• Symptoms of sacro-iliac (SI) join pain include pain in the buttocks, which may radiate to the back of the thigh but no as far as calf.
  • It is usually felt when standing upright and putting weight on the same leg.
  • In persistent and widespread pain, SI joint pain is a very rarely the only cause, but rather a secondary mechanical dysfunction.

SI joint pain and dysfunction

The term SI joint comes from the English words ”sacroiliac joint” (sacrum = sacrum, ilium = ilium joint.). It is a common mechanical dysfunction in which, in cases with short-term symptoms, the symptoms should already be improving significantly after 2-4 treatment sessions. In cases of persisten symptoms, it is always necessary to take a comprehensive look at the causes leading to the more long term pain.

SI joint symptoms

Symptoms of SI joint dysfunction and malalignment are most commonly described as local pain in the buttock area. The pain is usually unilateral. In prolonged cases, the pain and tension spread and may be felt, for example, in the lower back, groin, and hamstrings. The upward and forward rotation of the pelvis on the same side, which is typical of SI joint dysfunction, is not likely to be the cause of the symptoms, but rather a consequence caused by muscle tension resulting from other contributing factors. In it good to note, that the position of the pelvis is not completely symmetrical in anyone without symptoms.

Causes of prolonged SI joint symptoms

Prolonged symptoms are usually caused by a combination of several factors rather than just one of the factors listed below.

  • Increased physiological load on the SI joint due to previous injuries, premature wear, or functional disorders, especially in the lower back, hip, knee, ankle, and foot on the same side.
  • Insufficient or excessive physical load.
  • Psychological factors, such as anxiety, depression, and/or excessive mental strain, commonly known as stress.
  • Lifestyle factors, such as too little or too repetitive exercise, insufficient or poor-quality sleep, and obesity.
  • Central sensitization of the nervous system
  • Inflammatory or intestinal diseases that can cause direct inflammation of the SI joint.

Treatment and rehabilitation of SI joint pain

Treatment usually includes:

  • Manual therapy to treat joint, muscle, and fascia dysfunctions.
  • Neurological rehabilitation to address individual neurological deficits.
  • Individual exercises to improve posture and movement.
  • Acupuncture to treat pain and pain sensitization.
  • Lifestyle guidance to improve exercise, sleep, rest, and eating habits.

Read more about related pain syndromes:

Low back intervertebral disc problems

Sciatic pain

Low back pain

Gluteal / buttock pain

Hip flexor pain (Psoas syndrome)

Piriformis syndrome

Hip joint pain

Viimeksi päivitetty 13.10.2025

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I provide assessment, treatment, and rehabilitation for musculoskeletal issues and neurological conditions. I specialize in long-lasting and complex dizziness, vertigo, and pain, where symptoms often have multiple contributing factors. Our goal is not only to reduce your symptoms but also to focus on the individual aspects that increase your active role in your own recovery and long-term health.

Your first visit includes a thorough interview, an examination to find the cause of your symptoms, and a personalized treatment plan. If the examination is completed during that visit, we’ll also start treatment in the same visit. The first appointment lasts 40 minutes and costs €120.

You are warmly welcome to expert, personalised care.

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Jani Mikkonen, D.C., B.Sc. (Hons), DACNB, Ph.D.
Doctor of Chiropractic, Bachelor of Science (Honours), Diplomate of the American Chiropractic Neurology Board, Doctor of Philosophy

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