Sacroiliac (SI) Joint Dysfunction: Causes, Symptoms & Treatment

The sacroiliac (SI) joints connect the spine to the pelvis. Each SI joint is formed by the sacrum (base of the spine) and the right and left iliac bones (pelvis). Strong ligaments support these joints and help stabilize the body during standing, walking, and lifting.

Because the SI joints carry significant body weight and have limited motion, they are prone to stress, wear, and inflammation over time.

What is Sacroiliac Joint Dysfunction?

Sacroiliac joint dysfunction (SI joint pain) occurs when the SI joint becomes irritated, inflamed, or misaligned. This can cause pain in the lower back or just above the buttock area.

Common terms include:

• SI joint dysfunction
• Sacroiliac joint inflammation (sacroiliitis)
• SI joint strain
• SI joint syndrome

SI Joint Pain Symptoms

Common symptoms of SI joint dysfunction include:

• Pain in the lower back or upper buttock (one or both sides)
• Sharp or stabbing pain with movement
• Pain when standing up from sitting
• Pain with walking or prolonged standing
• Pain that improves when lying down
• Stiffness or reduced range of motion
• Locking or instability in the pelvis
• Weakness or difficulty bearing weight

Pain may also radiate into the hips, thighs, or groin depending on severity.

Common Causes of SI Joint Dysfunction

SI joint pain may develop gradually or suddenly. Common causes include:

Posture and Lifestyle

Poor posture, prolonged sitting, crossed legs, or uneven weight distribution can place stress on the SI joints. A sedentary lifestyle and weak core muscles can also increase risk.

Injury or Trauma

Falls, accidents, or lifting injuries can strain or misalign the SI joint.

Pregnancy

Hormonal changes during pregnancy relax ligaments, increasing SI joint movement and instability.

Degenerative Changes

With age, cartilage can wear down and lead to arthritis in the SI joints.

Biomechanical Imbalances

• Leg length differences
• Hip, knee, or foot problems
• Altered walking patterns

Inflammatory Conditions

Conditions such as rheumatoid arthritis, gout, or ankylosing spondylitis can also affect the SI joints.

How SI Joint Dysfunction is Diagnosed

Diagnosis starts with a physical examination and medical history. Your provider may use movement-based tests that stress the SI joint to help identify the source of pain.

Imaging such as X-ray, MRI, or CT scan is not always required initially. However, it may be used if symptoms do not improve or if further evaluation is needed.

SI Joint Dysfunction Treatment Options

Treatment focuses on reducing pain, improving alignment, and restoring stability.

Chiropractic Care

Chiropractic adjustments may help realign the SI joints, reduce inflammation, and improve joint movement.

Movement & Exercise Therapy

Once pain improves, targeted exercises can help:

• Stabilize the pelvis
• Strengthen core muscles
• Improve flexibility and mobility

Supportive Therapies

• SI belts for added stability
• Stretching programs (including yoga or Pilates)
• Physical therapy
• Activity modification during flare-ups

Anti-Inflammatory Approaches

Short-term NSAIDs may reduce pain. However, long-term use is not recommended due to potential side effects. Natural anti-inflammatory approaches and regenerative therapies may also be considered depending on the case.

Prognosis for SI Joint Pain

Most cases improve with conservative care, especially when related to posture, pregnancy, or mechanical stress. Chronic inflammatory conditions may require ongoing management, but symptoms can often be significantly reduced.

Can SI Joint Dysfunction Be Prevented?

Not all cases can be prevented. However, risk may be reduced by:

• Maintaining a healthy body weight
• Staying active with regular exercise
• Strengthening core muscles
• Improving posture and ergonomics
• Avoiding prolonged sitting