SI Joint Pain Treatment

The sacroiliac (SI) joints connect your spine to your pelvis on either side. These joints are designed for stability, not mobility — but when they become irritated or dysfunctional, they can produce significant pain in the lower back, buttock, and sometimes down the leg.

Common symptoms of SI joint dysfunction include:

• Pain on one side of the lower back or buttock
• Discomfort that worsens with prolonged sitting, standing, or stair climbing
• Pain when shifting weight from one leg to the other
• A feeling of instability or “giving way” in the pelvis
• Pain that may radiate into the groin, hip, or upper thigh

SI joint dysfunction is often mistaken for sciatica or a disc problem because the pain patterns can overlap. Common causes include pregnancy and postpartum changes, asymmetrical movement patterns, falls or trauma, and repetitive stress from activities like running or heavy lifting.

The good news is that SI joint pain responds very well to physical therapy when the treatment is specifically targeted to the joint and the muscle imbalances contributing to the problem. Most patients experience meaningful relief within the first few weeks of targeted care.

Our therapists use a combination of manual techniques and targeted exercise to restore normal SI joint mechanics and build lasting stability. Your treatment plan typically includes:

• SI joint mobilization — hands-on techniques to restore proper alignment and reduce joint irritation
• Pelvic stabilization exercises — strengthening the deep muscles of the core, glutes, and pelvic floor that directly support the SI joint
• Muscle energy techniques — gentle contract-relax methods that help realign the pelvis and correct asymmetries
• Hip and lumbar mobility work — improving flexibility in the surrounding joints to reduce compensatory stress on the SI joint
• dry needling — targeting trigger points in the glutes, piriformis, and lumbar muscles that may be referring pain to the SI region
• Activity modification guidance — adjustments to how you sit, sleep, exercise, and perform daily tasks to protect the joint during recovery

Every session is one-on-one with a licensed physical therapist. SI joint issues require precise assessment and treatment — what looks like an SI problem may actually involve the hip, lumbar spine, or pelvic floor. Our therapists are trained to differentiate these sources and adjust your treatment accordingly.

For patients whose SI joint pain is related to pregnancy or postpartum recovery, we offer specialized pelvic floor therapy that addresses the broader muscular and hormonal changes that contribute to SI joint instability.

Your initial evaluation will include specific SI joint provocation tests, a movement assessment, and analysis of your posture, gait, and pelvic alignment. These tests help us confirm the SI joint as the source of your pain and rule out other potential causes.

Follow-up sessions are typically 30 minutes, 2–3 times per week. Many patients notice improvement within the first 2–3 weeks, especially when combined with a consistent home exercise program focused on pelvic stability.

Wear comfortable clothing that allows easy movement. Bring any imaging reports if available, though diagnosis of SI joint dysfunction is primarily clinical — imaging alone often cannot confirm it.

In Delaware, you don’t need a referral to start physical therapy for the first 30 days. Most major insurance plans are accepted, including Medicare. Our team can check your benefits before your first appointment so there are no surprises.