A deep ache on one side of your low back or buttock, right around the dimple, that flares when you climb stairs, roll over in bed or stand on one leg. That pattern often points to the sacroiliac joint.
Yes, physical therapy can help sacroiliac (SI) joint pain. The SI joints connect the base of your spine to your pelvis, one on each side. When a joint and the tissues around it are irritated, exercise to strengthen the hips and trunk, hands-on treatment and changes to daily movement often help. At ARI Physical Therapy in Bakersfield, every visit is one-on-one with a licensed physical therapist.
Does this sound like you?
✓Pain on one side of the low back or buttock, near the dimple at the back of the pelvis
✓Pain that spreads into the buttock, groin or back of the thigh, usually not below the knee
✓Pain climbing stairs, standing on one leg or putting on pants
✓Pain rolling over in bed or getting in and out of the car
✓Sitting on the sore side or standing for a long time makes it worse
✓Pain that started after a fall onto your buttock, or during or after pregnancy
What the SI joint is and why it hurts
You have two SI joints, where the sacrum, the flat bone at the base of your spine, meets the pelvis. They are strong, tightly braced joints that move only a little, and they pass the weight of your upper body down to your legs. They can get irritated by:
Pregnancy, when hormones loosen the pelvic ligaments and your posture changes. Pain at the back of the pelvis is very common in pregnancy. See back and pelvic pain during pregnancy.
A fall onto the buttock, or a jolt like missing a step.
Repeated one-sided loading from running, lifting or twisting.
Changes in how you move after a hip, knee or foot problem, or after a low back fusion.
Arthritis, including types of inflammatory arthritis that affect the SI joints.
Is it really “out of place”?
Many people are told their SI joint has “slipped” or is “out.” Because these joints are so tightly braced, they rarely move out of place. The pain usually comes from an irritated joint and the ligaments and muscles around it, and it often settles with the right strengthening and movement.
SI joint pain can also be hard to tell apart from pain coming from the low back or the hip, so your evaluation checks all three. See our sciatica and back pain and hip pain guides.
How physical therapy helps
Treatment usually combines hands-on care to ease pain, exercises that strengthen the hip, buttock and deep trunk muscles so the pelvis is better supported, and easier ways to do the things that flare it up, like stairs, getting dressed and turning in bed. A support belt helps some people for a while, especially during pregnancy, and your therapist can tell you whether one is likely to help you. After your baby arrives, see postpartum therapy.
What treatment at ARI looks like
1
A one-on-one evaluation
Your first visit takes about 45 to 60 minutes. We check your low back, hips and pelvis, test your strength, watch how you walk, stand on one leg and climb stairs, and use a group of specific tests to see whether the SI joint is the likely source.
2
Calm and support
Hands-on treatment to ease pain, strengthening for the hips, buttocks and trunk, and simple changes to how you sit, sleep, climb stairs and get out of the car.
3
Steady and strong
Exercise that builds up to the lifting, running, work or childcare you need to do, and a home program to keep your pelvis well supported.
No referral needed to start. In California, you can see a physical therapist directly for up to 12 visits or 45 days, whichever comes first. Some insurance plans still require a referral for coverage; call us at (661) 282-8584 and we'll help you check.
When to see a doctor first
See a doctor promptly if you have:
Numbness in the groin, buttocks or inner thighs, or new trouble controlling your bladder or bowels. These can be signs of cauda equina syndrome: get emergency care
Leg or foot weakness that is getting worse
Back or buttock pain with fever, chills or feeling unwell, which can be an infection
Back or buttock pain that started at a young age, has lasted for months, comes with morning stiffness that eases with movement, and wakes you in the second half of the night, which can be inflammatory arthritis
Pain after a fall or accident, especially if you have osteoporosis, or with a history of cancer or weight loss you can’t explain
During pregnancy: vaginal bleeding, leaking fluid, or back pain that comes and goes in waves, which needs a call to your OB right away
Why patients choose ARI
Care at ARI is always one-on-one and in person with a licensed physical therapist at our Bakersfield clinic: 8200 Stockdale Hwy, Suite B2, in the Town & Country Village center next to Trader Joe's. Our clinic director, Deepa Konnur, PT, MPT, OCS, is a board-certified Orthopedic Certified Specialist. We accept most private insurance plans and Medicare, and we have staff who speak Spanish and Hindi.
SI joint pain FAQs
It can be hard to tell. SI joint pain is usually on one side, near the dimple at the back of the pelvis, and it often hurts with stairs, standing on one leg or rolling over in bed. Pain that runs below the knee, or tingling in the foot, is more likely to come from the low back. A physical therapy evaluation uses a group of tests to sort it out.
Rarely. The SI joints are strong, tightly braced joints that move only a small amount. The pain usually comes from irritation of the joint and the tissues around it, and strengthening and hands-on treatment can help.
Yes. Pain at the back of the pelvis is very common during pregnancy, as hormones loosen the ligaments and your posture changes. For many women it improves after birth, and gentle physical therapy can help both during pregnancy and afterward.
A support belt helps some people, especially during pregnancy or for walking and standing tasks. It works best as a short-term aid alongside strengthening, not as the whole treatment. Your therapist can tell you whether one is likely to help you.
Many people are most comfortable on their side with a pillow between the knees, or on their back with a pillow under the knees. When you roll over, keep your knees together and turn your body as one unit.
No. In California you can see a physical therapist directly for up to 12 visits or 45 days, whichever comes first. Some insurance plans still require a referral for coverage, so call us at (661) 282-8584 and we'll help you check.