SI Joint Pain: What That One-Sided Low Back Ache Could Mean

If you have a deep ache low in your back, just to one side of your spine, right around the dimple above your buttock, the source may be your sacroiliac joint, often called the SI joint. SI joint pain is easy to confuse with a regular low back strain, a hip problem, or even sciatica, and that confusion is one reason it can linger. Here in Hot Springs, we see it in all kinds of people, from new moms and runners to folks who spend a long weekend moving furniture or working in the yard.

This post explains what the SI joint is, what SI joint pain usually feels like, what tends to aggravate it, and what care can look like. It is general information, not a diagnosis.

What Is the SI Joint?

You have two sacroiliac joints, one on each side, where the base of your spine (the sacrum) meets the pelvis. These joints do not move much, but they play a big role in carrying the weight of your upper body down into your legs and absorbing force every time you walk, climb stairs, or step off a curb. Strong ligaments hold them together. When the joint or the tissues around it get irritated, the result can be pain that feels surprisingly sharp for such a small amount of motion.

What SI Joint Pain Usually Feels Like

Everyone is a little different, but common descriptions include:

• A dull or sharp ache on one side of the low back, near the top of the buttock
• Pain that can spread into the buttock, groin, or the back of the thigh, usually not below the knee
• Pain when standing up from a chair, getting out of the car, or rolling over in bed
• Discomfort climbing stairs or standing on one leg, such as when putting on pants
• Stiffness after sitting for a long time, like a long drive or a full day at a desk

Because these symptoms overlap with other problems, a careful exam matters. Pain that shoots below the knee with numbness or tingling, for example, may point more toward an irritated nerve, which we covered in our post on sciatica.

Common Causes and Triggers

Uneven or repetitive loading

Activities that load one leg more than the other, such as running on a sloped shoulder, carrying a child on one hip, or always stepping off with the same foot, can irritate the joint over time.

A fall or sudden jolt

Landing hard on your buttock, missing a step, or a sudden jolt in a car accident can strain the ligaments around the SI joint.

Pregnancy and the months after

Hormonal changes in pregnancy loosen the pelvic ligaments to prepare for delivery, and the extra weight changes how you stand and walk. SI joint discomfort is a common complaint during and after pregnancy.

Stiffness or weakness in nearby areas

Tight hips, weak glute and core muscles, or a stiff lower back can shift more stress onto the SI joint. Long hours of sitting can make this worse.

What You Can Try at Home

• Keep moving gently. Short, easy walks are often better than long periods of sitting or lying down.
• Break up sitting time. Stand and move every 30 to 45 minutes, especially on long drives.
• Sleep with support. Side sleepers often find a pillow between the knees more comfortable. Back sleepers may like a pillow under the knees.
• Move symmetrically. When getting out of the car, swing both legs out together. Take stairs one at a time if they flare your pain.
• Use heat or ice for comfort. Use whichever feels better, for about 15 to 20 minutes at a time, with a cloth between it and your skin.
• Go easy on aggravating activities. Back off long runs, heavy lifting, or lopsided carrying for a while rather than pushing through sharp pain.

When to Get It Checked

Consider an exam if the pain lasts more than a couple of weeks, keeps coming back, is affecting your sleep or work, or started after a fall or accident. Please seek medical care right away if you have back pain with fever, unexplained weight loss, numbness in the groin or inner thighs, new trouble controlling your bladder or bowels, or weakness in your legs.

How Lake Hamilton Family and Sports Chiropractic Can Help

At Lake Hamilton Family and Sports Chiropractic, Dr. Tyler Kight starts by listening to your history and examining how your low back, pelvis, and hips are moving. The goal is to figure out whether the SI joint is likely the main source of your pain or whether something else, such as a disc or hip issue, fits better. If chiropractic care is not the right fit, he will refer you to the appropriate provider.

When care is appropriate, it may include gentle adjustments, soft tissue work, and simple exercises to improve how your hips and core support the pelvis. Research on SI joint pain is still growing, and results vary from person to person, so we focus on a clear plan and check in on how you are responding. You can read more about our approach on our back pain relief in Hot Springs page.

Our Hot Springs office is at 1880 Airport Rd, Suite B, and is open Monday through Friday from 8:30am to 5:30pm. Call (501) 762-9648 or book your appointment online. To learn more about our team and services, visit the Lake Hamilton Family and Sports Chiropractic home page.

SI Joint Pain FAQ

How do I know if my pain is from the SI joint or my lower back?

It can be hard to tell on your own because the symptoms overlap. SI joint pain is usually felt on one side, low near the top of the buttock, and often flares with standing up, stairs, or standing on one leg. An exam with a few specific movement tests helps sort it out.

Is SI joint pain the same as sciatica?

No. Sciatica comes from irritation of the sciatic nerve and often causes pain, numbness, or tingling down the leg, sometimes below the knee. SI joint pain can spread into the buttock or thigh but usually comes from the joint itself.

How long does SI joint pain take to get better?

Many flare-ups settle within a few weeks with activity changes and care, while longer-lasting cases may take more time. Your provider can give you a better idea after an exam.