Have you been diagnosed with SIJ dysfunction or an injury to the SI joint and want to know more about it? Read this helpful article.

What is the “SIJ”?

The sacroiliac joint is located in the lower part of the back and joins the tail bone (sacrum) to one of the pelvic bones (ilium). There are two sacroiliac joints; one on either side of the spine. Due to the SIJ’s anatomical structure, its primary function is stability. However, studies have shown that the SIJ acts to transfer weight from the spine to the pelvis and allows a small amount of movement to occur in this area. Very often, either due to injury, lack of movement or overuse; the SIJ can get stuck OR has too much movement which causes dysfunction or pain in the area.

Where is my back pain coming from?

SIJ back pain

Diagnosing the cause of back pain is quite challenging as multiple structures in the lower back region can cause pain. Therefore, an accurate diagnosis is paramount in the treatment of lower back pain and SIJ pain. Your physiotherapist has the tools to clinically diagnose the cause of your pain and injury with specific tests which can differentiate lower back pain from SIJ pain and can, therefore, be treated accordingly.

What does SIJ pain feel like?

The pain can be dull or sharp – often on one side of your lower back. It often starts at your SIJ, but it can move to your buttocks, thighs, groin, or upper back. Most commonly the symptoms occur when standing up from sitting down, turning in bed, getting in or out of a car and going up and down stairs. You may notice that it bothers you more in the morning and gets better during the day.

What is happening to you?

Cause of SIJ pain

The pain starts when your SIJ gets irritated or locked. The most common causes of SIJ pain are:

  • A fall onto, or a big force through, your lower back
  • Repetitive pounding (i.e. jogging, jumping)
  • One leg is longer than the other (which gives uneven stride when walking or running)
  • Lax (loose) ligaments (often with pregnant women when the body releases Relaxin to loosen the ligaments in preparation for birth) cause SIJ instability which may cause pain
  • Arthritis


How do you treat SIJ pain?

SIJ brace

Physiotherapy treatment for SIJ dysfunction can speed up the healing, ensure an optimal outcome and reduce the likelihood of future recurrence. Treatment may be any of the following per the source of the problem or dysfunction:

  • soft tissue release (muscles and ligaments)
  • mobilisation
  • manipulation
  • electrotherapy (e.g. laser or ultrasound)
  • taping (see our article on Kinesio taping)
  • the use of an SIJ belt or lumbar brace
  • correction of any leg length discrepancy
  • dry needling (see more on this topic)
  • muscle energy techniques
  • education
  • activity modification advice
  • biomechanical correction
  • ergonomic advice
  • exercises to improve flexibility, strength, posture and core stability (Pilates)
  • a gradual return to activity programme

Contact a physiotherapist near you if you are still experiencing pain or discomfort after being treated for some time.