SI Joint Pain Physiotherapy in North York & Don Mills

What Is the Sacroiliac (SI) Joint?

The sacroiliac joints are located where the sacrum—the triangular bone at the bottom of your spine—connects with the pelvis.

There is one SI joint on each side of the body.

These joints help transfer forces between your spine, pelvis and legs during activities such as:

• Walking
• Climbing stairs
• Standing from a chair
• Running
• Lifting
• Turning
• Moving between sitting and standing

The SI joints are strong, relatively stable joints with a small amount of movement.

Pain can sometimes arise from the SI joint or surrounding structures, but identifying the SI joint as the source of symptoms can be challenging because pain in this region can also originate from the lower back, hip, muscles or other nearby structures.

For this reason, assessment should consider the whole clinical picture rather than assuming that pain near the SI joint automatically means the joint is the problem.

What Does SI Joint Pain Feel Like?

SI joint-related pain is often experienced on one side of the lower back or buttock, although symptoms can vary.

You may experience:

• Pain around one side of the lower back
• Buttock pain
• Pain around the back or side of the pelvis
• Discomfort around the hip or groin
• Pain when moving from sitting to standing
• Pain with walking or climbing stairs
• Discomfort when turning in bed
• Pain during certain lifting or twisting activities
• Symptoms associated with prolonged positions or changes in activity

Pain can sometimes extend into the thigh or leg.

However, symptoms travelling down the leg—particularly when accompanied by tingling, numbness or weakness—may suggest nerve involvement or another condition and should be appropriately assessed.

What Can Contribute to SI Joint Pain?

SI joint-related symptoms can develop in different circumstances.

Possible contributing factors may include:

• A fall or other trauma involving the pelvis
• Sudden changes in activity or physical workload
• Repetitive or demanding physical activities
• Pregnancy and postpartum changes
• Changes in strength or physical conditioning
• Arthritis or inflammatory conditions affecting the joint
• Previous lower-back or pelvic injuries
• Activities that repeatedly aggravate the area

Sometimes symptoms develop without one obvious cause.

Rather than looking for a single “imbalance” or assuming that the pelvis is out of alignment, physiotherapy assessment considers your symptoms, movement, strength, activity demands and other factors that may be contributing to the problem.

How Do I Know if My Pain Is Coming From the SI Joint?

This is an important question because pain around the SI joint does not necessarily mean the SI joint is causing it.

Lower-back conditions, hip problems, nerve-related pain and muscular conditions can produce symptoms in similar areas.

There is also no single movement or self-test that can reliably tell you whether your pain is coming from the SI joint.

A physiotherapist may use a combination of:

• Your symptom history
• Location and behaviour of your pain
• Movement testing
• Functional activities
• Strength assessment
• Hip and lower-back examination
• A combination of clinical SI joint tests
• Neurological assessment when appropriate

The goal is to determine whether your presentation appears consistent with SI joint-related pain and whether other potential sources of symptoms need to be considered.

Can Physiotherapy Help SI Joint Pain?

Yes. Physiotherapy can help many people experiencing SI joint-related pain.

Treatment begins with understanding how the symptoms are affecting your movement and daily activities and identifying factors that may be contributing to the problem.

Your physiotherapist can then develop an individualized rehabilitation plan designed to restore movement, strength and function.

Rather than simply trying to “put the pelvis back into alignment,” treatment focuses on helping you move comfortably, build physical capacity and return to the activities that matter to you.

How Is SI Joint Pain Treated With Physiotherapy?

There is no single treatment program that is appropriate for everyone with SI joint pain.

Your physiotherapy program may include several approaches depending on your assessment.

Education and Activity Modification

Understanding which activities aggravate your symptoms—and which activities are safe to continue—can help you remain active while recovering.

Your physiotherapist may recommend temporarily modifying certain activities while gradually rebuilding your tolerance.

Hip and Trunk Strengthening

Strengthening exercises may focus on the muscles around your hips, trunk and legs.

Depending on your needs, your program may include:

• Hip strengthening
• Trunk strengthening
• Gluteal exercises
• Progressive resistance exercises
• Functional strengthening
• Balance and control exercises

The exercises should become progressively more challenging as your symptoms and physical capacity improve.

Mobility and Movement

Some people with SI joint-related pain become hesitant to move normally because particular movements have become uncomfortable.

Your physiotherapist may use specific exercises and gradual exposure to help restore comfortable movement and confidence.

Manual Therapy

Hands-on treatment may be used when appropriate to help reduce symptoms or improve comfortable movement.

Manual therapy should generally support a broader rehabilitation program rather than being the only treatment.

Functional Rehabilitation

As you improve, exercises can be progressed toward activities that are important to you.

These may include:

• Walking
• Climbing stairs
• Lifting
• Carrying
• Household activities
• Work activities
• Gym exercise
• Running
• Recreational sports

The objective is not simply to perform exercises in the clinic but to prepare your body for the activities you want to return to.

What Exercises Help SI Joint Pain?

There is no single set of exercises that works for everyone with SI joint pain.

Exercise selection should depend on your symptoms, strength, movement and activity goals.

A rehabilitation program may include:

• Hip strengthening
• Gluteal strengthening
• Trunk strengthening
• Progressive resistance exercise
• Mobility exercises
• Balance and movement-control exercises
• Walking or cardiovascular activity
• Functional exercises such as squatting, stepping or lifting

Your physiotherapist can help determine which exercises are appropriate and how they should be progressed.

Should I Rest or Stay Active With SI Joint Pain?

In most uncomplicated musculoskeletal presentations, prolonged inactivity is usually not the goal.

You may need to temporarily modify activities that significantly aggravate your symptoms, particularly early in recovery.

However, comfortable walking and everyday movement can generally be continued as tolerated.

As symptoms improve, gradually rebuilding activity is important for restoring strength, movement and confidence.

Your physiotherapist can help you determine how much activity is appropriate and how to progress.

Is Sitting Bad for SI Joint Pain?

Sitting itself is not necessarily harmful to the SI joint.

However, remaining in one position for a long time may aggravate symptoms for some people.

If sitting is uncomfortable, it may help to:

• Change position regularly
• Take short movement or walking breaks
• Adjust your workstation for comfort
• Alternate between sitting and standing when possible
• Gradually increase your tolerance rather than avoiding sitting altogether

There is no single “perfect posture” that everyone needs to maintain.

Comfort, movement variety and your ability to tolerate a position are generally more useful considerations than trying to sit rigidly in one prescribed posture.

Is SI Joint Pain the Same as Sciatica?

No.

SI joint-related pain and sciatica can sometimes produce symptoms in similar areas, but they are different clinical presentations.

SI joint pain is commonly experienced around the lower back, pelvis or buttock.

Sciatica usually refers to nerve-related symptoms extending from the lower back or buttock into the leg. These may include:

• Radiating leg pain
• Tingling
• Numbness
• Changes in sensation
• Weakness

Because the symptoms can overlap, assessment may be necessary to distinguish between them.

If your main concern is pain, numbness or tingling extending down the leg, visit our:

[Internal link: Sciatica Physiotherapy in North York & Don Mills]

What if Lower Back Pain Is My Main Symptom?

If your primary concern is generalized or central lower-back pain rather than pain concentrated around the SI joint or buttock, our main Back Pain Physiotherapy page is the better place to start.

It provides more information about acute, recurring and persistent back pain, physiotherapy assessment, exercise, strengthening and returning to everyday activity.

[Internal link: Back Pain Physiotherapy in North York & Don Mills]

Can Pregnancy Cause SI Joint and Pelvic Pain?

Pregnancy can be associated with pain around the lower back, pelvis and SI joint region.

Pregnancy involves changes in body weight, movement, physical demands and the structures surrounding the pelvis. Some people therefore experience pain with activities such as:

• Walking
• Climbing stairs
• Turning in bed
• Standing on one leg
• Getting in and out of a car
• Carrying or lifting

Postpartum demands—including feeding, carrying a baby and changes in exercise and sleep—can also contribute to ongoing musculoskeletal symptoms.

Physiotherapy can help assess the factors contributing to your symptoms and develop an appropriate exercise and activity plan.

[Internal link: Pelvic Health / Pregnancy Physiotherapy, if appropriate]

Can an SI Belt Help?

An SI or pelvic support belt may provide temporary symptom relief for some people, particularly in certain pregnancy-related or pelvic pain presentations.

A belt is not necessary for everyone and should not automatically replace strengthening and rehabilitation.

If a support belt is appropriate, your physiotherapist can help determine how and when to use it while continuing to work toward improvedrebuild strength and return to the activities that matter to you.

Book Your Assessment Online