Condition guide
SI Joint Pain Treatment: Sacroiliac Pain Explained
The sacroiliac joints, often called the SI joints, sit at the back of the pelvis where the base of the spine meets the pelvic bones. SI joint pain usually causes aching low down on one side of the back or in the buttock, often worse when standing on one leg, climbing stairs or turning in bed. SI joint pain treatment with physiotherapy focuses on strength, movement and how you load the pelvis day to day. This page is general information rather than a diagnosis, and an assessment is the sensible next step if your symptoms are not settling.
What is SI Joint Pain?
Each SI joint is a strong joint held firmly by ligaments, with only a small amount of movement. It transfers load between the spine and the legs every time you walk, stand or lift. Pain can come from the joint itself or the tissues around it. It is common in pregnancy and after birth, after a fall onto the buttock, in people with uneven loading such as a leg injury, and in some inflammatory conditions. Because low back pain, hip pain and nerve pain can all feel similar, a careful assessment matters more than the label.
Typical Symptoms
- Aching or sharp pain low in the back on one side, over the dimple at the top of the buttock
- Pain in the buttock that can spread into the back of the thigh, usually not below the knee
- Pain standing on one leg, climbing stairs or getting in and out of a car
- Discomfort turning over in bed or after sitting for long periods
- Stiffness that eases as you get moving
Common Causes & Triggers
- Pregnancy and the months after birth, when load through the pelvis changes
- A fall onto the buttock or a jarring step
- Uneven loading, for example after a leg injury or with a limp
- Repeated one sided activities such as lifting a toddler on one hip
- Inflammatory conditions such as axial spondyloarthritis, which your GP should assess
How We Treat SI Joint Pain at Bluebell
- 1
A detailed history and examination of the lower back, pelvis and hips, using a cluster of tests rather than one single test.
- 2
Clear explanation of what the findings suggest and what is likely to help.
- 3
Strengthening of the glutes, trunk and legs, progressing towards the activities that bring your pain on.
- 4
Advice on pacing, sitting, sleeping positions and how you lift and carry.
- 5
Hands-on treatment where it helps, and referral to your GP if the pattern suggests an inflammatory condition or something other than a mechanical problem.
Honest Recovery Timeline
SI joint pain often improves over weeks to a few months as strength and confidence build, although flare-ups can happen with busy days or one sided lifting. Pregnancy-related pain may change again after birth. Your physiotherapist will review progress at each appointment and explain what is realistic for you.
SI joint pain and other back pain
If your pain sits across the lower back rather than to one side of the pelvis, our lower back pain guide explains the common causes. Pain that travels below the knee with tingling is more typical of a nerve, and our sciatica guide covers that pattern. If your pain started in pregnancy, our page for new and expectant mothers explains the support available.
Booking an assessment for SI joint pain
Our back pain treatment service explains the exercise, advice and hands-on care used for persistent back and pelvic pain. Appointments are at Warren Road, Blue Bell Hill, Chatham ME5 9RD, with free parking, Monday to Saturday 8am to 8pm. You can self-refer online or call 01634 757123.
When SI Joint Pain Needs Urgent Medical Attention (Not Physio)
- •Numbness around the back passage or genitals, new bladder or bowel problems, or weakness in both legs, go to A and E straight away.
- •Back or pelvic pain with fever, feeling unwell or unexplained weight loss, see your GP promptly.
- •Morning stiffness lasting more than half an hour that improves with exercise, especially if you are under 45, ask your GP about inflammatory back pain.
- •Severe pelvic pain after a fall, go to A and E to rule out a fracture.
SI Joint Pain — Common Questions
What does SI joint pain treatment involve?
Usually an assessment of the back, pelvis and hips, a clear explanation, progressive strengthening and advice on daily activities. Hands-on treatment may be used where it helps.
How long does SI joint pain take to improve?
Many people improve over weeks to a few months, but it varies. Your physiotherapist will explain what is likely in your case rather than giving a fixed date.
Is SI joint pain the same as lower back pain?
It is one possible source of pain low in the back. Pain from the spine, hip and nerves can feel similar, so an assessment helps work out where your symptoms are coming from.
Do I need a scan for SI joint pain?
Not usually. Scans are reserved for situations where the history suggests an inflammatory condition, a fracture or another cause, and your GP can arrange them when needed.
What affects the cost of treatment?
The number of appointments you need is the main factor. Ask the clinic for current fees when you book, and check with your insurer if you have a policy.