SI Joint Dysfunction

What is SI Joint Dysfunction?

The sacroiliac (SI) joints connect the spine to the pelvis. Dysfunction occurs when these joints become too stiff or unstable, causing low back or buttock pain.

Common Symptoms

• Pain in the lower back, buttocks, or groin

• Pain with standing, walking, or climbing stairs

• Asymmetrical pelvic alignment

• Sometimes radiating pain into the thigh

Physical Therapist Diagnosis

A PT uses history, palpation, and movement tests such as the FABER, Gaenslen’s, or compression tests. Functional assessment of gait and pelvic control provides additional clues.

Why it Happens

SI dysfunction often results from trauma, repetitive stress, pregnancy, or muscle imbalances around the pelvis.

Why it Doesn’t Always Heal on Its Own

Stiffness or instability typically persists without targeted intervention, leading to chronic pain or compensation elsewhere.

Ideal Physical Therapy Treatment

Treatment depends on whether the SI joint is too stiff or unstable. Dry needling may help reduce muscle tightness around the pelvis.

Key strategies include:

• Manual therapy to restore alignment and mobility

• Dry needling for surrounding glute and hip muscles

• Core and hip strengthening to stabilize the pelvis

• Postural retraining for daily movements

• Education for self-management strategies

Expected Outcomes

Most individuals improve within weeks with proper rehab. Long-term strengthening maintains stability.