Sacroiliac Joint Pain: The Back Problem Often Missed
Sacroiliac joint (SIJ) dysfunction is one of the most commonly missed diagnoses in lower back pain — and one of the most satisfying to treat when correctly identified. The SIJ connects the sacrum (base of the spine) to the pelvis on each side. It's designed for stability, not movement, but when it becomes irritated or stiff, it produces a very specific pattern of pain that can mimic disc, hip, or even sciatic symptoms.
How do you know if the SIJ is involved in your back pain?
SIJ pain typically presents on one side of the lower back or buttock, often with a sharp ache directly over the dimple area. It's usually aggravated by standing on one leg, walking up stairs, rolling in bed, or sitting for extended periods. Some people feel a clicking or instability sensation in the pelvis. Unlike disc pain, it rarely causes symptoms below the knee.
Pregnancy, leg length differences, previous falls onto the tailbone, and asymmetrical loading (such as always carrying a bag on one side) are common contributing factors. We see a significant number of SIJ presentations across Berwick and the broader Casey region, particularly in new and returning mothers, and in people returning to exercise after a period of reduced activity.
Why the SIJ is so often missed — and what gets it wrong
Standard lumbar spine X-rays and MRI scans don't reliably show SIJ dysfunction. The joint can be stiff, inflamed, or malaligned without showing dramatic structural change on imaging. This leads many people down a frustrating diagnostic path — back scans, nerve tests, and pain management — without anyone considering the pelvis. Clinical examination using provocation tests specific to the SIJ is the most reliable way to identify it.
It's also worth understanding that the SIJ doesn't operate in isolation. The way your lumbar spine, hip, and even thoracic spine move all influence how the SIJ is loaded. Treating the joint without addressing these contributing factors often produces short-term relief that doesn't last. The pelvis has to be understood as part of the whole kinetic chain.
Osteopathic treatment for SIJ dysfunction
Treatment involves assessing and addressing pelvic alignment, mobility through the lumbar spine and hip, and the muscular control that supports the joint. Hands-on techniques to mobilise a stuck SIJ often produce rapid improvement in pain and function. We also prescribe specific exercises to build the stability the joint needs long-term.
If you've been told your lower back is fine but something still doesn't feel right, the SIJ may be the missing piece. Book a thorough assessment at our Berwick clinic and we'll give you a clear answer about what's driving your pain and what to do about it.
Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
