🩺Sacroiliac Joint Pain: Why It’s Common and Chiropractic Treatment Options

Sacroiliac (SI) joint pain is a common source of discomfort in the lower back, pelvis, and buttock region. The sacroiliac joints connect the sacrum at the base of the spine with the pelvis and help transfer forces between the upper body and legs.

Because the SI joints are involved in everyday activities such as walking, standing, sitting, bending, lifting, and changing positions, irritation or dysfunction in this area can affect how a person moves and feels.

Research suggests that SI joint dysfunction may account for approximately 25% of chronic low back pain cases, although determining whether the SI joint is actually the source of pain can be challenging because several other conditions can produce similar symptoms.

Why Is Sacroiliac Joint Pain So Common?

The SI joints are exposed to repetitive loading and forces throughout the day. Activities involving lifting, twisting, prolonged standing, walking, running, or changing direction can place stress on the pelvis and surrounding tissues.

SI joint symptoms can also develop following:

• Heavy lifting
• A fall or direct impact to the buttocks
• Motor vehicle accidents
• Repetitive athletic activities
• Changes in gait or movement patterns
• Prolonged sitting or standing
• Pregnancy and the postpartum period

Sports and recreational activities that involve repetitive weight-bearing, twisting, jumping, or sudden changes in direction may also contribute to SI joint symptoms.

What Does SI Joint Pain Feel Like?

Sacroiliac joint pain may be felt on one or both sides of the lower back or buttocks and is usually located off-center rather than directly over the middle of the spine.

Some people may experience:

• Aching or sharp pain around the SI joint
• Buttock or pelvic discomfort
• Pain when getting up from a chair
• Discomfort with prolonged sitting or standing
• Pain when turning in bed
• Difficulty walking normally
• Pain that may extend into the leg

Because symptoms can overlap with problems involving the lumbar spine, hip, muscles, or nerves, SI joint pain should not be assumed based on location alone. A thorough evaluation is important.

How Is Sacroiliac Joint Pain Evaluated?

There is no single physical test that can reliably identify the SI joint as the source of pain. Instead, a clinician may use a combination of medical history, movement assessment, physical examination, and several SI joint provocation tests.

Evidence suggests that a combination of at least three positive provocation tests can help support a diagnosis of SI joint dysfunction. Imaging is not routinely necessary for uncomplicated SI joint pain but may be appropriate when another condition needs to be ruled out.

This is one reason a comprehensive musculoskeletal evaluation can be helpful before deciding what type of treatment is appropriate.

What Are the Best Chiropractic Treatment Options for SI Joint Pain?

Treatment should be individualized rather than based on a one-size-fits-all approach. For appropriate patients, conservative chiropractic care may include several components.

1. Manual Therapy

Manual therapy may be used to address restricted movement, muscle tightness, and other mechanical factors involving the pelvis, lower back, and surrounding structures.

2. Spinal or SI Joint Manipulation When Appropriate

Manipulative therapy is one conservative treatment option for SI joint-related pain. Research indicates that manipulation can provide short-term improvements in pain and function for some patients.

The specific technique used should depend on the individual’s examination findings, symptoms, tolerance, and overall clinical presentation.

3. Therapeutic Exercises

Exercises can help address flexibility, strength, coordination, and pelvic stability. Depending on the individual, an exercise program may include stretching and strengthening involving the hips, gluteal muscles, abdominal musculature, and other structures supporting the pelvis.

Exercise is particularly important because treatment is not simply about reducing symptoms—it is also about helping the patient move and function more effectively.

4. A Combination of Manual Therapy and Exercise

For many patients, combining hands-on treatment with an individualized exercise program may be a practical conservative approach.

Evidence supports the use of exercise, manual therapy, or a combination of the two for SI joint dysfunction. Some research suggests that manual therapy may provide more immediate symptom improvement while exercise can contribute to longer-term improvements in pain and function.

5. Coordination With Other Healthcare Professionals When Appropriate

Not every case of SI joint pain is appropriate for chiropractic treatment alone. Persistent, severe, or unusual symptoms may require additional medical evaluation, diagnostic testing, physical therapy, pain management, or referral to another healthcare professional.

The goal should always be to identify the most appropriate course of care for the individual patient.

Can Chiropractic Care and Exercise Work Together?

Yes. Chiropractic care does not have to be an either/or decision between hands-on treatment and exercise.

A conservative treatment plan may combine manual therapy or manipulation, when appropriate, with therapeutic exercises designed to improve mobility, strength, and function. Current evidence supports both approaches, although the research does not establish one universal treatment that is best for every person with SI joint pain.

When Should You See a Healthcare Professional for SI Joint Pain?

Consider seeking professional evaluation if pain is persistent, recurrent, worsening, or interfering with normal activities.

Prompt medical evaluation is particularly important when back or pelvic pain occurs with symptoms such as significant trauma, fever, unexplained weight loss, bowel or bladder changes, significant weakness, or other concerning symptoms. These can indicate a condition that requires evaluation beyond routine conservative care.

Chiropractic Care for Sacroiliac Joint Pain in Clearwater, FL

If you’re experiencing lower back, pelvic, or buttock pain that may be related to the sacroiliac joint, Dr. Sessa can provide a comprehensive musculoskeletal evaluation to determine whether conservative chiropractic care, manual therapy, spinal or SI joint manipulation when appropriate, and individualized therapeutic exercises may be appropriate for your condition.

The goal is to develop an individualized approach focused on improving mobility, function, and comfort while determining whether additional evaluation or referral may be appropriate.

Contact Clearwater Sports & Wellness, P.A. at (727) 669-3900 to schedule an appointment.

Educational Disclaimer

This article is intended for general educational and informational purposes only and is not intended to diagnose, treat, cure, or prevent any medical condition. Sacroiliac joint pain can have multiple causes and may resemble other conditions affecting the lower back, pelvis, hip, or nervous system. A qualified healthcare professional should evaluate persistent, severe, or concerning symptoms to determine the appropriate diagnosis and treatment.