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Sacroiliac Joint Syndrome and Chiropractic Treatment
What Is the Sacroiliac (SI) Joint?
The sacroiliac joints are located at the base of your spine, where the spine meets the pelvis. You can often spot them by the small dimples just below your waist at the back. These joints transfer weight and movement between the upper body and legs.
Although once believed to be immobile, we now know that SI joints do move — and when irritated or injured, they can become a major source of lower back pain.
What Is Sacroiliac Joint Syndrome?
Sacroiliac Joint Syndrome (also called SI joint sprain) happens when these joints become irritated or overstressed. It may be caused by a single injury or develop over time through repeated strain.
This condition is not the same as sacroiliitis, which involves inflammation due to an underlying disease.
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What Causes SI Joint Pain?
SI joint pain can be caused by repetitive microtrauma, which results from repeated strain over time. Muscular imbalance or weakness around the pelvis can also contribute, especially if these muscles aren’t supporting the joint effectively. Traumatic injuries such as falls or car accidents, prolonged bending or lifting, and the loosening of ligaments during pregnancy can all increase the risk. In addition, issues with the feet, knees, or hips may affect how your body moves, putting added stress on the sacroiliac joints.
Who Is Most Affected?
Women tend to be affected more than men due to greater ligament flexibility. People with previous injuries, poor core strength, or a sedentary lifestyle are also more prone. As we age, the joints stiffen, making sprains less common but recovery slower if they occur.
Symptoms of SI Joint Sprain
Localised pain near the dimples of the lower back
Pain in the buttocks, groin, or front of the thigh
Pain that spreads down one leg (often mistaken for sciatica)
Worsens when sitting, bending, or standing on one leg
Relief when lying down
In most cases, there’s no numbness or tingling. If nerve symptoms are present, your chiropractor will rule out disc involvement or other causes.
Diagnosing SI Joint Issues
Your chiropractor will assess your posture, movement, and muscle control, and will manually test the joint for restriction or excess motion. If the condition has been present for a long time or if other medical concerns are suspected, an X-ray may be used to rule out other causes. However, the diagnosis of SI joint sprain is made clinically — imaging can support, but not confirm, the diagnosis.
Chiropractic Treatment
Chiropractic care is highly effective for SI joint dysfunction. Treatment usually involves a combination of spinal and pelvic adjustments, stretching, and stabilisation exercises. Over time, the goal is to reduce inflammation, restore joint function, and prevent flare-ups. Your chiropractor may also offer advice on posture, walking, and exercises to improve spinal support.
Why SI Joint Pain Often Returns
When ligaments heal after injury, they form scar tissue, which is weaker and less elastic. This increases the risk of reinjury. Even after the pain subsides, the deep stabilising muscles around the joint can remain weak, making it more likely the problem will come back unless strengthened properly.
How to Prevent Recurrence
The best way to prevent SI joint pain from coming back is to improve your core and glute strength, maintain good posture, and follow your chiropractor’s rehabilitation plan. Avoid long periods of sitting, learn proper lifting techniques, and stay active with exercises that support your spine and pelvis.
When to Seek Help
Get checked if you:
Have ongoing lower back or buttock pain
Feel pain when bending, sitting, or walking
Had previous back issues or injuries
Are pregnant and experiencing pelvic pain
Have tried rest or painkillers with little success
Bottom Line
SI joint sprains are common, but very treatable — especially with early diagnosis and the right chiropractic care. Left untreated, they can lead to chronic pain and ongoing flare-ups.
Don’t wait. The sooner you get assessed and start treatment, the faster you’ll recover and get back to normal life.
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