Do you have ongoing lower back pain that feels different from regular back pain? You might be dealing with sacroiliac joint pain (SIJ pain). About 1 in 4 people 1Source: National Library of Medicine with long-term lower back pain have this condition but often mistake it for other problems related to the lower spine or pelvic area.
At Rasura Chiropractic Centres, we understand how frustrating it can be when your pain isn't properly identified or treated. That's why we've created this comprehensive guide to help you understand sacroiliac joint pain, recognise its symptoms, and explore treatment options available to help you move more freely and live life to its fullest.
What are the Sacroiliac Joints?
We all have two sacroiliac joints (SIJ) that connect our spine to our pelvis – one on each side of the pelvis. These joints are found where your sacrum (top of your tailbone) meets your pelvis (where you put your hands on your hips). They work like a bridge, helping transfer your upper body weight down to your legs.
Even though they're small, these joints do important work every day. They help absorb shock when you walk or run, and they keep your pelvis stable. The sacroiliac joints don't move much – they only twist a little bit and shift by less than 2 millimetres – but this small movement is exactly what your body needs.
These joints stay stable thanks to strong ligaments and muscles around them. If something damages these supporting structures – like an injury or being misaligned, even childbirth – it can throw off this delicate balance. When this happens, you might feel a lot of pain that can affect your daily life.
How to Recognise SIJ Pain
SIJ pain can affect anyone at any age, and is particularly common in women aged 30 to 50. Once you have had this pain, it is fairly common to have it a few times a year.
It feels different from regular back pain. The main sign is a deep, aching pain and stiffness on one side of your lower back, just below where your belt sits. Many people can point to the exact spot where it hurts with one finger.
The pain usually feels deep and throbbing, but not always. It can be different from the sharp, shooting pain you might get with pinched nerves, although some patients report it as a pinch type feeling or feeling trapped or heavy. The pain often spreads from your SIJ into your buttock, sometimes into the hip, or even the groin. Sometimes it can travel down the side of the thigh, but it usually doesn't go below your knee (like sciatica often does).
What makes this pain tricky is that you can feel it in different places, not just your back. This is because the joint is connected to several nerve pathways in your body. That is why it's often misdiagnosed as a hip problem or other conditions.
You might notice your pain gets worse during certain activities. Common triggers include:
- Sitting for a long time
- Getting out of the car
- Getting up from a chair
- Walking up stairs
- Lying on the painful side
- Standing on one leg (like when putting on pants)
- Stepping up onto a curb
What Causes Sacroiliac Joint Pain?
SIJ pain often stems from injuries or accidents, such as:
- Car accidents
- Falls on your bottom
- Sudden twisting movements like when lifting children or weights at the gym
- Sitting for long periods of time
Some health conditions can also be the cause:
- Sacroiliac joint dysfunction (when your joint moves incorrectly or isn't lined up properly)
- Sacroiliitis (when the joint becomes inflamed and painful)
- Injuries (from sudden accidents or repeated strain over time)
- Age-related joint wear and tear (like arthritis)
- Pregnancy
- During pregnancy, hormones make the joints more flexible to prepare for childbirth. Extra weight and changes in how you carry yourself can also stress these joints, making sacroiliac joint pain common in pregnant women and new mothers.
- Infection
- Ankylosing spondylitis (AS)
- Other autoimmune disorders
These usually affect younger people and need special treatment.
You can also develop sacroiliac joint pain from repeated movements, especially if you:
- Run regularly
- Dance
- Play sports with lots of quick direction changes
Other factors that can lead to pain include:
- Back surgery
- Having one leg longer than the other
- Muscle imbalances
- Poor posture or movement patterns
These can put uneven pressure on your sacroiliac joints over time.
How SIJ Pain is Diagnosed
To check if you have SIJ pain, your chiropractor will perform some physical tests. They may move your legs in different positions and press on your joints to see what hurts. Because it's difficult to be sure from just one test, doctors usually perform at least three different tests.
They may also look at where your pain spreads in your body, through what’s called a referral map, to help figure out if it's coming from your sacroiliac joint.
It's important not to try diagnosing yourself. Sacroiliac joint pain can feel similar to many other conditions, so you need a proper examination by a healthcare professional. Trying to diagnose yourself might mean you don't get the right treatment for what's actually causing your pain.
How is Sacroiliac Joint Pain Treated?
Good news – SI joint pain usually gets better with the right treatment. Most people see big improvements in their pain and daily life. It's best to start with simple treatments before trying more complex ones.
Hands-on Treatment
Chiropractors and other health professionals can help by using their hands to gently adjust your joints and muscles. This can help reduce pain right away and fix underlying problems. Many people feel better after just a few sessions.
Dry Needling
This treatment uses very thin needles placed into tight muscles around your painful joint. It helps relax the muscles and increase blood flow to help with healing. It's especially good for muscle problems that might be causing your pain.
Exercises and Stretches
There are a number of special exercises you can do at home to help both treat and prevent pain. These focus on making your core and pelvic muscles stronger and more flexible.
Discover 6 proven exercises in our comprehensive guide on how to relieve SIJ pain.
Pain Medicine
Anti-inflammatory medications (like ibuprofen) can help reduce pain and swelling, especially during bad episodes. These work best when used along with other treatments.
Advanced Treatments
If simpler treatments don't help enough, doctors might suggest injections or other procedures. Surgery is rarely needed and is only used as a last resort.
Daily Tips for Managing Pain
Small changes in your daily routine can make a big difference in how you feel.
Better Posture
- When sitting, use a small cushion to support your lower back.
- Take breaks to stand and walk every hour.
- Stand with your weight even on both feet.
Sleep Better
If you sleep on your side, put a pillow between your knees. If you sleep on your back, put a pillow under your knees. This helps keep your body aligned properly.
Change How You Move
- Bend your knees, not your back, when lifting things.
- Take stairs one at a time if needed.
- Use handrails for support.
Use Heat and Ice
Use ice for 15-20 minutes when pain flares up. Use heat for stiff, tight muscles.
Special Cases
Some people need extra care with sacroiliac joint pain:
Pregnant Women
Safe treatment options include gentle chiropractic care and support belts. Water exercises can be especially helpful. Always check with your healthcare provider first.
Athletes
Get help early to prevent long-term problems. Your treatment should match your sport's needs. Return to sports gradually to avoid reinjury.
Long-term Pain
If you've had pain for a long time, focus on managing it daily. Learn what makes your pain worse and take action early when you notice warning signs.
When to Get Help
We recommend you see one of our chiropractors right away if you have:
- Severe pain in your low back or pelvic area after an injury
- Pain with fever
- Problems controlling your bladder or bowels
Also get help if:
- Pain lasts more than a few days despite rest
- Pain stops you from daily activities or sleep
- Pain keeps coming back
Getting help early usually leads to better results. Most people can get back to their normal activities with the right treatment.
Getting Better
SI joint pain is treatable, and most people get better with proper care. The key is getting the right diagnosis and treatment, and following through with your care plan.
Don't let this pain stop you from living your life. With the right treatment, you can get back to doing what you love. Book an appointment with one of our experienced chiropractors and start your path to feeling better.
