Chronic low back pain is one of the most common and disabling conditions worldwide. But what many people don’t realize is that 14 to 22% of these cases are actually caused by problems in the sacroiliac joint (SIJ) , not the spine itself.
In many cases, SI joint dysfunction develops from mechanical stress, past injuries, or even childbirth. It’s often misdiagnosed because the symptoms mimic Sciatica, and even imaging has a hard time showing its true source.
One study found those with weak gluteus maximus muscles took the longest to recover, averaging 9 months and 21 therapy sessions. Patients that received targeted treatment saw results much faster often within 3.5 to 4.3 months.
Chiropractic care is one of those approaches. When adjustments are combined with exercises that stabilize the pelvis, it creates a real shift in how the body moves.
A Detailed Look at SI Joint Dysfunction
The sacroiliac joint (SIJ) connects the sacrum, the base of your spine to the two ilia, or pelvic bones. You have one SI joint on each side. Structurally, it’s a C-shaped, synovial joint surrounded by a thick fibrous capsule and reinforced by strong ligaments and deep pelvic muscles.
It doesn’t move much, but it plays a huge role in transferring load between your upper and lower body and stabilizing the pelvis during walking, lifting, and single-leg movement.
The joint is also packed with nerve endings. The dorsal rami from L4 to S3 supply the joint with nerves that transmit both pain and temperature. The L5 nerve root runs close to the front of the joint capsule, and the S1 nerve passes just underneath it.
That’s why SI joint irritation can sometimes mimic sciatic pain or nerve root compression, even though the source is the joint itself.
Pain from SI dysfunction is often felt just below the beltline, off to one side, in an area about 3 cm wide and 10 cm long.
Common Causes of SI Joint Dysfunction
Most patients I see with SI joint dysfunction didn’t hurt themselves in one clear moment. In fact, many can’t point to a specific injury at all. That’s because SI dysfunction often builds over time.
That said, there are a few common patterns I see often:
Pregnancy and Postpartum Changes
During pregnancy, the body releases hormones that loosen ligaments to prepare for delivery. That includes the ones around the SI joint. The pelvis becomes more loose, and after birth, those changes can linger.
Herniated Disc
When you suffer a herniated disc in the lower back, the body compensates by shifting loads on one side of the pelvis, placing extra stress on the SI joint. Over time, the joint can become irritated in a way similar to Sciatica. Even after the disc improves, that imbalance may stick around. That’s why we often see SI pain lingering in patients with a history of disc issues.
Sports Injuries
Athletes put high demand on the pelvis and SI joints. Sports like basketball, soccer, and football involve rapid direction changes and single-leg loading. These sudden movements create uneven stress on the joint. Over time, the joint can shift or become inflamed. In some cases, an acute injury like a fall or awkward landing may trigger dysfunction immediately.
Leg Length Differences or Gait Abnormalities
Even a small leg length difference can change how your pelvis tilts and how your weight is distributed when you walk. Over time, one SI joint ends up doing more work than the other. The longer that imbalance continues, the more stress builds in the joint.
Ankylosing Spondylitis
Ankylosing spondylitis is a chronic inflammatory condition that often starts in the sacroiliac joints. Symptoms usually include deep stiffness and pain in the low back or buttocks. In advanced cases, chronic inflammation can cause fusion of the spine.
Osteoarthritis of the SI Joint
Although less common than hip or knee degeneration, osteoarthritis can affect the sacroiliac joints particularly in older adults. Over time, cartilage wears down, the joint space narrows, and inflammation can develop. Patients often report a dull, aching pain that worsens with prolonged standing or walking.
Treatment Options We Offer for SI Dysfunction
Fixing SI joint dysfunction may seem daunting but with proper assessment and the right treatment plan it can be treated. Here’s what we focus on at The Disc Chiropractic:
Chiropractic Adjustments
When the SI joint becomes restricted, the surrounding muscles often tighten to protect it, ironically making the joint even harder to move. Precise thrust to the SI joint, lumbosacral spine, and the hips, help restore mobility and reduce mechanical stress. This helps calm irritation and allows the stabilizing muscles to function properly again.
Spinal Decompression Therapy
Sacroiliac joint dysfunction often coexists with lower lumbar issues. Our Triton DTS system gently reduces pressure within the discs by creating negative intradiscal pressure, which encourages fluid and nutrient exchange and may help relieve nerve irritation.
By improving lumbar alignment and reducing compensatory stress, this can also ease strain on the affected SI joint.
Shockwave Therapy
Chronic SI joint issues often lead to tight, inflamed muscles and connective tissue in the glutes and low back. Shockwave therapy helps address this by breaking up scar tissues and trigger points, thus promoting your body’s natural healing process in the surrounding structures.
Therapeutic Exercises
Once the joint starts moving better, the goal shifts to building lasting support. That’s where corrective exercise makes the biggest difference. We focus on activating the glutes, retraining core stability, and improving how the deep pelvic muscles work together with the spine. Each movement is chosen based on how your body responds.
FAQs About Anterior Pelvic Tilt
How Do I Know if My Low Back Pain Is Coming From the Si Joint?
The pain from SI joint dysfunction is usually felt just below the beltline, off to one side. It may feel sharp during certain movements like standing from a chair, twisting, or rolling over in bed. Unlike disc pain, which often radiates in a straight line down the leg, SI pain tends to stay in the buttock, outer hip, groin, or upper hamstring.
Can SI Joint Dysfunction Cause Symptoms in the Leg or Foot?
Yes, in some cases. While the SI joint itself doesn’t directly press on nerves, inflammation or mechanical irritation around the joint can involve nearby nerve roots, especially L5 and S1. This can create referred symptoms such as numbness, tingling, heaviness, or aching in the leg.
Will an MRI or X- Ray Detect SI Joint Dysfunction?
In most cases, no. Traditional imaging like X-rays, CT scans, or MRIs are limited when it comes to detecting movement dysfunction, capsular strain, or early joint inflammation in the SI joint. Diagnosis comes down to clinical skill and testing. We use orthopedic provocation tests, SI compression tests, and motion palpation to confirm SI involvement.
What Makes SI Joint Pain Flare Up?
The most common triggers include uneven weight-bearing (like standing on one leg), transitional movements (getting out of bed), and repetitive loading (running or jumping). For some, even sleeping on one side for too long can create stress on the joint.
Can Chiropractic Care Help Fix SI Joint Dysfunction?
Yes and it’s one of the most effective conservative treatments available. But adjustments are just one piece of the process. We combine chiropractic care with shockwave, and therapeutic exercise to support the joint, calm inflammation, and help the pelvis move better.
Is SI Dysfunction Permanent?
No. While SI joint issues can linger if untreated, most patients recover well with a combination of manual therapy and guided rehab. The key is to address the mechanical cause and retrain the neuromuscular support system around the joint.
Take the First Steps Toward SI Joint Pain Relief
Many of the patients I see have been through imaging, medication, or physical therapy, but still haven’t gotten answers. Once we identify the SI joint as the source and treat it properly, the change can be immediate.
At The Disc Chiropractic in Wheat Ridge, I help patients across Denver stabilize this small but powerful joint, reduce inflammation, and regain real control over their movement again.
Book your $97 First Visit today.
Includes a full consultation, movement assessment, and personalized care recommendations.