Sacroiliac Joint Dysfunction
Find Relief from SI Joint Pain and Get Back to Moving Comfortably
Does your lower back hurt when you stand up from a chair, climb stairs, or roll over in bed? Maybe you experience a deep ache near one side of your pelvis that makes walking, sitting, or even getting comfortable at night frustrating. The source of your discomfort could be your sacroiliac (SI) joint. Sacroiliac joint dysfunction can contribute to persistent lower back, buttock, and pelvic pain. Although symptoms sometimes resemble sciatica or other spinal conditions, the underlying problem may involve irritation or altered load tolerance around the joints connecting your spine and pelvis. Seeking sacroiliac joint dysfunction physical therapy may help relieve these symptoms and improve your mobility.
At Reform Physical Therapy, our licensed physical therapists provide personalized, one-on-one care to help identify contributing factors, improve movement, build strength, and support a return to everyday activities. With seven convenient locations throughout Southern and Midcoast Maine, our team is here to help you move with greater comfort and confidence.
What Is Sacroiliac Joint Dysfunction?
The sacroiliac joints are located where the sacrum, a triangular bone at the base of your spine, connects to the iliac bones of your pelvis. You have two SI joints, one on each side. These joints play an important role in transferring forces between your upper body and legs during walking, standing, lifting, and other movements. Unlike highly mobile joints such as the shoulder or hip, the sacroiliac joints normally allow only small amounts of movement. Their stability comes from strong surrounding ligaments, joint surfaces, and supporting muscles. Sacroiliac joint dysfunction is a term commonly used when the SI joint or surrounding structures are believed to contribute to pain or difficulty with movement.
Symptoms may develop when the joint becomes irritated, experiences excessive or repetitive loading, or is affected by inflammatory or degenerative changes. However, pain in the SI joint region does not always mean the joint itself is the source. Similar symptoms can arise from the lumbar spine, hips, muscles, and nearby nerves. A thorough evaluation is important for identifying the most likely contributors to your discomfort.
Where Is Sacroiliac Joint Pain Located?
Sacroiliac joint pain often occurs near the dimples of the lower back, just above the buttocks. Depending on the individual, discomfort may affect one side or both sides of the pelvis.
Common areas of pain include:
- Lower back, particularly near the beltline
- One or both buttocks
- Back or side of the pelvis
- Hip region
- Groin
- Back of the thigh
- Occasionally, areas farther down the leg
Some people experience a dull, persistent ache, while others notice sharp discomfort during particular movements. Because these symptoms overlap with several other conditions, pain location alone cannot confirm sacroiliac joint dysfunction.
Common Symptoms of Sacroiliac Joint Dysfunction
SI joint-related pain can affect everything from getting dressed in the morning to exercising or spending a full day at work.
Symptoms may include:
- Pain on one side of the lower back or buttock
- Discomfort when transitioning from sitting to standing
- Pain while climbing stairs
- Difficulty standing on one leg
- Increased discomfort during prolonged sitting or standing
- Pain when rolling over in bed
- Discomfort while walking or taking longer strides
- Pain during lifting, bending, or twisting
- Tenderness around the back of the pelvis
- Reduced tolerance for exercise and daily activities
Symptoms can vary depending on activity, physical demands, and other contributing conditions. Experiencing these symptoms does not automatically mean you have SI joint dysfunction. A physical therapist can assess how your back, pelvis, hips, and surrounding muscles are functioning together.
What Causes Sacroiliac Joint Dysfunction?
Several factors may contribute to pain around the sacroiliac joints.
Repetitive Stress and Overuse
Activities involving repeated lifting, bending, running, or prolonged standing may increase the demands placed on the pelvis. When those demands exceed what the surrounding tissues can comfortably tolerate, pain may develop.
Pregnancy and Postpartum Changes
During pregnancy, changes in posture, body weight, muscle function, and ligament properties can influence how forces move through the pelvis. Some individuals experience pelvic girdle pain during pregnancy or after childbirth, including discomfort near the sacroiliac joints. Not all pregnancy-related pelvic pain originates from the SI joints, so an individualized assessment is important.
Injury or Trauma
A fall, sudden impact, or other injury may irritate structures around the sacroiliac joint. Symptoms can also appear after a change in physical activity or a period of increased loading.
Arthritis and Joint Changes
Degenerative changes may affect the sacroiliac joints over time. Inflammatory conditions, including certain forms of spondyloarthritis, can also involve the SI joints and may require medical management.
Muscle Weakness or Reduced Load Tolerance
The gluteal muscles, abdominal muscles, and other supporting tissues help manage forces through the pelvis. Reduced strength, endurance, or coordination may contribute to discomfort during demanding activities.
Changes in Walking or Movement Patterns
Hip limitations, lower extremity injuries, and altered movement strategies can influence how forces are distributed across the lower back and pelvis. Your physical therapist will evaluate these factors rather than assuming that one specific muscle or joint is responsible.
Who Is at Risk for SI Joint Pain?
Although sacroiliac joint dysfunction can affect people of many ages and activity levels, certain situations may increase the likelihood of experiencing pain in this region.
Examples include:
- Pregnancy or the postpartum period
- Physically demanding jobs
- Repetitive lifting or twisting
- Running and other high-impact activities
- Previous lower back or pelvic injuries
- Certain inflammatory joint conditions
- Changes in activity levels or exercise intensity
A person’s symptoms, health history, and physical examination are more informative than risk factors alone.
Sacroiliac Joint Dysfunction vs. Sciatica
SI joint dysfunction and sciatica can produce similar symptoms, particularly pain that extends from the lower back into the buttock or leg. However, the conditions are not interchangeable. Sacroiliac joint dysfunction involves pain believed to arise from the SI joint or surrounding structures. Discomfort often remains concentrated around the lower back and buttock, although referred pain may extend into the leg. Sciatica, on the other hand, describes symptoms along the sciatic nerve pathway, commonly associated with irritation of nerve roots in the lower spine.
Sciatica may include burning pain, tingling, numbness, or muscle weakness. Because symptom patterns overlap, a physical therapy evaluation may include neurological screening, lumbar spine assessment, and tests designed to investigate whether the SI joint is contributing to pain.
Sacroiliac Joint Dysfunction vs. Lower Back Pain
Not all lower back pain originates from the spine itself. Sometimes, discomfort near the beltline may involve the sacroiliac joint, hip structures, or surrounding muscles. Lower back conditions such as herniated discs, lumbar radiculopathy, and degenerative changes can also create symptoms near the pelvis. During your evaluation, your physical therapist will consider how symptoms respond to movement, positioning, and physical testing. Understanding the likely source of pain helps guide treatment and reduces the risk of focusing on the wrong area.
Sacroiliac Joint Dysfunction vs. Hip Pain
Hip conditions can sometimes mimic SI joint symptoms. For example, problems involving the hip joint or surrounding tendons may cause pain in the buttock, groin, or outer hip. A hip-related condition may become more noticeable during activities requiring deeper hip movement, such as squatting, putting on shoes, or getting in and out of a car. Meanwhile, SI joint-related symptoms may be aggravated by activities that place uneven forces through the pelvis, including stair climbing or standing on one leg. These patterns are not definitive. A comprehensive examination can help determine which structures are most likely contributing to the discomfort.
How Is Sacroiliac Joint Dysfunction Diagnosed?
Diagnosing SI joint-related pain can be challenging because symptoms overlap with several other musculoskeletal conditions. No single physical examination test reliably identifies every case of SI joint pain. A physical therapist may use a combination of findings, including your medical history, symptom behavior, movement assessment, and SI joint provocation tests.
Your Evaluation May Include:
Medical History and Symptom Review
We’ll discuss when your pain started, what makes it worse, what provides relief, and how symptoms affect your daily routine.
Lumbar Spine and Hip Assessment
Movement and strength testing can help identify whether the lower back or hips may be contributing to symptoms.
Sacroiliac Joint Provocation Testing
Your therapist may use a combination of clinical tests that apply controlled pressure through the pelvis to see whether familiar pain is reproduced.
Strength and Movement Assessment
Examining walking, single-leg balance, squatting, and other functional activities can reveal areas that may benefit from rehabilitation.
Neurological Screening
When appropriate, your therapist may check sensation, reflexes, and muscle strength to evaluate possible nerve involvement. In certain cases, additional medical evaluation or diagnostic procedures may be necessary to clarify the source of pain.
Can Physical Therapy Help Sacroiliac Joint Dysfunction?
Yes. Physical therapy is a common conservative treatment option for people experiencing SI joint-related pain. Treatment focuses on improving how your body manages movement and physical demands rather than simply trying to force the pelvis into a particular position.
An individualized rehabilitation program may help:
- Reduce pain during daily activities
- Improve hip and lower back mobility
- Strengthen muscles supporting the pelvis
- Build tolerance for walking and standing
- Improve movement coordination
- Increase confidence with lifting and exercise
- Support a gradual return to work, recreation, and physical activity
Your response to treatment will depend on the underlying contributors, symptom duration, and individual health factors. At Reform Physical Therapy, we take the time to understand your goals and develop a plan that fits your needs.
How Reform Physical Therapy Treats Sacroiliac Joint Dysfunction
Our physical therapists use evidence-informed rehabilitation strategies tailored to each patient’s presentation.
1. Individualized Movement Assessment
Effective treatment begins with understanding how your body moves. Your therapist will assess relevant activities, identify movement limitations, and determine which strategies may improve comfort and function.
2. Hip and Glute Strengthening
The gluteal muscles help manage forces through the pelvis during walking, climbing stairs, and lifting. Depending on your needs, exercises may include bridges, supported squats, hip strengthening, and controlled single-leg activities.
3. Core Strengthening and Trunk Control
Your abdominal and back muscles contribute to trunk stability and movement coordination. A progressive program may include gentle abdominal exercises, functional strengthening, and activities that challenge your ability to control movement.
4. Manual Therapy
Hands-on techniques may be used to address muscle discomfort, movement restrictions, or associated symptoms. Manual therapy can complement exercise and education, but it is not intended to permanently reposition an SI joint.
5. Mobility and Flexibility Exercises
Limited movement in the hips or surrounding areas may influence the demands placed on the pelvis. When appropriate, your therapist may recommend targeted mobility exercises to improve comfortable movement.
6. Functional Movement Training
Rehabilitation should prepare you for the activities that matter most.
Treatment may include practicing how to:
- Get out of bed more comfortably
- Transition from sitting to standing
- Climb stairs
- Lift objects safely and efficiently
- Carry groceries or children
- Return to recreational activities
7. Activity Modification and Education
Your physical therapist can help you identify temporary changes that make everyday tasks more manageable. Together, you’ll develop a gradual plan for returning to activities as your symptoms and tolerance improve. In selected cases, your healthcare provider may also recommend additional treatments or external support, such as an SI joint belt.
Exercises for Sacroiliac Joint Dysfunction
Exercise is often an important part of conservative treatment for SI joint-related pain. However, there is no single exercise routine that works for everyone. Depending on your symptoms and examination findings, your physical therapist may incorporate:
Glute Bridges
Bridges can strengthen the hips and surrounding muscles while practicing controlled movement through the pelvis.
Clamshell Exercises
These exercises target muscles around the outer hip that contribute to lower extremity control.
Gentle Hip Mobility
Appropriate mobility exercises may help reduce stiffness and improve comfortable movement.
Abdominal Strengthening
Progressive trunk exercises can build strength and endurance for daily tasks.
Sit-to-Stand Training
Practicing controlled transitions can help improve strength and tolerance for getting up from a chair.
Walking Progressions
Gradually increasing walking duration may help restore activity tolerance without unnecessarily aggravating symptoms.
Important: Exercises should be selected based on your individual presentation. Stop activities that cause significant worsening of symptoms and consult a healthcare professional for guidance.
How Long Does SI Joint Pain Take to Improve?
Recovery time varies considerably. Some people experience improvement over several weeks with appropriate activity modification and rehabilitation. Others may require a longer treatment period, particularly when symptoms have persisted for months or involve additional health conditions.
Factors that may influence recovery include:
- How long symptoms have been present
- The likely source of pain
- Current strength and activity tolerance
- Work and recreational demands
- Coexisting hip or spinal conditions
- Consistency with an appropriate rehabilitation plan
Rather than promising a specific recovery timeline, your physical therapist will help establish realistic goals and monitor your progress.
Can Sacroiliac Joint Dysfunction Go Away on Its Own?
Mild symptoms sometimes improve with time, changes in activity, and a gradual return to normal movement. However, persistent or recurring pain may benefit from a professional evaluation. Physical therapy can help address contributing movement limitations, strength deficits, and activity-related challenges. If symptoms continue despite conservative treatment, your therapist may recommend follow-up with another healthcare professional.
When Should You Seek Medical Attention?
Most lower back and pelvic pain does not require emergency treatment, but certain symptoms warrant prompt medical assessment.
Seek immediate medical care if you develop:
- New loss of bladder or bowel control
- Numbness in the groin or saddle region
- Severe or rapidly worsening leg weakness
- Significant pain following major trauma
Other symptoms, including fever, unexplained weight loss, persistent night pain, or new pain associated with a known inflammatory condition, should be discussed with a medical professional. A physical therapist can help determine whether your symptoms are appropriate for rehabilitation or require additional evaluation.
Why Choose Reform Physical Therapy for SI Joint Pain?
At Reform Physical Therapy, we believe your care should be as individual as you are. Whether your goal is walking without discomfort, getting through your workday, returning to running, or simply sleeping more comfortably, our team is committed to helping you make meaningful progress.
What Makes Reform Different?
One-on-One Physical Therapy
Your appointments focus on you, not a room full of patients being treated at the same time.
The Same Physical Therapist Throughout Your Care
Build a relationship with a licensed physical therapist who understands your history, progress, and goals.
No Aides or Technicians
Your treatment is provided directly by a licensed physical therapist.
Personalized Treatment Plans
Your rehabilitation program is developed around your symptoms, movement needs, and everyday activities.
Independent, Locally Owned, Woman-Owned
We’re proud to provide personalized physical therapy services to the communities we serve throughout Maine.
Sacroiliac Joint Dysfunction Physical Therapy Near You
Reform Physical Therapy proudly serves patients throughout Southern and Midcoast Maine at seven convenient clinic locations:
Our team provides individualized rehabilitation for lower back pain, hip pain, mobility limitations, and other musculoskeletal conditions that may contribute to discomfort around the pelvis.
Stop Letting SI Joint Pain Limit Your Everyday Life
You shouldn’t have to plan your entire day around lower back or pelvic discomfort. Whether pain is making it difficult to walk, exercise, work, or get comfortable at night, Reform Physical Therapy can help you understand your symptoms and develop a plan for moving forward. With personalized, one-on-one care and a treatment approach focused on your goals, our team is here to support you every step of the way.
Ready to take the next step?
Schedule Your Physical Therapy Evaluation at Reform Physical Therapy Today
Seven Maine locations. One-on-one care. Your recovery matters.