The MSK Studio - spinal physiotherapy and Clinical Pilates clinic in Adelaide

Sacroiliac Joint Dysfunction

Region affected

Pelvis / Base of spine

Common in

Adults 20-50, post-partum women

Onset

Gradual or post-trauma

Related conditions

Low Back Pain, Sciatica, Pelvic Girdle Pain

The sacroiliac joint (SIJ) connects the base of the spine to the pelvis, sitting between the sacrum and the ilium on each side. It is a strong, stable joint that transmits load between the lower limb and the trunk, and when it becomes dysfunctional, it can produce significant pain that is frequently misattributed to lumbar disc or facet pathology.

Research suggests that the SIJ is the primary pain driver in approximately 20% of lower back pain presentations. Despite this, it remains one of the most commonly missed diagnoses in spinal physiotherapy, in part because SIJ pain mimics other conditions so closely, and in part because standard imaging often fails to identify it. Accurate clinical diagnosis using a cluster of specific provocation tests is essential.

What Causes Sacroiliac Joint (SIJ) Dysfunction?

Signs and Symptoms

The SIJ can become painful through a range of mechanisms:

SIJ pain most commonly presents as:

  • Childbirth – hormonal ligament laxity during pregnancy and the mechanical demands of labour
  • A fall or direct impact to the pelvis
  • Motor vehicle accident
  • Repetitive asymmetrical loading through work or sport
  • Inflammatory conditions such as ankylosing spondylitis affecting the SIJ
  • Deep, one-sided buttock pain
  • Low back or pelvic pain that varies in location
  • Pain referral into the hip, groin or upper thigh
  • Discomfort with transitional movements – sitting to standing, rolling in bed, climbing stairs
  • Pelvic stiffness, asymmetry or a sense of instability
  • Symptoms that are worse with sustained activity and ease with rest

What Causes Sacroiliac Joint Dysfunction?

The SIJ can become painful through a range of mechanisms:

  • Childbirth – hormonal ligament laxity during pregnancy and the mechanical demands of labour
  • A fall or direct impact to the pelvis
  • Motor vehicle accident
  • Repetitive asymmetrical loading through work or sport
  • Inflammatory conditions such as ankylosing spondylitis affecting the SIJ

Signs and Symptoms

SIJ pain most commonly presents as:

  • Deep, one-sided buttock pain
  • Low back or pelvic pain that varies in location
  • Pain referral into the hip, groin or upper thigh
  • Discomfort with transitional movements – sitting to standing, rolling in bed, climbing stairs
  • Pelvic stiffness, asymmetry or a sense of instability
  • Symptoms that are worse with sustained activity and ease with rest

How The MSK Studio Treats
Sacroiliac Joint Dysfunction

At The MSK Studio in Adelaide, SIJ assessment uses a cluster of evidence-based provocation tests to confirm whether the sacroiliac joint is the primary pain driver. Treatment differs significantly depending on whether the joint is presenting as stiff and restricted, or hypermobile and unstable, which is more common in post-partum presentations. A sacroiliac support belt may be recommended as a short-term adjunct during the acute phase.

See our SIJ physiotherapy service below:

Sacroiliac Joint Physiotherapy

Related Conditions

Sciatica

Facet Joint Syndrome

Discogenic Back Pain

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