads the SI joint
How we treat si joint pain
We combine multiple disciplines under one roof so you get the right care for your case — not just whatever one provider happens to offer.
Chiropractic care
Specific SI joint mobilization or manipulation depending on whether the joint is hypo- or hypermobile.
Learn more →Physical therapy
Pelvic stabilization, glute and core strengthening, and SI belt education.
Learn more →SI joint injections
Image-guided diagnostic and therapeutic SI joint injections for confirmed pain sources.
Learn more →Pain management
Long-term pain plans combining injections with rehab and lifestyle modification.
Learn more →What to expect on your first visit
- 5–6 specific SI provocation tests during the exam (Gaenslen's, FABER, compression, distraction, thigh thrust, sacral thrust)
- Differentiation from lumbar and hip sources
- Trial of conservative care over 4–6 weeks
- Diagnostic SI injection if needed to confirm
- Coordination with your OB-GYN if pregnancy-related
Frequently asked questions
How is SI joint pain different from sciatica?
SI joint pain is usually localized to one side of the low back/buttock and rarely travels below the knee. Sciatica typically shoots down the back of the leg into the calf or foot. The exam findings are also very different.
Can SI joint pain be treated without surgery?
Almost always yes. SI joint fusion is a last resort — most patients respond well to chiropractic, PT, and (when needed) SI joint injections.
Should I wear an SI belt?
For acute flare-ups or pregnancy-related SI pain, a pelvic belt can provide significant relief. We'll fit you and teach proper use as part of your plan.
Ready to start treatment?
Same-day appointments available. We accept most major insurance, workers' comp, and personal injury liens.
Related conditions we treat
Other spine and musculoskeletal conditions commonly seen alongside si joint pain.
Facet Joint Pain
Facet joints are the small paired joints at the back of every spinal segment that guide motion. When they become arthritic, irritated, or injured, they generate a distinct pattern of dull, achy spinal pain that worsens with extension (leaning back) and rotation. Treatment ranges from chiropractic and PT to highly targeted interventional procedures like medial branch blocks and radiofrequency ablation.
Learn more →Whiplash
Whiplash is a soft-tissue neck injury caused when the head is rapidly snapped backward and then forward — most commonly in rear-end auto accidents. The sudden force overstretches cervical muscles, ligaments, and facet joints, and can also irritate or injure cervical discs. Symptoms often appear hours or days after the crash, which is why same-day documentation matters for both your recovery and any personal injury claim.
Learn more →Sciatica
Sciatica is pain that radiates along the path of the sciatic nerve — from the lower back, through the buttock, and down one leg. It's almost always caused by compression or irritation of a lumbar nerve root, most often from a herniated disc, spinal stenosis, or facet arthritis. The good news: the vast majority of sciatica cases resolve without surgery when treated early with the right combination of decompression, manual therapy, and rehab.
Learn more →