Condition
SI Joint & Pelvic Pain
SI joint and pelvic pain show up as one-sided lower back, buttock, or pelvic pain. Often worse with rolling over in bed, prolonged sitting, or single-leg standing. The SI joint itself is rarely the original problem. The kinetic chain framework finds the upstream input. Lost hip extension, weak glute control, a thoracic spine that stopped rotating. And resolves the joint shear by addressing what is loading it.
Where it actually starts
The SI joint sits between the sacrum and the ilium. Connecting the spine to the pelvis. It is built for stability, not motion. When stability fails, the joint shears and produces pain. The pattern that drives most chronic SI joint pain is upstream: a hip that lost extension, glutes that stopped firing, a thoracic spine that stopped rotating. The pelvis compensates by absorbing motion the rest of the chain should be doing. Pregnancy, prolonged sitting, post-surgical recovery, and any functional leg-length discrepancy can be the trigger that exposes the underlying pattern.
Common symptoms
- One-sided pain in the lower back, buttock, or pelvis
- Pain with rolling over in bed or transitioning positions
- Pain with prolonged sitting or standing
- Pain on stairs or single-leg standing
- Sharp catching pain with twisting or stepping off a curb
- Pelvic-floor or groin pain that may radiate down the back of the leg
How we treat it
We treat the local SI joint with manual therapy and joint mobilization, plus dry needling into the deep glute, piriformis, and lumbar paraspinals when those are locked in protective tension. The RX2600 addresses chronic tightness across the posterior pelvis. The lasting change comes from restoring hip extension, retraining glute control, and rebuilding the thoracic rotation that stops the pelvis from absorbing every motion. Pregnant and post-partum cases get adapted protocols that respect the timeline and tissue tolerance of recovery.
Modalities we use
The tools behind the treatment.
Dry Needling
Thin filament needles release deep trigger points and restore movement faster than manual work alone.
Read moreManual Therapy
Joint mobilization and myofascial work delivered one-on-one with your therapist. No aides, no handoffs.
Read moreThe RX2600 Therapeutic Robot
Sustained pressure, targeted heat, and controlled vibration that hands cannot replicate. The only RX2600 Therapeutic Robot in the region.
Read moreSoft Tissue Mobilization
Hands-on release of trigger points and tight tissue around the joint or chain you’re working on.
Read moreCorrective Exercise and Movement Training
Prescribed corrective work that retrains how your body moves and locks in the gains we make in clinic.
Read moreRelated conditions
Often connected.
Back Pain
Most back pain isn’t a back problem. It’s a hip, an ankle, or a thoracic spine that stopped moving.
Read moreHip Pain
Your hip might be reacting to what your ankle isn’t doing. We trace it back to find the actual source.
Read moreSciatica
Sharp, radiating pain through the leg. We find what’s compressing the nerve and resolve it at the source.
Read moreCommon questions
Common questions.
How do I know if my pain is from my SI joint or my lumbar spine?
The kinetic chain assessment includes specific tests that differentiate SI joint pain from lumbar disc, facet, and muscular sources. The treatment plan changes based on what we find. Mistaking one for the other is a common reason chronic pelvic pain doesn't resolve.
Is SI joint pain common after pregnancy?
Yes. Pregnancy hormones soften the SI joint ligaments to allow the pelvis to expand for delivery. Then strength and stability take time to return. We work with new mothers on adapted protocols that respect the post-partum timeline and rebuild stability around the joint without aggravating it.
Will I need an SI joint injection or fusion?
Rarely. Most SI joint pain resolves with kinetic chain treatment that addresses the upstream input, not the joint itself. Injections and fusions are downstream options when conservative care has failed and structural pathology is confirmed. We will be straight with you if your case is in that category.
Can I keep working out with SI joint pain?
Often, with modifications. We identify which lifts, postures, and motions are loading the joint and adjust until the underlying pattern changes. Total avoidance of training is rarely the right answer.
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