Hip & pelvis
Sacroiliac joint pain
Pain near the back of the pelvis
What it means
The sacroiliac joints connect the sacrum to the two sides of the pelvis. Nearby pain can overlap with pain from the hip or low back. A cluster of provocation tests is better at lowering suspicion when negative than confirming the joint as the source when positive. [1, 2]
What I check in the clinic
I ask what happens when you roll in bed, stand on one leg to dress, or get out of a car. I compare which movements bring on the same symptom and retest the task that matters if changing support or movement helps.
What the evidence says about care
I use the retest to see whether a change is worth keeping. The evidence on diagnostic tests supports considering several possible contributors and avoiding strong conclusions from one exam response. [1, 3]
Common questions
Why does the spot by my pelvis hurt when I roll over but feel okay walking?
Show me where you feel it and describe the part of the roll that brings it on. I’d compare what happens with support and also check nearby areas that could fit what you’re feeling.
I got out of the car more easily today. How should I check it next time?
Notice when the usual pain appears during your normal car transfer. If it’s easier or you hesitate less, tell me exactly where you noticed the difference.
Why does standing on one leg to dress feel worse than standing at the counter?
I’d ask which side and where the discomfort starts. We can compare the dressing motion with support nearby and use that response alongside the rest of the exam.
Does feeling better after a change tell us it was the SI joint?
It tells us that change mattered for the task. I’d use that alongside the hip, back, and other exam findings before drawing a conclusion about the joint.
Can you tell whether my pelvis is out of place?
I use the exam to see what reproduces the pain and what changes it. A movement response alone cannot establish a positional diagnosis. [2]
What should I bring to an evaluation?
Bring one example of a movement or activity you want back, along with any relevant imaging or treatment notes you already have.