Sacroiliac Joint Dysfunction: What Is It and How Can Physiotherapy Help?

If you've been struggling with pain around your lower back, buttock or pelvis, you may have been told it's "just back pain." However, for many people, the real cause is the sacroiliac (SI) joint.

At Revive Physio, we regularly assess and treat sacroiliac joint dysfunction, helping people reduce pain, restore normal movement and return to the activities they enjoy.

What is the sacroiliac joint?

The sacroiliac joints sit at the base of your spine where the sacrum (the triangular bone at the bottom of your spine) joins your pelvis on either side.

Although these joints only move a small amount, they play a vital role in transferring forces between your upper body and your legs whenever you walk, run, bend, lift or change position.

When the joints are moving too much, too little, or the surrounding muscles are not supporting them effectively, they can become painful and irritated.

What causes sacroiliac joint dysfunction?

There isn't always a single cause. More commonly, several factors contribute to the problem.

Common causes include:

• Twisting or lifting awkwardly

• Sudden increases in exercise or sporting activity

• Pregnancy and postnatal changes

• Falls or direct trauma

• Prolonged sitting or standing

• Muscle weakness around the pelvis and core

• Reduced hip mobility

• Previous lower back injuries

• Leg length differences or altered walking patterns

Many people also develop symptoms gradually as poor movement patterns place repeated strain through the pelvis over time.

What does sacroiliac joint pain feel like?

SI joint pain can often mimic other conditions, which is why a thorough assessment is so important.

Symptoms may include:

• Pain on one side of the lower back

• Pain over the "dimples" at the bottom of your back

• Buttock pain

• Pain that can spread into the groin or upper thigh

• Difficulty turning in bed

• Pain when standing from sitting

• Pain walking or climbing stairs

• Pain on running

• Pain when standing on one leg

• A feeling that the pelvis is "out of place" or unstable

• Stiffness after sitting for long periods

Unlike sciatica, SI joint pain usually doesn't travel all the way down the leg into the foot, although some people can experience referred pain into the thigh and calf.

Why does it keep coming back?

Many people experience temporary relief with massage, rest or pain medication, only for the pain to return weeks later.

This is because the underlying reason the joint became irritated hasn't been addressed.

Often this involves:

• Poor pelvic control

• Weak deep core muscles

• Reduced glute strength

• Altered movement patterns

• Limited hip mobility

• Persistent muscle imbalance

Unless these issues are corrected, the joint can continue to become overloaded.

How can physiotherapy help?

At Revive Physio, treatment doesn't simply focus on reducing pain—we aim to identify why your SI joint has become painful and correct the underlying cause.

Following a detailed assessment, your treatment plan will be tailored specifically to you.

Manual therapy

Hands-on treatment can be highly effective at restoring normal movement and reducing pain.

Depending on your assessment, this may include:

• Gentle sacroiliac joint mobilisation

• Lumbar spine mobilisation

• Hip joint mobilisation

• Soft tissue massage

• Myofascial release

• Muscle energy techniques where appropriate

These techniques can help reduce muscle spasm, improve movement and allow the body to move more efficiently.

Functional alignment

One of the most important aspects of treatment is restoring normal movement through the pelvis.

Rather than simply trying to "put the pelvis back into place," we assess how your body moves during everyday activities such as:

• Walking

• Sitting to standing

• Climbing stairs

• Bending

• Squatting

• Single-leg balance

Small changes in movement can make a significant difference to the forces passing through the SI joints.

By improving functional alignment, we reduce unnecessary stress on the pelvis and lower back.

Pelvic and core stability

Research consistently shows that improving the strength and control of the muscles supporting the pelvis is key to achieving long-term recovery.

Your rehabilitation programme may include exercises to improve:

• Deep abdominal control

• Pelvic floor activation

• Glute strength

• Hip stability

• Core endurance

• Balance and coordination

Exercises are progressed gradually so you build confidence while returning safely to normal daily activities, work and sport.

Will I need scans?

In most cases, scans such as X-rays or MRI scans are not required.

A detailed physiotherapy assessment can usually identify whether your symptoms are likely to be coming from the sacroiliac joint while also ruling out other possible causes of pain.

If your assessment suggests further investigation is needed, we'll advise you accordingly and liaise with your GP if appropriate.

When should you seek physiotherapy?

The earlier SI joint dysfunction is treated, the easier it is to prevent ongoing pain and compensation.

You should consider booking an assessment if you:

• Have persistent pain around the pelvis or lower back

• Keep experiencing recurrent episodes

• Struggle walking, bending or standing

• Feel unstable through your pelvis

• Have pain during pregnancy or after childbirth

• Have tried resting but the pain keeps returning

Early assessment can help prevent symptoms becoming chronic and reduce the risk of developing secondary problems elsewhere in the back or hips.

How Revive Physio can help

At Revive Physio, we take time to understand the whole picture rather than simply treating the painful area.

Your assessment includes a detailed examination of your posture, movement patterns, joint mobility, muscle strength and functional control to identify the root cause of your symptoms.

Treatment may include:

• Comprehensive physiotherapy assessment

• Hands-on manual therapy

• Functional movement retraining

• Pelvic and core stability rehabilitation

• Individual exercise programme

• Education and self-management strategies

• Advice on returning safely to work, exercise and everyday activities

Our aim isn't simply to relieve today's pain—it's to help prevent it from returning.

If you're experiencing lower back, buttock or pelvic pain, physiotherapy may help you move more comfortably, regain confidence and get back to doing the things you enjoy.

Revive Physio – Specialist Women's Physiotherapy & Wellbeing Clinic provides expert physiotherapy in Mosley Common, conveniently located for Worsley, Walkden, Boothstown, Tyldesley, Astley, Atherton and the surrounding Greater Manchester area. If you're struggling with sacroiliac joint pain, we'd be happy to help you get back to moving with confidence.