Targeted chiropractic care to restore normal pelvic motion and relieve one-sided low back and buttock pain.
Sacroiliac (SI) joint dysfunction is pain caused by abnormal motion or inflammation in the joints that connect the base of the spine to the pelvis, usually felt as one-sided lower back or buttock pain that worsens with sitting, standing, or climbing stairs.
You have two sacroiliac joints, one on each side, where the triangular sacrum at the base of your spine meets the wings of the pelvis. These joints are wrapped in thick ligaments and are built for stability rather than movement, transferring load between your spine and your legs every time you walk, sit, or stand. When one of them becomes stuck and moves too little, or loosens and moves too much, the result is the deep, nagging, one-sided pain that defines SI joint dysfunction.
At Advanced Wellness Chiropractic in Bridgeton, MO, SI joint dysfunction is one of the most commonly missed drivers of one-sided lower back pain. Patients often arrive after weeks or months of being treated for a disc or a muscle strain that never quite added up, because the true source was the pelvis the whole time. The pain typically sits low and to one side, just below the belt line, and can refer into the hip, groin, or upper thigh.
The key to getting it right is a careful exam that distinguishes SI joint pain from sciatica and from true hip pain, since each one looks similar from the outside but responds to a different treatment plan. Once the pelvis is identified as the source, conservative chiropractic care is usually all that is needed to settle the joint down and keep it there.
Most SI joint and low back pain responds well to conservative chiropractic care, but certain warning signs mean you should go to an emergency department or contact your primary care provider right away rather than waiting for a chiropractic evaluation:
SI joint dysfunction has a recognizable pattern once you know what to look for. The following are the symptoms our patients report most often.
These are simplified versions of the provocation tests Dr. JC uses in the office to decide whether your pain is coming from the SI joint rather than the disc or hip. None of them replace a proper exam, but if one or more reproduces your familiar one-sided pain, the pelvis is a likely culprit. Stop any check that causes sharp pain or sudden weakness, and skip them entirely if you have any of the red-flag symptoms above.
How to do it
When your pain is at its worst, point with one finger to the exact spot that hurts most without thinking about it too hard.
What to watch for
If your finger lands on the small bony dimple just below the belt line and to one side of the spine, that points toward the SI joint. Pain you wave a whole hand over is more typical of muscular or disc pain.
What it suggests
A precise, one-sided point of pain over the joint is one of the most consistent signs that the sacroiliac joint is the source.
How to do it
Lie on your back and rest the ankle of the painful side on the opposite bent knee, making a figure 4. Let the bent knee relax gently toward the floor.
What to watch for
Pain felt in the back of the pelvis or buttock on the side being tested. Pain felt deep in the groin instead usually points toward the hip joint rather than the SI joint.
What it suggests
Reproducing your typical buttock pain in this position is a classic sign of SI joint involvement and helps separate it from a hip problem.
How to do it
Stand near a counter or wall for safety. Slowly lift the knee on your painful side up toward your chest as if marching, and hold the single-leg position briefly.
What to watch for
A pinch or deep ache low in the back or buttock on the standing or lifting side, or a sense that the pelvis feels unstable as you load it.
What it suggests
Pain or instability when loading one side of the pelvis suggests the SI joint is not transferring load smoothly, a hallmark of dysfunction.
If one or more of these reproduces your familiar pain, the next step is a full evaluation. Dr. JC will examine the pelvis, lumbar spine, and hips together to confirm the SI joint is the driver and rule out sciatica or a hip issue before building your plan.
Chiropractic care helps SI joint dysfunction by addressing the mechanics of the joint directly. A precise chiropractic adjustment restores normal motion to a sacroiliac joint that has become stuck or misaligned, which relieves the irritation and inflammation responsible for the pain. Because the SI joint is meant to move only slightly, restoring that small, normal glide often produces noticeable relief.
Adjustments are only part of the picture. The muscles around a dysfunctional SI joint, especially the glutes and deep hip rotators, tend to tighten and guard, which keeps pulling the joint back out of position. Soft-tissue work such as the Graston Technique and Pin and Stretch therapy releases this tension so the adjustment can hold, and gentle flexion-distraction can offload the joint when the surrounding lumbar spine is also involved.
Research supports conservative, hands-on care as a sensible first-line approach for sacroiliac and mechanical low back pain, ahead of injections or surgery. Just as important as relieving the current flare-up is keeping it from returning, which is where pelvic stabilization exercises come in. By retraining the deep core and hip muscles to hold the pelvis steady, most patients can manage the condition long-term and avoid repeat episodes.
We tailor every SI joint treatment plan to the individual based on a thorough examination of the pelvis, lumbar spine, and hips. Your care plan may include:
Precise, low-force adjustments to restore normal motion to a sacroiliac joint that has become stuck or misaligned.
A gentle, non-thrusting technique that offloads the lumbar spine and pelvis when both are contributing to the pain.
Graston Technique and Pin and Stretch to release the tight glutes and hip rotators that keep pulling the joint out of position.
Targeted core and hip retraining so the pelvis holds its position between visits and the relief lasts.
These are the exercises Dr. JC most often sends home with SI joint patients. The goal is to calm the joint, release the muscles that crowd it, and rebuild the deep stability that keeps the pelvis steady. Keep every movement gentle and pain-free, and stop any exercise that sharpens your one-sided pain or makes it travel down the leg.
Releases the deep gluteal muscles that tighten and guard around a dysfunctional SI joint.
Dosage: Hold 30 seconds, 3 reps, twice daily.
Strengthens the glutes and posterior pelvis so the SI joint is supported through everyday movement.
Dosage: 10 reps, 2 sets, once daily.
Wakes up the deep core that stabilizes the pelvis and eases early-morning stiffness in the low back.
Dosage: 10 reps, 2 sets, twice daily.
Gently engages the inner-thigh and pelvic-floor muscles that help compress and stabilize the SI joints.
Dosage: 10 reps, 2 sets, once daily.
Home exercises are powerful, but they are one piece of a larger plan. Most patients with SI joint dysfunction also have a joint that is stuck or moving abnormally, and stabilization work alone will not restore that motion. If your symptoms are not clearly improving after two to three weeks of consistent home exercise, or the pain keeps returning to the same spot, come in for an evaluation so we can find and treat what is driving it.
Certain jobs, activities, and life stages drive most of the SI joint cases we treat at Advanced Wellness Chiropractic. If you recognize yourself in one of these, you are not alone, and conservative chiropractic care is often all you need to get the pelvis moving and feeling right again.
SI joint pain is one of the most common complaints of the late second and third trimesters, as pregnancy hormones loosen the pelvic ligaments and the joint becomes less stable. Gentle, pregnancy-safe care gives most patients meaningful relief.
The pelvis stays loose for months after delivery, and constant lifting, carrying, and one-sided nursing positions can keep an SI joint irritated. We see this pattern often in new mothers across North County.
Patients from Centene, World Wide Technology, Edward Jones, and other corporate offices who sit eight-plus hours a day. Prolonged sitting compresses one side of the pelvis and is a leading driver of SI joint pain.
Hours of seated vibration with the pelvis tilted toward the pedals, then heavy lifting at the dock. Truckers and delivery route drivers are a classic SI joint demographic in our clinic.
The sudden force of a car accident can jam or destabilize a sacroiliac joint, sometimes overshadowed by neck and back complaints at first. We evaluate the whole pelvis after a collision.
A slip on ice or a fall directly onto the buttock or tailbone is a frequent trigger. The impact drives one side of the pelvis out of its normal position and sets off one-sided pain.
The Amazon, Walmart, and Schnucks hubs around North County run on repeated lift, twist, and lower cycles. Twisting under load is hard on the SI joints as well as the lumbar discs.
Repetitive one-sided impact from running, plus weekend rounds of golf, gardening, or pickup sports after a sedentary week, can overload a pelvis that is not used to the demand.
When a segment of the lower spine is fused, the SI joints below take on extra motion and load. This is a well-recognized cause of new one-sided pain in fusion patients.
If your SI joint pain followed a car accident or is work-related, Dr. JC can help document the injury and coordinate with your auto-injury or workers' compensation carrier. We see patients from Bridgeton, Maryland Heights, Hazelwood, Florissant, St. Ann, Creve Coeur, and across North County St. Louis.
SI joint dysfunction refers to pain that comes from abnormal motion or inflammation in the sacroiliac joints, the two joints that connect the base of your spine (the sacrum) to the pelvis. These joints are not built to move much, so when one becomes too stiff or moves too freely, it can produce a deep, one-sided ache low in the back or in the buttock. It is a mechanical problem with the joint itself, not a problem with the nerve or the disc.
They overlap, which is exactly why SI joint dysfunction is so often missed. Sciatica is nerve pain that shoots well past the knee and is usually driven by a compressed nerve root in the lumbar spine. SI joint pain tends to stay low on one side of the back or in the buttock and may refer into the hip or groin, but rarely travels below the knee. True hip pain is usually felt deeper in the groin and worsens with rotation. Dr. JC uses specific orthopedic tests during the exam to tell these apart, since each one responds to a different treatment approach.
Common drivers include pregnancy and the postpartum period, when hormones loosen the pelvic ligaments and the joint becomes less stable; prolonged sitting in desk workers and drivers; a fall onto the buttock or tailbone; and the impact of a car accident. Leg-length differences, repetitive one-sided loading, and previous lumbar fusion can also overload the joint. In many patients it is simply a buildup of these factors over time rather than one single event.
Chiropractic care addresses the mechanical cause directly. Specific adjustments restore normal motion to a sacroiliac joint that has become stuck or misaligned, which relieves the irritation and inflammation that produce the pain. Soft-tissue work releases the surrounding gluteal and hip muscles that tighten in response to the dysfunction, and targeted stabilization exercises retrain the pelvis to hold its position. This combination relieves current symptoms while reducing the chance the joint slips back into the same pattern.
The vast majority of SI joint dysfunction responds well to conservative care and does not require surgery. Surgical fusion of the joint is reserved for a small number of cases that fail months of appropriate non-surgical treatment. Most major insurance plans cover medically necessary chiropractic care, and our Bridgeton office is happy to verify your benefits before your first visit so you know your coverage up front.
Many patients notice meaningful relief within the first few visits as normal joint motion is restored, with most cases settling over a four-to-eight-week course of care depending on how long the problem has been present and what is driving it. Acute flare-ups, such as a recent fall, often respond faster, while long-standing dysfunction tied to posture or pregnancy may take longer and relies heavily on consistent home stabilization work.
Yes. SI joint pain is one of the most common complaints we see during pregnancy and the postpartum period, because the same hormones that prepare the pelvis for delivery also loosen the SI ligaments. Dr. JC uses gentle, pregnancy-safe techniques and positioning, along with stabilization exercises that are appropriate for each stage. Our Bridgeton office regularly cares for expecting and new mothers with pelvic and low-back pain.
Yes. A fall or a car accident is a frequent trigger for SI joint dysfunction, and we see patients from Bridgeton, Maryland Heights, Hazelwood, Florissant, and across North County St. Louis for exactly this. If your pain followed a collision, Dr. JC can evaluate the pelvis and lumbar spine, document the injury, and coordinate with your auto-injury or workers' compensation carrier where applicable.
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These conditions often share the same root causes and respond to the same chiropractic care. Explore how we treat each one.
Precise adjustments restore normal motion to a stuck or misaligned sacroiliac joint.
Learn MoreSI joint dysfunction is a commonly missed driver of one-sided lower back pain.
Learn MoreLearn how SI joint pain differs from true sciatic nerve pain and why the distinction matters.
Learn MoreKnow the signs that one-sided back pain needs a chiropractic evaluation.
Learn MoreAdvanced Wellness Chiropractic
Pain rarely fixes itself. The longer a problem goes untreated, the longer it usually takes to heal. The sooner we find the cause, the sooner you feel like yourself again.
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