If you’re dealing with a persistent ache in your lower back, discomfort in your buttocks, or even pain radiating down your leg, you may be experiencing sacroiliac (SI) joint dysfunction. This condition affects more people than you might think and can make even simple activities—like getting out of a chair or turning in bed—feel like a painful chore.
At Lake Mary Chiropractic, SI joint issues are a frequent concern. Fortunately, most people can find meaningful, long-lasting relief through safe, non-invasive treatments that help the body heal naturally, without surgery or endless rounds of injections.
This guide will help you understand what the SI joint is, why it becomes a source of pain, and which conservative treatment options offer the most effective path forward. We’ll explore the benefits of chiropractic care, the promise of shockwave therapy, and also give you a balanced look at medical interventions like injections and surgery. If you’re tired of pain controlling your life, you may find the solution is much closer than you imagined.
Understanding the SI Joint and Why It Matters
At the foundation of your spine sits the sacrum, a triangular-shaped bone that connects to the ilium bones on either side
—those broad, wing-like structures that form the back of your pelvis. The point where the sacrum meets each ilium is called the sacroiliac joint, or SI joint. You have one on each side of your pelvis.
While joints like the shoulder or knee are designed for significant movement, the SI joints are relatively immobile. Their p
rimary role is to transfer the weight of your upper body to your legs and absorb the shock of everyday activities like walking, standing, and running. To carry out these demanding functions, the SI joints are supported by some of the strongest ligaments in the human body.
However, despite this strength, the SI joints can still become irritated or dysfunctional. When the joint moves either too much or too little, it can create pain, stiffness, and inflammation in the surrounding tissues. This is what we call SI joint dysfunction—a deceptively simple term for a condition that can significantly impact your quality of life.
What Causes SI Joint Dysfunction?
The dysfunction typically stems from two primary causes. The first is hypermobility, which means the joint is moving too much. This can happen when the ligaments around the SI joint become loose, often due to injury, repetitive stress, or hormonal changes during pregnancy. When the joint becomes unstable, it can irritate the surrounding nerves and lead to inflammation and pain.
The second cause is hypomobility, where the joint becomes restricted or “stuck.” This may result from arthritis, poor posture, muscle imbalances, or prolonged periods of sitting. When a joint that’s meant to absorb and distribute movement becomes locked up, the surrounding muscles and joints often have to work harder to compensate, leading to additional pain and strain.
It’s also important to note that pain may not always originate within the joint itself. Sometimes, the ligaments or muscles around the SI joint become inflamed or strained, mimicking the symptoms of true joint dysfunction. That’s why getting an accurate diagnosis is so essential to successful treatment.
Recognizing the Symptoms of SI Joint Dysfunction
Symptoms of SI joint dysfunction vary from person to person, but certain patterns are quite common. Most people report localized lower back pain, usually on one side and slightly off-center. Pain in the buttocks is also frequent and may be described as either a deep ache or a sharp, stabbing sensation. In some cases, the discomfort radiates into the upper thigh or groin, which can lead to confusion with sciatica or hip problems.
Many individuals find that their symptoms worsen while sitting, especially on hard surfaces, or when they lean to one side. Prolonged standing or walking can also aggravate the joint. Movements that require a shifting of weight—like getting into a car, climbing stairs, or turning in bed—often trigger pain. Some people even notice stiffness or a popping sensation in the area.
Since these symptoms can overlap with other back and hip conditions, proper diagnosis is key. A skilled healthcare provider can perform targeted tests to determine whether the SI joint is truly the source of the problem.
The Good News: You Have Options
When it comes to treating SI joint dysfunction, many people are surprised to learn that surgery is rarely necessary. In fact, most individuals find lasting relief through conservative care. These non-invasive approaches aim to reduce pain, improve joint function, and strengthen surrounding muscles to prevent future episodes. At Lake Mary Chiropractic, our philosophy is rooted in helping the body heal itself, and the results speak for themselves.
Chiropractic Adjustments: Restoring Motion Naturally
Chiropractic care is often the first step in addressing SI joint dysfunction. Chiropractors are specially trained to assess and correct issues with joint movement, particularly in the spine and pelvis. If the SI joint is restricted and not moving properly, precise chiropractic adjustments can help restore its natural motion. These adjustments relieve pressure, reduce inflammation, and promote healing.
Even in cases where the joint is hypermobile, chiropractic care can be beneficial. Instead of manipulating an already unstable joint, the chiropractor may focus on stabilizing surrounding muscles through targeted exercises and supportive care. In both cases, chiropractic adjustments aim to restore the body’s structural balance and allow for natural healing without medications or surgery.
This approach is backed by both research and years of clinical success. A systematic review published in the Journal of Manual & Manipulative Therapy highlighted the role of manual therapies, including chiropractic adjustments, in effectively managing chronic lower back pain. This category often includes SI joint-related problems.
Shockwave Therapy: Stimulating Healing at the Cellular Level
Another effective, non-invasive treatment for SI joint dysfunction offered at Lake Mary Chiropractic is focused shockwave therapy. Also known as Extracorporeal Shockwave Therapy (ESWT), this advanced technique uses acoustic sound waves to penetrate deep into the tissues surrounding the SI joint. These waves create controlled microtrauma, which stimulates the body’s natural healing response.
Focused shockwave therapy increases blood flow, encourages the formation of new blood vessels, and promotes tissue regeneration. It also helps break down scar tissue and reduces sensitivity in overactive nerve endings, which can be especially beneficial for chronic or recurring pain.
For individuals whose pain stems from ligament sprains, muscle tension, or persistent inflammation around the joint, focused shockwave therapy can provide meaningful relief. Best of all, the treatment is quick, performed in-office, and requires no downtime.
What About Injections? A Closer Look
While conservative care is often sufficient, some patients may be offered corticosteroid injections for SI joint pain. These injections deliver a combination of a strong anti-inflammatory medication and a numbing agent directly into the joint space, aiming to provide rapid pain relief.
In some cases, injections can be helpful, especially if the pain is so severe that it prevents participation in physical therapy or other treatments. However, it’s essential to recognize that this approach addresses only the symptom, not the cause. The pain relief is typically temporary, lasting from a few weeks to a few months. As the medication wears off, the underlying joint dysfunction remains.
Moreover, repeated steroid injections can carry risks, including tissue weakening, increased blood sugar levels, and even potential nerve damage. For these reasons, injections should be seen as a temporary measure and not a long-term solution. They can serve as a bridge to more lasting therapies, but should not be relied upon as the primary treatment strategy.
SI Joint Fusion Surgery: Risks, Realities, and Caution
For a very small percentage of patients—those with persistent, disabling pain that hasn’t improved with months of conservative care—surgery may become an option. The most common procedure for SI joint dysfunction is fusion surgery, which involves permanently joining the sacrum and ilium with hardware to eliminate joint movement.
While the theory behind fusion surgery makes sense—eliminate the motion, eliminate the pain—the reality is far more complex. Once the joint is fused, it can no longer absorb shock or transfer movement as it once did. This can place increased stress on adjacent joints, particularly in the lumbar spine and hips, potentially leading to new areas of pain.
The surgery itself is not without risks. Complications may include infection, nerve damage, hardware failure, bleeding, or incomplete fusion (a condition known as non-union). Even in successful surgeries, recovery can be long and arduous, requiring extensive physical therapy and pain management.
A systematic review of studies from 2000 to 2014, involving 430 patients, investigated the effectiveness of sacroiliac joint (SIJ) fusion for treating SIJ pain or dysfunction. The review found that while surgery might benefit a small group of patients, the authors cautioned against performing the operation without serious consideration of the pain’s cause and alternative treatments. This is due to the challenges in accurately diagnosing SIJ pain and the limited strong evidence supporting the efficacy of sacro-iliac joint fusion itself. (Zaidi et al., J Neurosurg Spine. 2015)
Why Conservative Care Should Come First
The team at Lake Mary Chiropractic believes in empowering the body to heal itself. Chiropractic adjustments and shockwave therapy offer a powerful combination for addressing SI joint dysfunction. These treatments don’t just mask pain—they correct the underlying biomechanical issues that cause it.
When a joint is moving properly, inflammation decreases, pain subsides, and strength returns to surrounding muscles. By restoring alignment and encouraging tissue regeneration, conservative care provides a sustainable path to long-term healing.
Unlike injections that offer temporary relief or surgeries that carry significant risks, chiropractic and shockwave therapy support your body’s natural processes. They allow you to heal without compromising your mobility or facing months of recovery.
A Better Future Starts Today
If you’re living with SI joint pain in Lake Mary, Sanford, Longwood, or Altamonte Springs, now is the time to take action. You don’t have to settle for a life limited by discomfort and fear of movement. Whether your pain is new or something you’ve endured for years, conservative care offers real hope.
Imagine sitting comfortably, walking without a limp, turning in bed without bracing for pain, and returning to your favorite hobbies with confidence. All of this is possible with the right treatment plan and support.
At Lake Mary Chiropractic, we take a personalized approach to healing. Our experienced team performs thorough evaluations to identify the true source of your pain and develops a customized plan that may include chiropractic adjustments, shockwave therapy, and guided rehabilitation exercises.
You don’t have to live with chronic SI joint pain. Help is available—and it starts with a single step.
To schedule your consultation, visit www.lakemarychiropractic.com or call 407.302.5161 today. Let us help you get back to living life on your terms—strong, stable, and pain-free.
