What is Sacroiliac (SI) Joint Pain and How Do You Treat It?
Is your SI joint causing your back pain?
It’s time to fix that nagging, painful SI joint.
The sacroiliac joints (or SI joints), which connect your pelvis to the base of your spine, are usually very stable joints. They have to be – your SI joints are the most important connection point for load transfer between your legs and the rest of your upper body. But even slight dysfunction in these joints can be a cause of persistent low back pain.
It’s not an uncommon problem – up to 30% of all lower back pain problems actually originate from the sacroiliac joint and not the spine. SI joint pain is something I help patients find relief from every day as a chiropractor in Brookfield, WI.
“SI join pain is deceptive – it can be mistaken for disc or lower back pain, or even hip or groin pain. For this reason, SI joint disorders are often the missing piece in the low back pain puzzle.”
Dr. Grant Radermacher, Brookfield Chiroractor
If sacroiliac pain is hindering your performance at the gym or affecting your daily activities, you probably want it gone ASAP. That’s why today we’re going to explore everything you need to know about SI joint pain, including how to mobilize a stuck, inflamed sacroiliac joint and then how to stabilize it so it doesn’t happen again.
What is the Sacroiliac (SI) joint?
If you put your hands at the base of your lower back, you’ll feel two ‘bumps’ on either side of your tailbone. These bumps are your sacroiliac joints.
The sacroiliac joints connect the sacrum (the triangular bone at the base of the spine) to the two ilium bones (the large bones that makes up the upper part of the pelvis), with strong ligaments that hold them in place. They’re responsible for transferring weight and forces from your upper body to your legs, and vice versa.
These joints are designed to move just enough to facilitate the transfer of power, but remain relatively stable most of the time. This means they play just as much a role in simple movements like standing and walking as more powerful movements like jumping, running and heavy lifting.
What does SI joint pain (sacroilitis) feel like?
The symptoms of SI joint pain can vary from person to person, but usually includes some degree of lower back pain and stiffness at those ‘bumps’ on either side of your tailbone. For some, this pain can be dull and achy, for others it can be sharp and stabbing.
It’s also not uncommon to experience hip pain, groin pain, or pain that radiates to your butt or down the back of your thigh caused by an irritated SI joint.
A ‘stuck’, inflamed SI joint will usually be aggravated by activity, such as standing, walking, or climbing stairs.
How do you tell the difference between SI joint pain and sciatica?
While they’re often confused with each other, SI joint pain is notably different from sciatica. Sciatica refers to pain that runs along the path of the sciatic nerve. This nerve is the longest nerve in your body and extends from your lower back through your hips, buttocks, and down each leg.
Like SI joint pain, sciatica usually only affects one side of your body at a time. But unlike pain that originates in your sacroiliac joint – which is usually easy to pinpoint – sciatica tends to cause pain, tingling and numbness that radiates down the sciatic nerve path, making it more difficult to localize.
And while sciatica often produces symptoms that go all the way down to the feet, SI joint pain rarely goes past the knee.
What causes SI joint pain?
So if your SI joint is causing you pain, the natural question is “why is my sacroiliac joint not working like it’s supposed to?”
There are a ton of possible causes, including osteoarthritis, poor posture while sitting, even abnormal walking patterns. Repetitive movements like running, jumping, and heavy lifting can all put extra stress on the joint and cause biomechanical dysfunction.
Other factors that can cause sacroiliac pain include:
- Stiff, inflamed facet joints at the lumbosacral junction (where your spine meets your tailbone).
- An anatomical difference in leg length.
- Abnormal walking patterns, such as favoring one leg due to pain.
- Foot problems such as flat, collapsed arches or high-arched, rigid feet.
- Anterior pelvic tilt and tight hip flexors.
- Long periods spent sitting – particularly if you add the extra pressure of sitting on a wallet.
- Hormonal changes and altered biomechanics during pregnancy.
- Knee injuries or degeneration.
- Prolonged or sudden high-intensity exercise.
- Spinal fusion surgery – which often leads to increased wear and tear on the sacroiliac joints.
- Although rare, septic bacterial or viral infections.
- Weakness or imbalance in the muscles supporting your sacroiliac and hip joints, particularly the glute medius.
How do you treat SI joint pain?
Granted, that’s a lot to sort through, so it’s important to see a chiropractor who can diagnose what’s actually going on in your SI joint and address the underlying causes. A chiropractor will usually be able to diagnose what’s wrong with your sacroiliac joint with just a thorough examination, but x-ray imaging is often important to rule out more serious red flags.
So once you figure out exactly what’s going on, what next? The science says your best bet is to 1.) Get adjusted and 2.) Strengthen the muscles supporting the joint.
A 2011 systematic review out of Interventional Pain Medicine concluded that the most effective corrective treatment for SI joint pain is a multidisciplinary approach that includes both exercise therapy and manipulation (chiropractic adjustments).
Targeted exercises, such as pelvic tilt movements, glute bridges and specific stretches, can help strengthen the surrounding muscles, reducing stress on the sacroiliac joint. A good chiropractor or physical therapist should also be able to provide guidance on posture correction and body mechanics, which are essential for long-term pain management.
What if you need relief right now? For immediate relief, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce swelling and tenderness and alleviate pain. Muscle relaxers might be prescribed to ease muscle tension in the affected area. And in more severe cases, corticosteroid injections directly into the sacroiliac joint can provide targeted pain relief and decrease inflammation (or at least enough to start exercise therapy & chiropractic treatment).
For cases especially resistant to traditional treatment, radiofrequency ablation can be considered. Ablation procedures reduce pain signals from the sacroiliac joint by ‘burning’ the nerves carrying pain messages from the joint.
This much is for sure: the faster you get corrective treatment after symptoms appear, the faster you can expect to get back to living pain-free.
The 4 best exercises for SI joint pain
Need relief right now? Here are two stretches to help mobilize the sacroiliac joint and two simple exercises that will help activate the pelvis-stabilizing gluteus muscles.
While these exercises should be safe and helpful for most causes of low back pain, if any of these exacerbate the pain you’re experiencing, stop and see your chiropractor or primary care doc first for a more in-depth evaluation.
Disclaimer: This is not a substitute for medical care. Please consult a doctor or healthcare professional to get a medical diagnosis, rule out any serious complications and get advice on a treatment plan for your particular condition.
This stretch targets the muscles surrounding the SI joint, including the glutes and hip rotators that connect to the iliac bone. When these muscles are tense or stiff, it can cause other muscles to compensate, resulting in even more pain. This movement helps stretch out those muscles and regain sacroiliac mobility.
How To Do It:
- Lie down on your back with arms extended at shoulder height.
- Bend your leg experiencing pain up so that there is a 90-degree angle both at the hip and knee.
- Bring your opposite arm across your body and grab your bent knee.
- Pull until you feel a nice stretch in glute, hip, and low back – but don’t overdo it.
- Hold for about 10 breaths then release.
Figure Four Stretch
Another great stretch targeting the sacroiliac joints while also mobilizing lumbar spine is the Figure Four Stretch. Make sure not to push through pain while performing this exercise.
How To Do It:
- Lie down on your back with your knees propped up.
- Cross the foot of the painful side over top of other knee.
- Use your same-side hand to push down the bent knee until you feel a stretch in that hip.
- If you need even more of a stretch, lace your hands around the knee with the foot propped upon it, pulling slowly towards your chest.
- Hold for 10 seconds.
- Repeat as often as needed.
SI Glute Bridge
After stretching out your sacroiliac joints, activating the muscles that support them is critical. These next two movements are great exercises you can do to help stabilize the sacroiliac joints.
How To Do It:
- Lie down on your back with both knees propped up.
- Take both hands to the knee of non-painful side.
- Pull that same knee up, creating an isometric contraction (knee pushing into your hands and vice versa).
- Push through planted heel (of the leg feeling pain) while squeezing your glutes and bridge your hips up.
- Hold for a few seconds at the top before resetting. Keep repetitions slow and controlled.
- Do 10-15 reps for 3-4 sets once per day.
Side Plank Clam Shell
This exercise helps train the hip stabilizing muscles. Regardless of where you feel most pain, perform this exercise on both sides.
How To Do It:
- Set up in a side plank position with your upper body propped on elbow with knees stacked upon each other.
- Lift hips so there is a straight line from your knees to your shoulders then hold the position.
- Lift the knee of your top leg – keeping feet touching – raising it until comfortable then slowly releasing down.
- Do 10-15 reps for 3-4 sets per day on both sides.
Remember, mobilization isn’t enough; stability matters too. Start with the first two stretches and follow with the second two stabilizing exercises.
Finding a chiropractor for SI joint pain
Sacroiliac joint pain is no joke. If you’re waking up to pain and stiffness in your SI joints every day, it’s time to do something about it.
There’s a reason why so many patients in Brookfield, WI choose us as their chiropractor: we utilize a combination of chiropractic treatment, soft tissue therapy and active exercise rehab to correct biomechanical problems in everything from your head to your toes. If you’ve been self-diagnosing, living in the pharmacy aisle, or being ignored by physicians, trainers, and therapists who aren’t interested in truly figuring out what’s causing your SI joint pain, it’s time to get the relief you deserve.
Ready to get started?
Make an appointment at Ascent Chiropractic in Brookfield today by calling 262-345-4166 or using our online scheduling app.