SI Joint Pain: The Most Commonly Misdiagnosed Cause of Hip & Lower Back Pain

If you have lower back pain that seems to shift between your hip, buttock, and lower back — and no one can figure out why — there's a good chance your sacroiliac (SI) joint is the culprit.

What Is the SI Joint?

The SI joint connects your sacrum (the triangular bone at the base of your spine) to your ilium (the large pelvic bone). It's designed for stability, not mobility — which means when it moves too much or too little, problems start.

How SI Joint Dysfunction Develops

The most common causes we see at Apex Chiropractic:

• Pelvic imbalance — One side of the pelvis rotates forward or backward, creating uneven stress
• Pregnancy and postpartum changes — Hormonal changes loosen ligaments, destabilizing the joint
• Repetitive asymmetric loading — Running, golf, or sitting with crossed legs habitually
• Leg length discrepancy — Even a small difference creates chronic SI joint stress

Why It's So Often Misdiagnosed

SI joint pain mimics several other conditions:

• Sciatica — SI dysfunction can refer pain down the leg
• Hip bursitis — Pain location overlaps significantly
• Lumbar disc issues — Both cause lower back and buttock pain
• Piriformis syndrome — The piriformis attaches near the SI joint

A proper assessment includes pelvic alignment evaluation, leg length assessment, and specific orthopedic tests — not just imaging.

What Treatment Actually Works

Our approach at Apex Chiropractic focuses on:

1. Pelvic and SI joint adjustments — Restoring proper alignment and joint mechanics
2. Corrective exercises — Strengthening the muscles that stabilize the pelvis
3. Leg length assessment — Identifying and addressing functional or anatomical differences

Our verified results: 85% pain reduction in 6 weeks for SI joint patients, with outcomes including resolved hip and lower back pain, corrected pelvic imbalance, and return to running.

Exercises That Help (And Ones That Make It Worse)

Helpful:

• Clamshells for glute medius activation
• Bird-dogs for core stability
• Pelvic tilts for alignment awareness

Avoid:

• Heavy squats with poor form
• Single-leg activities before stabilization
• Aggressive stretching of the hip flexors (can destabilize further)

When to Seek Help

If your lower back or hip pain has been present for more than 2 weeks, shifts sides, or worsens with transitional movements (sitting to standing, getting out of a car), an SI joint evaluation is warranted.

Based on verified patient outcomes tracked through ChiropracticResults.com