Sacroiliac Joint (SIJ) Dysfunction
Relieve lower back, pelvic, and buttock pain with personalised, evidence-based treatment designed to restore pelvic stability, improve movement, and support long-term recovery.
Understanding SIJ Dysfunction
The sacroiliac joints connect the sacrum to the iliac bones of the pelvis, transmitting load between the spine and lower limbs. SIJ dysfunction — either hypermobility (too much movement) or hypomobility (too little) — is a commonly overlooked cause of low back and pelvic pain, accounting for 15–25% of chronic low back pain presentations. It closely mimics lumbar disc and facet pain and is frequently misdiagnosed.
Causes
- Pregnancy and post-partum – hormonal changes and altered pelvic loading.
- Trauma – falls, motor vehicle accidents, or sudden asymmetrical force.
- Leg length discrepancy creating pelvic asymmetry.
- Lumbar spinal fusion – altering load distribution to the SIJ.
- Inflammatory arthritis – ankylosing spondylitis or psoriatic arthritis.
- Altered gait or lower limb dysfunction.
Symptoms
- One-sided pain in the lower back, buttock, or posterior pelvis.
- Pain radiating to the groin, hip, or thigh (rarely below the knee).
- Pain with prolonged sitting, standing, or walking.
- Difficulty transitioning from sitting to standing.
- Pain when rolling in bed or climbing stairs.
- Tenderness directly over the SIJ.
Symptoms
- One-sided pain in the lower back, buttock, or posterior pelvis.
- Pain radiating to the groin, hip, or thigh (rarely below the knee).
- Pain with prolonged sitting, standing, or walking.
- Difficulty transitioning from sitting to standing.
- Pain when rolling in bed or climbing stairs.
- Tenderness directly over the SIJ.
Treatment
- SIJ mobilisation and manipulation.
- Pelvic and gluteal stabilisation exercises.
- SIJ belt or support for unstable presentations.
- Core and lumbopelvic stability training.
- Gait correction and movement retraining.
- Post-partum pelvic rehabilitation.
Rehabilitation & Exercise
Caution: Perform all exercises only as directed by your Healthweave clinician. Stop any exercise that increases your pain and inform your practitioner. Exercise programs are tailored to individual needs and must not be self-prescribed.
SIJ rehabilitation focuses on restoring pelvic stability and motor control, correcting the muscle imbalances that create joint stress, and gradually reloading the pelvis with progressively challenging exercises.
- Gluteal and hip stabiliser strengthening.
- Pelvic floor and deep core activation.
- Bridge exercises – single and double leg progressions.
- Side-lying hip abduction for gluteus medius activation.
- SIJ belt use during high-load activities under clinician guidance.
- Posture correction and walking gait modification.
Specialist & Regenerative Medicine Options
For SIJ pain that is severe, persistent, or confirmed on diagnostic injection, our Prestidge sports physicians can offer targeted treatments to manage pain and address joint pathology.
- SIJ Corticosteroid Injections – fluoroscopy or ultrasound-guided injections provide effective pain relief where inflammation is the primary driver.
- Platelet Rich Plasma (PRP) – image-guided PRP injection into the SIJ may reduce inflammation and support joint health.
- Prolotherapy – well-established for SIJ laxity and instability, particularly in post-partum presentations.
- Radiofrequency Ablation (RFA) – for chronic confirmed SIJ pain, lateral branch ablation can provide extended relief.
- Stem Cell Therapy – for degenerative SIJ disease within TGA guidelines.
Our sports and exercise physicians at Prestidge work alongside your treating clinician to determine the most appropriate option for your condition, goals, and stage of recovery. All injectable and prescription treatments are subject to individual clinical assessment. Visit healthweave.com.au or prestidge.com to learn more.
Important: All specialist consultations, prescription treatments, and injectable procedures are subject to individual clinical assessment by a registered medical practitioner. Suitability, benefits, and risks will be discussed at your consultation. No outcomes are guaranteed. Prescription medicines are only available following appropriate medical review in accordance with TGA and AHPRA requirements. Exercise programs should be performed only as directed by your Healthweave clinician. Exercise images © CPDO / Educom Pty. Ltd. — used under licence.