Sacroiliac Joint Pain. What it is and how Telford Osteopaths can help.

Sacroiliac joint pain

Pain close to the dimples at the base of the back is sometimes described as sacroiliac joint pain. It may be felt mainly on one side and can become noticeable during activities such as standing up, turning in bed, climbing stairs or walking.

The phrase “sacroiliac joint dysfunction” is often used to describe this type of discomfort, but the location of pain does not confirm which structure is responsible. The lower back, hips, muscles and surrounding joints can produce overlapping symptoms, so assessment is important before drawing conclusions.

Osteopathy may be one option for some people with general backache or joint pain, depending on their symptoms, health history and individual assessment. Treatment responses vary.

What is sacroiliac joint pain?

The sacroiliac joints sit between the sacrum—the triangular bone at the base of the spine—and the two sides of the pelvis. They help transfer load between the upper body and the legs.

Pain in this region may be described as a deep ache, a localised sharp sensation or a feeling of stiffness around one side of the lower back or buttock. However, symptoms in this area do not always originate from the sacroiliac joint itself.

Similar discomfort can arise from the lower back, hip, surrounding muscles or other structures. This is why the term “sacroiliac joint dysfunction” should not be treated as a self-diagnosis.

Why does pain around this area happen?

There is not always one clear cause. Symptoms may be influenced by a combination of factors, including:

• A recent change in physical activity

• Repeated or unfamiliar loading

• Spending longer than usual in one position

• Changes in how the back, hips and pelvis are moving

• Muscle tension or reduced movement around the surrounding area

• A previous episode of lower-back or joint pain

Pain can also occur after injury or significant trauma. In those circumstances, medical assessment or imaging may be appropriate before considering treatment.

An assessment looks beyond the exact point of discomfort. It considers how the lower back, hips and pelvis are moving, what activities affect the symptoms and whether anything suggests that medical investigation is needed.

What symptoms do people commonly describe?

People with pain around the sacroiliac region sometimes report:

• An ache near one side of the base of the spine

• Discomfort extending into the buttock

• Pain when getting out of a chair

• Symptoms when turning over in bed

• Discomfort when climbing stairs

• Pain when standing on one leg to dress

• Stiffness after sitting or standing for a prolonged period

• Symptoms that change according to activity or position

These experiences are not specific to the sacroiliac joint. Pain travelling into the leg, altered sensation, weakness or other neurological symptoms require careful assessment because they may have a different source.

Everyday scenarios

Why does it catch when I stand after sitting?

Some people notice a brief catch or ache as they move from sitting to standing. This may reflect how the lower back, hips, pelvis and surrounding muscles have responded to being in one position.

The symptom alone does not identify a particular joint as the cause. Assessment may look at the movement itself, how long you have been sitting, whether the discomfort settles once you start walking and whether other activities produce similar symptoms.

Why does turning in bed make the area painful?

Rolling in bed involves movement through the lower back, pelvis and hips. If the area is already sensitive, this change in load may be uncomfortable.

An assessment may consider whether the pain occurs in both directions, whether particular sleeping positions affect it and whether symptoms are also present during daytime movement.

Why does it hurt when I climb stairs or stand on one leg?

Stairs, dressing and other single-leg activities place different demands on the hips and pelvis than standing evenly on both feet.

Pain during these movements may be associated with several musculoskeletal factors. It does not automatically mean that the pelvis is “out of alignment” or that a joint needs to be put back into place.

Why has an occasional ache become more frequent?

Symptoms can change when activity levels, working patterns, exercise, sleep or general health circumstances change. Sometimes people gradually avoid certain movements because they expect them to hurt, which can make day-to-day activity feel more restricted.

More frequent pain does not necessarily mean that damage is progressing. However, recurring, worsening or unexplained symptoms are reasonable grounds for seeking an assessment.

Will sacroiliac-region pain settle by itself?

Some episodes of lower-back or joint pain improve as normal movement becomes more comfortable and aggravating activities are adjusted. Other episodes persist, recur or interfere with daily activity.

How symptoms behave varies considerably. Factors such as general health, previous episodes, the nature of the symptoms and day-to-day demands can all influence the experience.

There is no single exercise, position or treatment that is appropriate for everyone. An assessment can help clarify what may be contributing and what options may be suitable.

How we assess pain around the sacroiliac region

At Telford Osteopaths, an initial consultation lasts up to an hour. A full case history is taken, followed by a physical examination where appropriate.

The assessment may consider:

• Where the pain is felt

• How and when it began

• Which movements or positions affect it

• Movement through the lower back, hips and pelvis

• Relevant muscle and joint function

• Previous health issues or injuries

• Whether medical referral or investigation may be appropriate

Findings are explained before any treatment begins, and there is an opportunity to ask questions throughout.

Where osteopathic treatment is considered appropriate, options may include agreed hands-on techniques, stretching, soft-tissue techniques and exercise or self-management advice. The proposed approach depends on the assessment and is discussed with you before treatment.

When to seek medical advice

Pain around the lower back or pelvis should not automatically be assumed to be a routine joint problem.

Urgent medical assessment is important if symptoms are associated with:

• New bladder or bowel disturbance

• Numbness around the saddle or genital area

• Progressive weakness or loss of control in a leg

• A significant fall, collision or other trauma

• Severe pain accompanied by fever or feeling very unwell

Medical advice is also sensible where pain is severe, rapidly worsening, unexplained or associated with other health concerns.

When do people consider seeking help?

People often arrange an assessment when:

• Pain keeps returning

• Symptoms are affecting walking, sleep, work or exercise

• They are uncertain whether the pain is coming from the back, hip or pelvic region

• Movement has become increasingly uncomfortable

• Self-management has not provided enough clarity

• They want an explanation of what may be contributing

An appointment does not assume that treatment will be suitable. The first step is to understand the symptoms, examine the relevant areas and explain the findings.

Frequently asked questions

Is sacroiliac joint dysfunction the same as lower-back pain?

Not exactly. The sacroiliac joints form part of the area where the spine and pelvis meet, but pain felt there may also arise from the lower back, hip or surrounding muscles.

“Sacroiliac joint dysfunction” is a descriptive term rather than something that can be confirmed by pain location alone. A clinical assessment helps consider the different possibilities.

Can osteopathy help with pain around the sacroiliac joint?

Osteopathy may help some people with general backache or joint pain, depending on the assessment and their individual circumstances.

It should not be assumed that the sacroiliac joint is the source of the symptoms without assessment. Treatment responses vary, and medical referral may sometimes be more appropriate.

Does the pelvis become misaligned?

Descriptions such as an “out-of-place pelvis” can oversimplify the causes of pain. Symptoms may be influenced by movement, sensitivity, muscle function, activity and several other factors.

Assessment focuses on how the area is functioning and what may be contributing rather than assuming that a bone needs to be put back into position.

Is sacroiliac pain the same as sciatica?

No. Sciatica commonly refers to symptoms associated with irritation of the sciatic nerve and may include pain, altered sensation or weakness extending into the leg.

Pain around the sacroiliac region can sometimes be felt in the buttock, but this does not automatically make it sciatica. Symptoms involving the leg require appropriate assessment.

Will I need a scan?

Many musculoskeletal presentations are assessed initially through the case history and physical examination. A scan is not automatically required.

Where the history, symptoms or examination findings suggest that imaging or medical investigation may be appropriate, this should be discussed and a referral made where necessary.

How many appointments might I need?

This varies according to the symptoms, how long they have been present, the assessment findings and how the individual responds.

After the initial consultation, suitable options and realistic expectations can be discussed. There is no pressure to commit to a predetermined number of appointments.

Understanding the next step

Pain around the sacroiliac region can overlap with several forms of lower-back, hip and joint pain. A careful assessment may help identify contributing factors, explain the findings and determine whether osteopathic care, self-management or medical referral is appropriate.

Osteopathy is one of several approaches used to manage musculoskeletal pain.

If you’d like to find out whether osteopathy could help, book online or call 07480699221.