Sacroiliac (SI) Joint Pain Care in Frisco
Pain on one side of the lower back, buttock, or pelvis is often assumed to be coming from a disc or the sciatic nerve. But another possible source is the sacroiliac (SI) joint, where the sacrum at the base of the spine connects with the pelvis.
SI joint problems can be particularly frustrating because the symptoms can overlap with lower back pain, sciatica, lumbar disc problems, hip problems, and other conditions. Two patients can point to almost the same painful area and still have very different underlying problems.
At Venn Chiropractic and Wellness Center in Frisco, Dr. Jason Venn’s first priority is determining where the pain is actually coming from before deciding how to treat it.
With more than 25 years of chiropractic experience, Dr. Jason Venn uses the Gonstead System to evaluate the lower spine, sacrum, pelvis, and SI joints along with the patient’s symptoms, joint motion, neurological findings, and imaging when clinically appropriate.
An important part of that evaluation is determining whether the SI joint appears to be restricted, excessively mobile or unstable, compensating for another problem, or not the primary source of the symptoms at all. Treatment is then based on what Dr. Venn actually finds rather than assuming that every patient with pain near the SI joint needs the same adjustment.
Not Every SI Joint Problem Is the Same
One reason SI joint problems need to be evaluated carefully is that the joint can behave differently from one patient to another.
In some patients, an SI joint may be restricted and not moving normally. This can alter how forces are transferred between the spine and pelvis and may contribute to pain or compensation in the surrounding muscles and joints.
In other patients, the problem may involve excessive movement or instability rather than restriction. Pregnancy-related changes, previous injuries, repetitive stress, and other factors can affect how well the pelvis is being stabilized.
This distinction matters because a joint that is restricted and a joint that is already moving excessively should not automatically be treated the same way. Dr. Venn evaluates the individual joint mechanics along with the patient’s symptoms and examination findings before determining whether an adjustment, stabilization work, rehabilitation, or another approach is appropriate.
Sometimes the examination also shows that the SI joint is not the primary problem at all. Pain in this area can originate from the lumbar spine, a disc, a nerve, the hip, or another structure, which is why identifying the likely source of the symptoms comes before treatment.
What Is the SI Joint?
You have two sacroiliac joints, one on each side of the pelvis. Each SI joint connects the sacrum—the triangular bone at the base of the spine—to the ilium of the pelvis.
Unlike joints such as the shoulder or knee, the SI joints are designed primarily for stability with a relatively small amount of movement. They help transfer forces between the upper body and the legs while absorbing and distributing stress during standing, walking, bending, lifting, and other everyday movements.
Because the SI joints sit directly between the lower spine and pelvis, problems in this area can produce symptoms that are easily confused with lower back pain, sciatica, hip pain, or a lumbar disc problem.
The important question isn’t simply whether pain is located near the SI joint. It’s whether the SI joint is actually contributing to the symptoms and, if so, what type of dysfunction is present.
How the SI Joint Affects the Lower Back, Pelvis, and Hips
The SI joints sit at an important mechanical transition point between the spine and the pelvis. Forces generated through the upper body must pass through this region into the pelvis and legs, while forces from walking, running, and other lower-body movements travel upward through the same area.
When an SI joint is not functioning normally, the body may begin changing how it moves to compensate. This can affect movement through the lower back, pelvis, hips, and surrounding muscles.
For example, a restricted SI joint may cause other areas to move differently to compensate for the lost motion. An unstable or excessively mobile SI joint may create a different problem, requiring the surrounding muscles and other structures to work harder to stabilize the pelvis.
This is one reason Dr. Venn evaluates more than just the location where the patient feels pain. The SI joint, lumbar spine, hips, and surrounding movement patterns need to be considered together to determine which structure is actually driving the problem.
When appropriate, spinal rehabilitation may also be used to improve strength, control, and stability around the affected region rather than relying on an adjustment alone.
What Does SI Joint Pain Feel Like?
SI joint pain is commonly felt on one side of the lower back or pelvis, although symptoms can sometimes occur on both sides. The discomfort may remain localized around the SI joint or spread into the buttock, hip, groin, or upper leg.
Common symptoms and patterns may include:
- Pain on one side of the lower back
- Buttock, hip, pelvic, or groin discomfort
- Pain when transitioning from sitting to standing
- Discomfort when climbing stairs
- Pain when standing or walking for longer periods
- Increased discomfort when putting more weight on one leg
- Pain when rolling over or changing positions in bed
- Stiffness or discomfort after prolonged sitting
- Tenderness around the SI joint or back of the pelvis
- Pain that travels into the upper leg and can sometimes feel similar to sciatica
The location of the pain alone does not confirm that the SI joint is responsible. Lumbar disc problems, nerve irritation, hip conditions, and other musculoskeletal problems can create overlapping symptoms, which is why Dr. Venn uses the examination to determine which area is most likely contributing to the patient’s pain.
What Can Cause SI Joint Pain?
SI joint pain can develop when the forces passing through the pelvis change or when one of the SI joints becomes restricted, irritated, or excessively mobile. Sometimes there is a clear injury or event that starts the problem. In other cases, symptoms develop gradually as the body repeatedly compensates for altered movement or loading.
Factors that may contribute to SI joint problems include:
- A fall or other trauma involving the pelvis or lower back
- Repetitive lifting, bending, or twisting
- Sports injuries or repetitive athletic movements
- Changes in movement or weight distribution during pregnancy
- Pelvic and SI joint problems that persist after pregnancy
- Differences in how the hips, pelvis, or lower spine are moving
- Prolonged or repetitive positions that continually stress the region
- Previous lower-back or pelvic injuries
Pregnancy deserves particular attention because changes in body weight, posture, ligament laxity, and pelvic loading can alter how the SI joints are being stressed. Some women develop SI or pelvic discomfort during pregnancy, while others continue experiencing symptoms after delivery.
The cause also affects how Dr. Venn approaches treatment. A restricted SI joint may require a different strategy than an SI joint that is already excessively mobile or unstable. When stability is part of the problem, strengthening and spinal rehabilitation may be particularly important alongside any appropriate chiropractic care.
How Does Dr. Venn Treat SI Joint Dysfunction?
Treatment begins with determining what type of SI joint problem is actually present. Dr. Venn does not automatically adjust an SI joint simply because the patient has pain in that area.
When the examination identifies a restricted SI joint that is not moving appropriately, Dr. Venn may use a specific chiropractic adjustment to improve motion and mechanics through the affected joint. Using the Gonstead System, the adjustment is directed toward the specific joint and direction of correction identified during the examination rather than using generalized twisting or routinely adjusting both sides of the pelvis.
When excessive movement or instability appears to be part of the problem, the treatment strategy may be different. In those cases, repeatedly trying to create more movement in an already mobile joint may not address what the patient needs. Stabilization and spinal rehabilitation may become a more important part of the treatment plan.
Dr. Venn also evaluates how the SI joint is interacting with the lumbar spine and surrounding structures. If another problem—such as a lumbar disc condition—is contributing to the patient’s symptoms, that condition may need to be addressed as part of the overall treatment plan.
The goal is not simply to adjust where it hurts. It is to identify the mechanical problem and choose the treatment that fits what Dr. Venn actually finds.
Your SI Joint Treatment Plan Is Based on What We Find
There is no single treatment plan that is appropriate for every patient with SI joint pain. Care depends on whether the primary problem involves restricted joint motion, instability, compensation from another area, an injury, or another condition producing similar symptoms.
Depending on the examination findings, your treatment plan may include:
- Specific Gonstead adjustments when restricted joint motion is identified
- Spinal rehabilitation and stabilization exercises when additional support and control are needed
- Movement recommendations based on activities or positions that aggravate the joint
- Postural or ergonomic changes when repetitive loading is contributing to the problem
- Treatment of related spinal or pelvic problems when they are contributing to abnormal mechanics
If the examination indicates that a herniated or bulging disc or another lumbar disc problem is also contributing to the symptoms, spinal decompression may be considered as part of the overall treatment plan. Decompression is not used simply because pain is located near the SI joint; there should be findings indicating that disc involvement is actually part of the problem.
As care progresses, Dr. Venn evaluates how you are responding and modifies his recommendations when appropriate. The goal is to address the findings contributing to the problem rather than placing every SI joint patient on the same treatment protocol.
What Improvement Can Look Like With SI Joint Care
When the SI joint is actually contributing to a patient’s symptoms and the underlying mechanical problem is appropriately addressed, improvement may involve more than simply noticing a lower pain number.
Depending on the individual problem, patients may notice:
- Less one-sided lower back pain
- Reduced pain around the buttock, hip, or pelvis
- Less discomfort when getting up from a chair
- Greater comfort when standing or walking
- Less pain when climbing stairs or changing positions
- Improved confidence putting weight through the affected side
- Better tolerance for exercise, work, or everyday activities
- Fewer limitations from movements that previously aggravated the area
Dr. Venn also looks at whether the mechanical findings identified during the examination are changing—not just whether the patient temporarily feels better after an adjustment.
The outcome that matters is whether the patient is making meaningful progress in the problem that originally brought them into the office. If that isn’t happening as expected, Dr. Venn reevaluates the diagnosis and treatment strategy rather than simply continuing the same care indefinitely.
SI Joint Pain vs. Disc Pain vs. Sciatica: How Can You Tell the Difference?
SI joint dysfunction, lumbar disc problems, and sciatica can produce symptoms in similar areas, which is one reason patients sometimes assume they know the cause of their pain based on where it hurts.
SI joint pain is often concentrated around one side of the lower back, back of the pelvis, or buttock and may extend into the hip, groin, or upper leg. Certain movements—such as standing from a chair, climbing stairs, rolling over in bed, or putting more weight through one leg—may aggravate it.
A lumbar disc or nerve-root problem can also cause lower-back or buttock pain, but may be more likely to produce symptoms that travel farther into the leg. Numbness and tingling, altered sensation, weakness, or other neurological findings can increase suspicion that a nerve is involved.
These patterns are helpful, but symptoms alone cannot reliably determine which structure is causing the problem. A patient can have an SI joint problem and a lumbar disc problem at the same time, and pain around the pelvis can also originate from the hip or other structures.
Dr. Venn therefore evaluates the patient’s symptom pattern together with spinal and SI joint motion, orthopedic and neurological findings, and imaging when clinically appropriate. The purpose is to determine whether the primary problem appears to involve the SI joint, lumbar spine, disc, nerve, or a combination of structures.
That distinction directly affects treatment. A restricted SI joint may respond to a specific adjustment, while instability may require greater emphasis on stabilization and spinal rehabilitation. When a disc problem is actually contributing to nerve irritation, spinal decompression may be considered when appropriate.
The goal is to treat the problem identified during the evaluation—not simply the area where the patient happens to feel pain.
Conditions That Can Overlap With SI Joint Pain
Because SI joint symptoms can resemble pain coming from other structures in the lower back, pelvis, and nerves, Dr. Venn may consider several possible sources during the evaluation.
These can include:
The presence of one condition does not rule out another. Some patients have more than one problem contributing to their symptoms, which is why identifying the primary pain generator and any contributing problems is important before determining the treatment plan.
When Should Lower Back or SI Joint Symptoms Be Evaluated Urgently?
Most mechanical SI joint problems do not require emergency care. However, some symptoms can indicate a more serious neurological, traumatic, or medical condition that should be evaluated promptly.
Seek appropriate medical evaluation if you experience new or progressive leg weakness, loss of bladder or bowel control, numbness in the groin or saddle area, significant trauma, unexplained fever, or other signs of serious illness along with your back or pelvic symptoms.
Dr. Venn also pays attention to neurological findings during the examination. If your symptoms or examination suggest that the problem falls outside the appropriate scope of chiropractic care, he will recommend medical evaluation or referral rather than continuing chiropractic treatment for a condition that requires a different type of care.
Frequently Asked Questions
How can I tell if my pain is coming from the SI joint?
SI joint pain is often felt on one side of the lower back, buttock, or pelvis and may be aggravated by movements such as getting up from a chair, climbing stairs, rolling over in bed, walking, or putting more weight through one leg.
However, symptoms in this area can also come from a lumbar disc problem, sciatica or nerve irritation, the hip, or another musculoskeletal condition. The location of the pain by itself is not enough to confirm that the SI joint is responsible.
Dr. Venn evaluates the pattern of your symptoms together with spinal and SI joint motion, orthopedic and neurological findings, and imaging when clinically appropriate. He also looks for whether the SI joint appears restricted, excessively mobile or unstable, or whether another structure is more likely to be producing the symptoms.
The goal is to identify the most likely source of the pain before deciding what should be treated.
Not necessarily. Many patients with SI joint dysfunction improve when the underlying mechanical problem is correctly identified and addressed.
How quickly and completely someone improves can depend on factors such as how long the problem has been present, whether the joint is restricted or unstable, previous injuries, pregnancy-related changes, surrounding muscle and joint function, and whether another lower-back or disc problem is also contributing to the symptoms.
For a restricted SI joint, improving joint mechanics may be an important part of care. When instability or excessive movement is involved, spinal rehabilitation and stabilization may play a larger role.
Dr. Venn monitors both the patient’s symptoms and functional progress throughout care. If the patient is not improving as expected, he reevaluates the problem rather than assuming that continuing the same treatment is automatically the answer.
Are SI joint adjustments safe?
SI joint adjustments are performed only after Dr. Venn evaluates the patient and determines that an adjustment is appropriate for the type of joint dysfunction he identifies.
This distinction is important because not every painful SI joint should automatically be adjusted. If the joint appears restricted and is not moving appropriately, a specific adjustment may be used to improve its mechanics. If the examination instead suggests excessive movement or instability, creating additional motion may not be the appropriate goal.
Using the Gonstead System, Dr. Venn determines which joint requires attention and the appropriate direction of correction rather than routinely twisting or adjusting both sides of the pelvis.
The patient’s health history, previous injuries, symptoms, examination findings, and other relevant factors are also considered before treatment is recommended. The goal is to use an adjustment when the examination indicates that an adjustment is appropriate—not simply because the patient has pain near the SI joint.
Yes, SI joint symptoms can return, particularly if the factors that contributed to the original problem are still present. Recurrence may be influenced by previous injuries, repetitive activities, instability, changes in movement or loading, pregnancy-related changes, or problems elsewhere in the spine or pelvis.
If symptoms return, Dr. Venn does not automatically assume that the same SI joint needs to be adjusted again. He reevaluates the area to determine whether the joint is restricted, unstable, compensating for another problem, or whether something else is now contributing to the symptoms.
For some patients, improving strength and control through spinal rehabilitation can be an important part of reducing recurring mechanical stress. Others may need changes in activities, movement patterns, or treatment of another contributing problem.
Recurring pain is a reason to determine why the problem keeps returning—not simply a reason to repeat the same adjustment indefinitely.
Find Out What’s Causing Your SI Joint or Pelvic Pain
If you’re dealing with one-sided lower back pain, buttock or pelvic discomfort, pain when standing or walking, or symptoms that feel similar to sciatica, the first step is determining where those symptoms are actually coming from.
Dr. Venn will evaluate your lower spine, sacrum, pelvis, SI joints, and relevant neurological findings to determine whether the problem appears to involve a restricted SI joint, instability, a lumbar disc problem, nerve irritation, or another contributing condition.
With more than 25 years of chiropractic experience, Dr. Venn bases his treatment recommendations on what he finds during the evaluation rather than assuming every patient with pain near the SI joint needs the same treatment.
Contact Venn Chiropractic and Wellness Center in Frisco to schedule an evaluation with Dr. Venn.
Reviewed by Dr. Jason Venn, DC
Doctor of Chiropractic | 25+ Years of Clinical Experience
This page has been reviewed by Dr. Jason Venn for clinical accuracy and reflects his experience evaluating and caring for patients with sacroiliac joint dysfunction, pelvic pain, and related lower-back conditions.
Venn Chiropractic and Wellness Center | Frisco, TX
