The Bespoken Word

Rx: SI Joint Pain


Rx: SI Joint Pain



The SI joint is the junction between your Sacrum and ilium, which are located at the base of your spine – connecting the spine to the hips. It’s supported by a number of ligaments and muscle groups to maintain a strong closure. When pain develops in this region, it’s usually felt in a very specific point at the back of your hip below your spine in the lower back and can refer into your butt and/or down the leg.

[Mechanism of Injury + Affected Tissues]

The 2 joints provide stability and play a role in absorbing when walking, running, weight lifting. The joint has a very small amount of motion. The SI joint may become painful when the ligaments become too tight or too loose. It may also occur when the movement on the pelvis is different on each side (asymmetry). This pain is usually due to an asymmetry in the amount of load that is being applied to the joint from the right and left sides. This can happen for a variety of reasons.  The asymmetry can occur when one leg becomes longer or weaker than the other, resulting from a change in musculature surrounding the pelvis.  An injury to the low back or lower extremity may also change your mechanics and ultimately leads to this asymmetrical loading.


To beat this kind of pain, you first need to restore your pelvis to its natural resting position, then improve the muscular contributions to closing this joint with movement. This requires work above and below the joint area.

Physical Therapy should focus on:

Modulating the pain

Mobilizing the soft tissue surrounding the joint (low back, hips and pelvis)

Sacroiliac manipulation done by your Physical Therapist

Postural alignment changes made by your Physical Therapist

Strengthening the muscles surrounding the joint (low back, hips and pelvis)

Making the proper  modifications to promote pain free activities & movements

Women who are pregnant are suffer from low back pain & SI joint discomfort. 2014 report in the Journal of Women’s Health Physical Therapy suggests that physical therapy is a  great treatment option for those patients. Below are the suggested physical therapy treatments

15 studies were assessed;  12 indicated the benefits of “stabilizing exercises,” as well as the “use of a nonelastic sacroiliac belt, and muscle energy techniques,” to address their pain.

“Three of the 15 studies supported sacroiliac manipulation, soft-tissue mobilization, postural alignment, pelvic belt use, and exercises in individuals with SIJD.”


[Healing Timeline]


Acute SI joint pain that may occur suddenly & can usually heal within several days to couple of weeks with proper physical therapy treatment

Chronic SI joint pain may persist for > than 3 month – this pain may be felt all the time & worsen with certain activities. If you have chronic SI joint pain, you need to seek proper physical therapy treatment and make the proper modification with your physical therapist



A  2014 study shared by the U.S. National Library of Medicine, states that the exact number of people who suffer from SI joint pain in the United States is unknown. They believe that it “could represent up to 15% of all patients seen in outpatient clinics with chronic lower back pain.”

Stats from the study

The average age of the patients in the study suffering from SI joint pain was 52 years old

Around 19%-29% of adults in the USA experience low back pain.

“With 234 million adults in the U.S., the national burden of SIJ [sacroiliac joint] pain could be as high as 234,000,000 × 29% × 15%, or 10 million.”

Patients who deal with chronic low back pain spend about 2x as much money on health expenses each year “with total mean direct annual costs of >$8,000.”

SI joint pain “appears to affect patients in their mid-life productive years, resulting in a very high economic burden of disease related to both the number of years of living with the disease, as well as associated limitations on productivity.”

Check out our Instagram post for a short SI Joint Pain rehab guide – @BespokeTreatments Rx: SI Joint Pain

*This does not constitute medical advice. If you have pain or injury please consult a medical profession in person