If you’ve been treating low back pain without lasting results, your sacroiliac joint could be the overlooked source. The SI joint, located where your spine meets your pelvis, is a surprisingly common cause of low back and buttock pain that frequently gets mistaken for other conditions. When it’s the real culprit, treatments aimed at the spine or disc often fail because they’re addressing the wrong structure. Here’s how to recognize SI joint pain and how we treat it here in Oklahoma City.
What Is the SI Joint?
The sacroiliac joint, or SI joint, connects the sacrum, the triangular bone at the base of your spine, to the ilium, part of your pelvis. You have one on each side, and they sit just below your lower back, roughly where the two dimples above your buttocks are located.
These joints don’t move much, but they play a crucial role. They transfer the load from your upper body to your legs and absorb shock as you walk, run, and move. Strong ligaments hold them in place and allow only small, controlled movements. When those movements become too much, too little, or misaligned, the joint can become a significant source of pain.
Why SI Joint Pain Gets Missed So Often
Here’s the frustrating part. SI joint dysfunction produces pain that closely mimics other, more commonly diagnosed conditions. Its pain is often felt in the lower back, buttock, and sometimes down the leg, which makes it easy to confuse with disc problems, sciatica, or general low back pain.
Because of this overlap, SI joint pain frequently gets misdiagnosed. Patients get treated for a disc issue or for sciatica, the treatment doesn’t fully work because it’s aimed at the wrong structure, and the pain persists. I’ve seen many patients in my Oklahoma City practice who’d been chasing the wrong diagnosis for months before anyone properly evaluated the SI joint.
Research suggests the SI joint is responsible for a meaningful percentage of chronic low back pain cases, yet it’s often overlooked in standard evaluations. This is exactly why a thorough, testing-based approach matters so much.
Signs Your SI Joint Might Be the Problem
While only a proper evaluation can confirm it, certain signs point toward SI joint involvement:
- Pain concentrated on one side of the lower back or buttock
- Pain that can radiate into the hip, groin, or down the back of the thigh (usually not below the knee)
- Pain that worsens with specific movements like standing up from sitting, climbing stairs, or rolling over in bed
- A feeling of instability or that the pelvis is “out of place”
- Pain when standing on one leg or putting weight through one side
- Discomfort sitting for long periods, often with a need to shift weight
One distinguishing feature is that SI joint pain is often pointed to with one finger right at the joint, whereas disc or muscle pain tends to be more spread out. That said, symptoms overlap enough that professional testing is the only reliable way to confirm the source.
What Causes SI Joint Dysfunction?
SI joint problems develop for several reasons. Too much movement in the joint (hypermobility) can cause instability and pain, which is common during and after pregnancy when ligaments loosen. Too little movement (hypomobility) can cause stiffness and pain from the joint being stuck. Injury from a fall, car accident, or sudden impact can disrupt the joint. And muscle imbalances or leg length differences can place uneven stress on it over time.
Pregnancy is a particularly common trigger because the hormone relaxin loosens pelvic ligaments to prepare for birth, which can leave the SI joints unstable. Our post on pregnancy and chiropractic care covers how we help expecting and new mothers with related pelvic issues.
How We Diagnose SI Joint Pain
Because SI joint pain mimics other conditions, accurate diagnosis is everything. We do not guess. We test.
When you come in with low back or buttock pain, our evaluation includes a detailed history, orthopedic and neurological examination, and a series of specific provocation tests designed to isolate the SI joint. These tests apply stress to the joint in controlled ways to determine whether it’s the source of your pain. We also assess your gait, posture, pelvic alignment, and leg length, and use on-site digital X-rays when indicated.
This thorough process is what allows us to distinguish SI joint dysfunction from disc problems, sciatica, and other causes of low back pain. Getting the diagnosis right is the difference between treatment that works and treatment that misses the mark.
How Chiropractic Care Treats the SI Joint
The good news is that SI joint dysfunction responds well to chiropractic care in most cases. The treatment approach depends on whether the joint is moving too much or too little, which is why proper diagnosis comes first.
Restoring Proper Movement
For a joint that’s stuck or restricted, chiropractic adjustments restore normal movement to the SI joint, relieving the pain that comes from the joint being locked up. This is often where patients feel the most immediate relief.
Stabilizing an Unstable Joint
For a joint that moves too much, the focus shifts to stabilization. We work on strengthening the muscles that support the pelvis and SI joint, particularly the deep core and gluteal muscles, so the joint has better support and stops moving excessively.
Addressing Muscle Imbalances
SI joint problems almost always involve surrounding muscle dysfunction. Tight muscles on one side, weak stabilizers, and compensatory patterns all contribute. We use soft tissue work, cold laser, and targeted rehabilitation to address these, which is central to the R.E.S.T.O.R.E. Method and to keeping the correction in place long-term.
Why Correction Matters for the SI Joint
SI joint pain has a tendency to return if only the symptoms are addressed. Adjusting a stuck joint feels great, but if the underlying muscle imbalance or instability that caused the problem isn’t corrected, the joint drifts back into dysfunction.
This is why our approach goes beyond just relieving the immediate pain. Once we’ve restored proper function, we focus on strengthening and stabilizing the pelvis so the SI joint stays healthy. That correction phase is what separates lasting relief from a temporary fix.
Frequently Asked Questions
How do I know if my back pain is from my SI joint or a disc?
The symptoms overlap significantly, which is why professional testing is necessary. SI joint pain tends to be more one-sided, concentrated near the joint, and often doesn’t radiate below the knee, while disc problems more commonly cause pain traveling further down the leg. Specific provocation tests during an evaluation help confirm the source.
Can SI joint pain go away on its own?
Mild cases sometimes settle with rest, but SI joint dysfunction often persists or recurs because the underlying instability or restriction remains. Proper treatment that addresses the root cause produces far more reliable, lasting results.
Is SI joint treatment painful?
No. The adjustments and techniques we use are generally comfortable, and many patients feel relief right away when a restricted joint is freed up.
How long does it take to treat SI joint pain?
Many patients see improvement within a few weeks, though the stabilization and strengthening phase that prevents recurrence takes longer. We provide a realistic timeline after your evaluation.
Stop Chasing the Wrong Diagnosis
If your low back pain has resisted treatment, it may be because the real source was never properly identified. Family Tree Chiropractic in Oklahoma City uses specific testing to determine whether your SI joint is the culprit, so your treatment finally targets the right structure.
Call us at (405) 340-4400 or book your appointment online. New patients start with our $49 comprehensive special, including consultation, adjustment, X-ray, cold laser, and a massage voucher.
