Before we get into how and why your Sacroiliac Joints could be a prime suspect for causing your low back pain let’s briefly outline what the Sacroiliac Joints are and why they are important.

What Are the Sacroiliac Joints?

The sacroiliac (SI) joints are two joints located where the sacrum (the triangular bone at the base of the spine) meets the ilium bones of the pelvis, one on each side. These joints connect your spine to your pelvis.

Why Are They Important?

• Support and Stability: The SI joints help transfer weight and forces between your upper body and legs, providing stability for standing, walking, and other movements.
• Shock Absorption: They act as shock absorbers, reducing stress on the spine and pelvis during movement.
• Movement Facilitation: While the SI joints allow only a small amount of movement, this slight flexibility is essential for normal motion and balance.

Importance to Low Back and Spinal Function

• Low Back Pain: Dysfunction or inflammation in the SI joints is a common cause of lower back pain.
• Spinal Alignment: Healthy SI joints help maintain proper alignment of the spine and pelvis, which is crucial for posture and movement.
• Mobility: They play a key role in activities like walking, bending, and lifting, making them essential for everyday function.

In summary, the sacroiliac joints are vital connectors between the spine and pelvis, supporting movement, stability, and overall spinal health.

The SI Joints Are Often Missed

The Sacroiliac Joints are often missed as a source of pain and even when they are identified the treatment fails or even aggravates the pain. Why?

For many decades the medical establishment refused to believe that the SI Joints moved. Even now their belief is that they move so minimally that they couldn’t be the source of pain unless trauma makes them unstable. 

Chiropractic has long appreciated the Sacroiliac Joints as a place that gets imbalanced and can cause pain and a number of other pelvic and low back pain issues. However, many chiropractors simply look for an imbalance in the SI Joints and look to restore balance without accurately determining:

• Which Joint is restricted
• Which Joint is causing the pain
• Most importantly is the problem really in the SI Joints or is it coming from somewhere else.

Are Your SI Joints Out of Alignment?

Here are a few ways to help you get an idea of whether your SI Joints might be out of alignment. This won’t tell you if that is the cause of the problem but it will give you an idea of whether there is an imbalance.

Common Signs and Symptoms:

• Sharp or stabbing pain in the lower back and hips, often pinpointed near the SI joints, possibly radiating to the buttocks or thighs.15
• Pain worsens with certain movements such as standing up from a seated position, climbing stairs, or turning in bed.14
• Sensation or appearance of uneven leg lengths—not due to actual bone length difference, but from pelvic tilt caused by SI joint dysfunction.15
• Difficulty with single-leg activities (stepping, lunging) or a feeling of instability in the pelvis5.
• Uneven gait or posture and a sense of “shifting” in the pelvis.56

Simple Self-Checks:

• Pelvic Level Test: Stand in front of a mirror with an assistant placing their hands on the top of each side of your pelvis. If one hand is noticeably higher, this suggests pelvic imbalance, often linked to SI joint misalignment.6
• Marching Test: While watching in the mirror, slowly raise each knee to waist height as if marching. If your hips or torso shift more to one side, or if one side feels stiffer or less mobile, this may indicate SI joint imbalance.6

Important Considerations:

• SI joint issues are often confused with other sources of lower back or hip pain, such as sciatica or hip arthritis.48
• Imaging (X-ray, CT, MRI) and diagnostic SI joint injections are sometimes used to confirm the diagnosis, especially when the cause is unclear or if initial tests are inconclusive.38

If you notice these signs or self-checks suggest imbalance, it is best to consult a healthcare provider, such as a corrective chiropractor for a thorough assessment and appropriate diagnostic testing.238

At Life Chiropractic in Grass Valley when I evaluate everyone on each visit this is the general process I go through:

• Standing I look to see if one side of the pelvis is higher than the other side. This is an indication of some SI imbalance.
• I have them march in place while I put a finger on each side of the SI joint to see if there is motion. This is done on each side.
• Sitting I look again to see if one side of the pelvis is higher than the other. Sometimes the imbalance shows sitting when it isn’t standing. 
• With an imbalance I start looking for what will restore balance. Is it the SI Joints, Sacrum, or lower lumbar spine?

In my experience at least 80% of the time the cause of the SI imbalance is coming from the lower lumbar spine. After I adjust L4 or L5 (most often) I will see an immediate balancing of the pelvis, restored SI motion, and people notice how much smoother marching in place is. 

Sometimes the pelvis needs to be adjusted. And, when it does it typically only requires adjustments a few times. Other joints often require much more frequent repetition but the SI joints often balance after one or two adjustments. 

About Dr. Berkowitz  

Dr. Bill Berkowitz is a dedicated chiropractor who brings reliability and depth to his practice at Life Chiropractic in western Nevada County. Focused on addressing chronic issues like low back pain, headaches, and anxiety, Dr. Berkowitz delivers patient-centered care rooted in proven methods without unnecessary extras.

Life Chiropractic, founded by Dr. Bill Berkowitz, offers reliable and results-driven chiropractic care for residents of western Nevada County. With a focus on foundational health solutions, the practice prioritizes quality and effectiveness to help clients achieve relief from chronic issues without unnecessary add-ons.

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