Read Time: 3 minutes
Low back pain gets blamed on the spine a lot.
But sometimes the real issue is the SI joint.
This is the joint where your spine connects to your pelvis. When it gets irritated, it can create pain that looks very similar to disc problems or facet irritation.
Knowing the difference helps you work on the right things.
Today we’re going to cover:
• What SI joint pain usually feels like
• How I differentiate it from other types of low back pain
• A few simple tests that can point toward the SI joint
• Exercises that may help calm it down
What SI Joint Pain Usually Feels Like
SI joint pain usually sits:
• Right over the back of the pelvis (near the dimples in your low back)
• Often spreads into the glute
• Occasionally creeps slightly into the low back
Many people can point to the exact spot with one finger.
If someone presses directly on the SI joint and it’s very tender, that’s often a clue the joint is involved.
How This Differs From Disc Pain
“I am really worried I have a disc herniation”
This is one of the most common things I hear when someone comes in the office with SI joint pain, so I figured I’d help clear it up for you.
Disc issues usually hurt when the spine bends forward.
Things like:
• Sitting and slouching
• Bending forward
• Picking objects up
SI joint pain behaves differently.
It often shows up when the hip and pelvis move in larger ranges.
Examples:
• Lunges
• Stepping forward or backward
• Rolling in bed
• Getting out of a car
The difference is that SI joint irritation is usually more sensitive during leg or hip movements, not just spine movements.
A Few Tests That Can Point Toward the SI Joint
These aren’t meant to diagnose anything on their own.
But if several of them reproduce your symptoms, the SI joint may be involved.
1. Fortin Finger Test
Press on the area just to the side of the spine near the top of the pelvis.
If that spot is very tender, the SI joint may be contributing.
2. FABER Test (Figure-4)
Lie on your back.
Place one ankle on the opposite knee and let the knee fall outward.
Pain in the back of the pelvis or glute during this position can sometimes point toward SI irritation.
3. Gaenslen’s Test
Lie near the edge of a bed.
Pull one knee toward your chest while letting the other leg hang off the side.
If this creates pain in the back of the pelvis, the SI joint may be stressed.
A Simple Routine That May Help
If the SI joint is irritated, many people improve when we work on glute strength and tissue irritation around the joint.
Here are 2 things that can sometimes help settle it down.
1. Glute Bridge Hold
Lie on your back with knees bent.
Lift your hips and hold.
• 3 sets of 30 seconds
If this is easy, progress to single-leg bridges.
If it’s too difficult, shorten the hold time.
These help the glutes support the pelvis so the SI joint isn’t doing all the work.
2. Hip Extension Isometric
Stand facing a wall or lie prone.
Lift one leg slightly behind you and hold.
• 3 sets of 10 seconds
Important:
Keep the spine completely still.
The movement should come from the hip only.
Occasionally this can create a small “pop” in the SI joint. When that happens, some people notice immediate relief.
When To Get Help
If pain:
• Continues to worsen
• Radiates down the leg
• Includes numbness or weakness
• Doesn’t improve after a few weeks
It’s worth getting evaluated.
Low back pain can come from several different structures, and the right plan depends on identifying the real cause.
Wrap up
If your pain matches what we talked about today, working on the glutes and reducing irritation around the SI joint can sometimes make a big difference.
Hopefully this gives you a better idea of what SI joint pain can look like and a few things that may help.
If you try these and run into issues, feel free to reply and let me know what you're experiencing. I’m always happy to help point you in the right direction.
See you next week,
Dr. Matt Moreno, D.C., C.C.S.P.®
The Move More Minute
When you’re ready, here’s how I can help:
Start here: Joint Basics – Low Back & Hips
A structured, stability-first starting point so you can stop guessing what matters first.
Learn More About Joint BasicsNot sure what fits? Reply to this email
Tell me what keeps flaring up and what you’re trying to get back to doing.
Disclaimer: The information provided in this newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, chiropractor, or other qualified healthcare provider with any questions you may have regarding a medical condition or before starting any new exercise program.
The exercises and suggestions provided are general recommendations and may not be suitable for everyone. If you experience pain, discomfort, or any concerning symptoms while performing these exercises (such as numbness, dizziness, or increased pain), stop immediately and consult a qualified healthcare professional.
Do not disregard professional medical advice or delay seeking it because of something you have read in this newsletter. The author, Move More Minute, and its affiliates assume no responsibility for injuries or issues that may arise from following the recommendations provided. By engaging with this content, you agree to do so at your own risk.
For personalized care or specific advice, please schedule an appointment with a qualified professional.
