SI Joint Pain: The Low Back Problem Most People Never Hear or Talk About
If your lower back pain is mostly on one side, sits right at the belt line, and sometimes shoots into your glute or upper thigh, you may have assumed or been told it’s sciatica. It very well could be, BUT… it might not be!
One of the most commonly misidentified sources of one-sided low back pain symptoms could be stemming from your sacroiliac joint. Since this is mostly shared in medical settings or it’s rarely talked about among peers outside of physical therapy clinics, most people have never considered it as the culprit.
What the SI Joint Is and What It Does
The sacroiliac joint sits where the sacrum – the triangular bone at the base of your spine between your dimples, connects to the iliac bones of the pelvis. You have one on each side. Together, they form the bridge between your spine and your legs.
The SI joints don’t move much. Their job is stability, not mobility. But they absorb an enormous amount of force throughout our days:
Every step
Every shift in weight
Every lift transfers load through these joints.
When they become irritated, inflamed, or start moving unevenly, the result is pain that can be surprisingly intense and surprisingly hard to pin down.
How SI Joint Pain Feels Different from Sciatica
sacroiliac joint dysfunction’s symptoms overlap enough that people confuse the two constantly. Both can cause one-sided low back pain. Both can send discomfort into the glute and upper leg. Most people commonly associate this with a shooting pain sensation.
The differences are in the details. SI joint pain tends to sit right at or just below the dimples of the low back – the posterior superior iliac spine, or PSIS. Pressing on that spot usually reproduces the pain. It’s often worse with transitions: standing up from sitting, rolling over in bed, climbing stairs, or standing on one leg.
True sciatica travels further – often all the way to the foot – and tends to have more of a radiating, electric quality. SI joint pain tends to stay more local, in the low back and upper glute region.
Why the Surrounding Musculature Is Usually the Real Problem
The SI joint itself is a joint – it’s not something soft tissue work can directly manipulate. But the muscles surrounding it are a different story.
The gluteus medius, piriformis, quadratus lumborum, and deep hip rotators all attach near or around the SI joint. When these muscles are chronically tight or imbalanced – from prolonged sitting, an old injury, asymmetrical loading from a sport or job – they pull unevenly on the pelvis and create shearing forces through the SI joint that drive the inflammation and pain.
This is where therapeutic massage becomes directly relevant. Releasing the muscular tension that’s pulling the pelvis out of balance removes one of the primary mechanical drivers of SI joint irritation. The joint doesn’t get fixed, but the thing aggravating it does.
What Sessions Look Like for SI Joint Pain
Work for SI joint pain focuses on the gluteal region, hip rotators, quadratus lumborum, and often the hip flexors on the affected side. Ashiatsu is particularly useful here because of the broad, sustained pressure it can deliver through the entire gluteal and low back region without the therapist fatiguing before the tissue has time to actually release.
Cupping on the lateral hip and QL is also commonly used alongside the manual work, particularly for clients who have had the pattern for a long time and developed significant fascial restriction in the area.
If you’ve been dealing with one-sided low back pain that hasn’t responded well to treatment and haven’t specifically investigated the SI joint as a potential driver, it’s worth mentioning at your next session. Describing where the pain sits, what positions trigger it, and whether it’s worse on transitions gives the therapist enough to work with, even without a formal diagnosis.
Ready to get to the root of your one-sided low back pain? Book your appointment online or call/text 719-459-0780. Inspire Movements Massage Therapy is located at 1295 Kelly Johnson Blvd, Suite 250 in Briargate, Colorado Springs 80920.
Open Monday, Tuesday, Friday, and Saturday 9am-7:30pm.
By appointment only.