SI Joint Pain Is One of the Most Commonly Missed Diagnoses in Low Back Care
The sacroiliac joints — the two joints where the sacrum meets the iliac bones of the pelvis — are responsible for transferring load between the spine and the lower extremities. They are heavily reinforced by ligaments and supported by the surrounding musculature, including the gluteal muscles, piriformis, and pelvic floor. When these joints are not moving or loading properly, the result can be significant pain — and significant diagnostic confusion.
Sacroiliac joint dysfunction is estimated to be responsible for 15 to 30 percent of chronic low back pain cases. Despite this, it is frequently misdiagnosed as lumbar disc pathology, dismissed as non-specific low back pain, or attributed to imaging findings that may not be the actual source of the problem. Patients with undiagnosed SI joint dysfunction often cycle through treatment after treatment without resolution — because the joint driving their symptoms is never properly assessed.
At Bray Chiropractic & Wellness in Glastonbury, sacroiliac joint dysfunction is evaluated as a distinct clinical presentation with specific assessment findings and a targeted treatment approach.
What Is the Sacroiliac Joint?
The sacroiliac joints sit at the base of the spine, connecting the triangular sacrum to the two large iliac bones of the pelvis. Unlike most joints in the body, the SI joints are designed for stability rather than mobility — they move only a few millimeters in normal function, but that small amount of movement is critical for load transfer and shock absorption during walking, running, and daily activity.
The SI joints are supported by some of the strongest ligaments in the body and are influenced by the surrounding musculature — including the gluteus maximus, piriformis, biceps femoris, and the pelvic floor. When any of these structures are dysfunctional, SI joint mechanics are affected. When the SI joints themselves are hypermobile, restricted, or inflamed, the surrounding structures compensate — often producing a cascade of secondary complaints that can make the diagnosis more complicated.
What Does SI Joint Dysfunction Feel Like?
SI joint dysfunction typically produces pain in the lower back, buttock, and sometimes the hip or groin. Symptoms are often:
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Unilateral — affecting one side more than the other, though bilateral presentation is possible
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Positional — worsened by prolonged sitting, standing, or transitional movements like getting up from a chair or rolling over in bed
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Activity-related — aggravated by walking, climbing stairs, or single-leg activities
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Difficult to pinpoint — patients often describe a deep, aching pain that is hard to localize precisely
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Mistaken for hip pathology or lumbar disc pain — because the referral pattern of SI joint dysfunction overlaps significantly with other conditions
Common Causes and Contributing Factors
Sacroiliac joint dysfunction can develop from a variety of causes and contributing factors, including:
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Trauma — a fall, motor vehicle collision, or direct impact to the pelvis
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Pregnancy and postpartum changes — hormonal laxity from relaxin, postural changes, and the demands of labor and delivery significantly affect SI joint mechanics
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Repetitive loading — asymmetrical activities, occupational demands, or sport-specific movement patterns that place uneven load through the pelvis
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Pelvic floor dysfunction — the pelvic floor plays a direct role in sacropelvic stability, and pelvic floor hypertonicity or weakness can contribute to SI joint dysfunction in ways that are rarely assessed
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Hip dysfunction — restricted hip mobility frequently transfers load to the SI joints, contributing to joint irritation and dysfunction
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Prior lumbar spine surgery — changes in lumbar mechanics following surgery can increase SI joint loading
The Pelvic Floor Connection
One of the most consistently overlooked contributors to sacroiliac joint dysfunction is the pelvic floor. The pelvic floor muscles attach directly to the coccyx and indirectly influence sacral and iliac mechanics through their connections to the surrounding soft tissue system. Pelvic floor hypertonicity — excessive tension in the pelvic floor — can alter sacral positioning and load transfer in ways that contribute to SI joint dysfunction and perpetuate symptoms even when the joint itself is being treated.
For patients with SI joint dysfunction that has not fully responded to chiropractic or physical therapy, pelvic floor assessment is one of the most important next steps. At Bray Chiropractic & Wellness, pelvic floor evaluation is integrated into the assessment of SI joint dysfunction as a standard part of the clinical process. Learn more about Pelvic Floor Therapy at this practice.
How SI Joint Dysfunction Is Evaluated at This Practice
Accurate diagnosis of sacroiliac joint dysfunction requires a cluster of clinical tests — no single test is definitive, and a thorough assessment is essential for distinguishing SI joint dysfunction from lumbar disc pathology, hip dysfunction, and pelvic floor-related pain.
Assessment at Bray Chiropractic & Wellness includes:
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Detailed health history including onset, mechanism, aggravating factors, and prior treatment history
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Orthopedic provocation testing — a battery of SI joint specific tests including FABER, FADIR, Gaenslen's, distraction, compression, and thigh thrust
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Lumbar spine and hip evaluation — to rule out contributing or concurrent pathology
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Functional movement assessment — evaluating load transfer through the pelvis during functional tasks
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Soft tissue assessment — gluteal, piriformis, and hip external rotator involvement
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Pelvic floor screening — particularly for patients with chronic or recurrent SI joint symptoms, postpartum patients, and those with concurrent pelvic symptoms
How SI Joint Dysfunction Is Treated at This Practice
Treatment for sacroiliac joint dysfunction at Bray Chiropractic & Wellness is individualized based on assessment findings and may include:
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Chiropractic manipulation and mobilization of the sacroiliac joints and surrounding spinal and pelvic structures
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Soft tissue therapy and orthopedic massage for gluteal, piriformis, and hip external rotator contributors
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Dry needling for myofascial trigger points contributing to SI joint loading and pain
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Pelvic floor assessment and rehabilitation when pelvic floor dysfunction is a contributing factor
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Rehabilitative exercise targeting sacropelvic stability, hip strength, and motor control — progressively loaded based on response
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Clinical nutrition guidance when systemic inflammation is contributing to joint sensitivity and delayed recovery
Learn more about Chiropractic Care, Pelvic Floor Therapy, and Rehabilitative Exercise at this practice.
SI Joint Dysfunction Treatment in Glastonbury, CT
Patients with sacroiliac joint pain and dysfunction in Glastonbury, South Glastonbury, Hebron, Marlborough, East Hartford, Manchester, and the surrounding Hartford County area will find a thorough, clinically integrated approach to SI joint care at Bray Chiropractic & Wellness that addresses both the joint and the contributing factors most practices miss.
No referral is required. New patients can schedule directly online or by calling or texting (203) 303-4760. Bray Chiropractic & Wellness is in-network with Aetna, Anthem BCBS, Cigna (ASH), and CT Medicaid (Husky). Self-pay and HSA/FSA options are also available.