Sacroiliac Joint Pain: Understanding It and Finding Relief

A lot of the sacroiliac joint pain that I see in clinic is caused in the same way. Someone twists getting out of the car after a long drive or stands up too quickly from a low sofa and there’s a sharp catch on one side of the lower back, right where the dimple sits above the buttock. Most people assume it’s their usual back pain flaring up again. Sometimes it is and sometimes it isn’t.

Sacroiliac (SI) joint pain comes from the small, sturdy joint that connects the pelvis to the base of the spine and it behaves differently from how a vertebral disc behaves and all other muscular problems.

It can also be one of the most commonly missed sources of lower back pain, because it tends to get grouped in with sciatica or general lumbar pain which is sometimes termed “lumbago”.

Using the information on this page I will explain what the sacroiliac joint actually does, why it becomes painful, how to tell it apart from the other sources of low back pain and what tends to help make it feel better. I’ll also cover where chiropractic care fits in to a recovery and care package.

“what really sets him apart is his wider knowledge and guidance around health”

“I can’t recommend Leslie highly enough. His treatment has played a huge part in my recovery, but what really sets him apart is his wider knowledge and guidance around health, mobility, and overall wellness. What started as treatment for an issue has genuinely led to a better understanding of how to maintain my health longer term. Leslie takes the time to explain things clearly, gives practical advice that I can actually stick to, and genuinely cares about getting lasting results rather than just a short-term fix. Professional, knowledgeable, and approachable — Thanks Leslie.”

Matthew L

What the Sacroiliac Joint is and Why it Hurts

Your sacroiliac joints sit either side of the sacrum, the triangular bone at the base of your spine, joining it to your pelvis. There are two of sacroiliac joints, one on each side  of the sacrum bone and their main job is transferring load between your upper body and your legs, along with a small amount of shock absorption when you walk, run or change position.

For years these  SI joints were thought to barely move at all. We now know they shift a few millimetres in different directions, which doesn’t sound like much. However, it’s enough to cause irritation, inflammation or instability around the joint when they malfunction. This can cause the pain and discomfort. Because the joint sits so close to the lower spine and shares nerve pathways with nearby structures, the pain doesn’t always stay in the same place. It often spreads into the buttock, groin or upper thigh, which is part of why it can get mistaken for something else.

an anatomical photograph of the lumbar spine and pelvis showing the sacroiliac joint and lumbar discs

Lumbar Spine and Sacroiliac Joint

What Causes Sacroiliac Joint Pain

In my experience, SI joint pain shows up for a few recurring reasons. Pregnancy is one of the main ones. During every trimester of pregnancy you experience hormonal changes which loosen the ligaments around the pelvis to prepare for childbirth and that can make the SI joint less stable and more prone to irritation, particularly in the second half of pregnancy. A meta-analysis of complementary manual therapies for pregnancy related back and pelvic pain, found a real benefit for pain relief compared with usual care, which matches what I see clinically. Here is a relevant academic article on potential etiology of sacroiliac joint pain which can often be either traumatic or atraumatic.

Leg length differences, whether structural or from an old hip or knee injury, change how weight passes through the pelvis and can overload one side. Repetitive strain from certain sports, long periods of sitting with poor support or a single awkward movement such as twisting to lift something out of the car boot, can all trigger sacroiliac pain too. Scoliosis is also a contributor to asymmetric SI loading. A fall directly onto one hip is a more obvious cause. Women are generally affected more often than men, largely because of having greater ligament flexibility.

What is the Difference Between Sacroiliac Pain, Sciatica and Disc Pain

This is where I spend a fair amount of time in a first appointment, assessment, because the three  conditions often get confused. During your first consultation I will differentiate between the three back pain conditions as well as eliminating other possible conditions.

Sciatica involves irritation of the sciatic nerve itself, so the pain typically travels down the back of the leg, sometimes past the knee and can also cause with numbness, tingling or weakness. If you’re not sure which one you’re dealing with, I’ve written a separate guide to sciatica that covers those nerve symptoms in more depth. SI joint pain tends to stay more localised, usually one sided, felt low down near that dimple above the buttock and it’s less likely to produce true nerve symptoms running down to the foot.

Disc related back pain often follows a different pattern. It’s frequently worse with sitting or bending forward and can ease with standing or walking. SI joint pain is often the opposite. Standing on one leg, getting out of a car or rolling over in bed tends to provoke the inflamed SI joint, while some people find sitting and slightly extending the leg on the affected side, slightly more comfortable.

None of this is foolproof on its own. A systematic review of clusters of pain provocation tests for the SI joint found that using several tests together gives a far more reliable picture than relying on any single test, which is why a proper chiropractic assessment matters more than trying to diagnose from symptoms alone.

What Can Help Sacroiliac Joint Pain on a Day to Day Basis

Movement, in the right amount, tends to help SI pain more than rest. Complete rest can let the surrounding muscles stiffen and weaken, which leaves the joint less supported. I usually recommend gentle activity, short regular walks and avoiding positions that provoke the pain repeatedly, such as standing on one leg for long periods or twisting under load.

A mix of gentle mobility work and targeted strengthening, particularly for the gluteal muscles and the deep core muscles that support the pelvis, matters more than any single treatment on its own. If you’re pregnant, a maternity support belt can sometimes take enough pressure off the joint to make daily activities more manageable in the meantime.

How Chiropractic Assessment May Help

When someone comes in to see me with suspected SI joint pain, I start with a detailed medical history and orthopaedic and mobility tests. That combination of investigation gives a much clearer picture than any single test in isolation and it’s backed by good diagnostic accuracy research.

If the sacroiliac joint does appear to be the source, chiropractic care usually involves a combination of gentle joint mobilisation, soft tissue work on the surrounding muscles and a home exercise plan. It’s worth knowing that the evidence increasingly points to manual therapy working through its effect on the nervous system’s pain processing, rather than mechanically putting a joint back into place. The joint barely moves in the first place. I think that’s useful to understand, because it sets more realistic expectations than the idea of something being out of place and needing to be reset.

A systematic review of physiotherapy interventions for sacroiliac joint dysfunction is encouraging and found manipulation, exercise and taping were each associated with meaningful reductions in pain and disability. Most patients I see notice a difference within a handful of sessions, though how long it takes really depends on how long the pain has been present and what’s driving it.

If you’re new to regarding chiropractic as a treatment option, my first visit page walks through what to expect also there are plenty of answers to the most commonly asked questions available through this link. If your pain sits more centrally in the lower back rather than to one side, it may be worth reading my extensive general back pain guide first.

If sacroiliac joint pain is getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

Book a free consultation

Or call for a chat on 01202 937568

When to seek medical attention first

Most sacroiliac joint pain isn’t a sign of anything serious, but it’s worth knowing the few situations where it’s best to see your GP or attend urgent care before booking a chiropractic appointment. These include pain alongside fever, unexplained weight loss, a history of cancer, significant trauma such as a fall or accident or any numbness around the groin or changes to bladder or bowel control.

Booking a Consultation at Bournemouth Chiropractic

If you’ve been dealing with one sided lower back or buttock pain that doesn’t quite fit the sciatica picture, I’d be glad to offer you more specific advice. It is for this reason I offer 15 minute free consultations in person or by phone, so you know you have come to the right place for your problem.

You do not need a GP referral and appointments are available Monday to Friday 7:30am to 6:30pm and Saturday 7:30am to 3:00pm.

Frequently Asked Questions About Sacroiliac Joint Pain

Many people with SI joint pain find that chiropractic care, combining gentle joint mobilisation, soft tissue work and targeted exercise, supports pain reduction and improved movement. Research suggests manual therapy’s benefit comes largely through its effect on how the nervous system processes pain, rather than physically realigning the joint. Results vary between individuals, so an assessment is the best starting point.

The pattern differs. SI joint pain typically sits below the belt line, to one side and rarely travels past the knee, whereas disc-related pain more often runs down the leg into the calf or foot. The SI joint is estimated to account for 15 to 30% of chronic low back pain. Examination is how I distinguish the two.

Yes. Hormonal changes during pregnancy loosen the ligaments around the pelvis to prepare for childbirth, which can make the SI joint less stable. It’s one of the most common causes of pregnancy related back and pelvic pain and manual therapy has shown good results for easing it alongside usual care.

Most people describe sacroiliac pain as a deep, dull ache low down on one side of the back or in the buttock, sometimes spreading into the groin or the back of the thigh. It often worsens with standing up from sitting, rolling over in bed or standing on one leg. Pain that consistently travels below the knee points more towards a nerve cause.

Not usually. Completely resting an SI joint pain can let the muscles supporting the joint stiffen and weaken, which often makes things worse. Gentle movement, short walks and avoiding positions that clearly provoke the pain tend to work better than staying still.

Seek urgent medical help rather than booking if you have numbness around the saddle area, loss of bladder or bowel control, weakness in both legs, or pain following a significant injury. These are rare but need same-day assessment through your GP, NHS 111, or A&E. Chiropractic care is not the right first step for these signs.

Whatever may be behind your sacroiliac joint pain, come and find out

There are a lot of possible causes behind sacroiliac joint pain and the first step is most often a proper assessment. If that's getting in the way of your day-to-day, I'd happily see you to find out whether chiropractic may help. During your first full visit you have a full consultation I'll take a detailed medical history, examine you carefully and answer your questions about what is going on.

Sacroiliac joint pain is a common reason people come through my door here in Bournemouth and Poole.

In most of the cases I see, chiropractic care is a very well-tolerated option worth considering and I'll explain clearly whether it's likely to help in your particular case. If I think you'd be better served by your GP, a specialist or another practitioner, I'll help point you in the right direction. Either way, you'll leave knowing more than when you arrived.

There's no pressure and no obligation, just come in, get assessed and let's find you a way forward.

The first step is just a conversation. Call me or message me, whatever's easiest and we'll take it from there.

References

Al-Subahi M, Alayat M, Alshehri MA, Helal O, Alhasan H, Alalawi A, Takrouni A, Alfaqeh A. The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. J Phys Ther Sci. 2017;29(9):1689-1694. doi:10.1589/jpts.29.1689

Saueressig T, Owen PJ, Diemer F, Zebisch J, Belavy DL. Diagnostic accuracy of clusters of pain provocation tests for detecting sacroiliac joint pain: systematic review with meta-analysis. J Orthop Sports Phys Ther. 2021;51(9):422-431. doi:10.2519/jospt.2021.10469

Hall H, Cramer H, Sundberg T, Ward L, Adams J, Moore C, Sibbritt D, Lauche R. The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: a systematic review with meta-analysis. Medicine (Baltimore). 2016;95(38):e4723. doi:10.1097/MD.0000000000004723

Miles DR, Bishop MD. Use of manual therapy for posterior pelvic girdle pain. PM&R. 2019;11(Suppl 1):S93-S97. doi:10.1002/pmrj.12172

Buchanan BK, Varacallo M. Sacroiliitis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK470299

Finucane LM, Downie A, Mercer C, et al. International framework for red flags for potential serious spinal pathologies. J Orthop Sports Phys Ther. 2020;50(7):350-372. doi:10.2519/jospt.2020.9971

Medical Disclaimer: This post is for information only and does not constitute medical advice. If you are experiencing severe or worsening symptoms, please consult your GP or call 111. Most sacroiliac joint pain isn’t a sign of anything serious, but it’s best to see your GP or attend urgent care before booking a chiropractic appointment if you have pain alongside fever, unexplained weight loss, a history of cancer, significant trauma such as a fall or accident, or any numbness around the groin or changes to bladder or bowel control. None of these are common with straightforward SI joint pain, but if any apply to you, it’s worth getting checked first so we can rule out anything else going on before starting care.

Practitioner: Leslie Budzynski D.C. | Doctor of Chiropractic | GCC registration: 00043 | BCA membership number: 0072

© 2026 Bournemouth Chiropractic Clinic Ltd. Company number 16589293.
Registered Address Suite 9 Pine Court Business Centre, 36 Gervis Road, Bournemouth, United Kingdom, England, BH1 3DH. Website by 3mil