SIJ Dysfunction
Sacro-Illiac Joint Sprain / Dysfunction
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The acronym SIJ stands for "Sacro-Illiac Joint" which is the joint connecting your tail bone (Sacrum Bone) at the bottom of your spine to your pelvis. A big function of the SIJ is to create stability and dissipate loads from the upper and lower body through the pelvis.

Causes of SIJ dysfunction
  • Traumatic Injury. A study performed by Bernard and Kirkaldy-Willis suggesteed that 58% of patients diagnosed with SIJ pain based on clinical examination findings had some traumatic injury (1).
  • As the SIJ assists in controlling forces coming from the upper and lower limb, any abnormal movement (especially repetitive) from above or below may create strain through this joint. Instances of SIJ Dysfunction can be attributed to poor walking patterns or imbalances from the legs.
  • Pregnancy creates changes in the pelvis that may lead to dysfunction in the SIJ.
  • There are some specific conditions (e.g. Some Arthritic Conditions) that can cause pain in this area.


  • Pain in one or both buttocks and can be variable from a dull ache to a sharp "knife like" pain
  • Pain may travel to the hips, the back of the thigh or even the back of the lower leg.
  • Pain is often worse in the morning and gets better with movement.
  • Pain is worse when sitting for long periods and when performing twisting/rotary movements.
  • Pain patterns occurring due to SIJ dysfunction can be variable. This is due to its wide range of different nerve supply (nerves transmit pain signals).

Osteopathic Diagnosis

  • Your osteopath will perform a detailed History and physical examination with an aim to determine the cause of your pain and rule out any symptoms requiring specialist referral.
  • In some cases a specialist referral may be required to rule out other conditions that may be causing the pain.
  • There are certain physical tests that may assist in determining SIJ Dysfunction.
  • You may also be referred for imaging (X-Ray, CT, or MRI) for further investigation into your SIJ or to rule out other causes of your pain.

Osteopathic Treatment & Management

  • Initially osteopathic treatment focuses on reducing pain and identifying the potential aggravating factors of the pain and working on a management plan to reduce those factors.
  • Pain Reliever and/or anti-inflammatory medication may assist during the acute phase (first 24-48 hours) of the injury (as directed by your pharmacist or general practitioner).
  • Often SIJ dysfunction is associated with muscle imbalances and weaknesses so your osteopath will introduce some stretching, strengthening and conditioning exercises to enhance recovery.
  • In some cases an SIJ belt may also be of assistance for a short term to reduce pain and stabilse the area.
  • You may be referred to a podiatrist if there are imbalances in your feet contributing to the imbalance in your SIJ.
  • Introducing a core stability program through Pilates, Yoga or Personal Training may reduce recurrence and/or enhance recovery from your injury.
  • Click Here for stretches for The Low Back and Pelvis
  • Click Here for Strengthening for The Low Back and Pelvis
(1) Bernard TN Jr, Kirkaldy-Willis WH. Recognizing specific characteristics of nonspecific low back pain. Clin Orthop Relat Res. Apr 1987;217:266-80.